Maternal psychological distress and child psychosocial functioning in girls with central precocious puberty: a prospective study before and after GnRH analogue treatment

OBJECTIVES: Central precocious puberty (CPP) may have psychosocial implications for girls and their mothers. We evaluated changes in maternal psychological distress during gonadotropin-releasing hormone analogue (GnRHa) therapy and associations with child emotional, behavioral, and peer-related functioning. METHODS: This prospective observational study included 40 girls with confirmed CPP and their mothers. Eligibility required documented progressive breast development before age 8, clinical progression, and biochemical central activation; isolated thelarche, isolated pubarche, and lipomastia were excluded. Child psychosocial measures and baseline maternal Depression Anxiety Stress Scale-21 (DASS-21) were completed at the same visit. Maternal DASS-21 was repeated at variable times during ongoing GnRHa therapy. RESULTS: Mean total maternal DASS-21 score decreased from 13.38 ± 10.58 to 7.13 ± 8.15 (p<0.001). Maternal total DASS-21 showed moderate positive associations with total internalizing symptoms (ρ=0.501, p<0.001) and several RCADS-P domains; the total internalizing association remained after adjustment for BMI SDS (partial ρ=0.510, p<0.001). Among behavioral and social outcomes, maternal total DASS-21 was associated with hyperactivity, while exploratory maternal anxiety analyses showed associations with the ADHD Index and hyperactivity. DASS-21 change was not associated with age at diagnosis or reassessment interval. CONCLUSIONS: Maternal psychological distress decreased over time during GnRHa therapy and showed moderate associations with mother-reported emotional symptoms in girls with confirmed CPP. These findings support individualized, family-centered psychosocial assessment as part of CPP care.