Biopsychological and cognitive differences in children with premature vs on-time adrenarche

Background: Puberty consists of 2 components: gonadarche and adrenarche. Bo th components have distinct endocrine changes. Adrenarche has virtually bee n ignored with respect to examining hormone-behavior relations. Objectives: To provide descriptive biological and behavioral information on children with premature adrenarche (PA) and to examine differences in biol ogical, psychological, and cognitive variables of children with PA and a he althy comparison group of children with on-time adrenarche. Design: Descriptive pilot study. Setting: A consecutive sample of patients was recruited from pediatric endo crine clinics; comparison children were recruited from the community. Participants: Children aged 6 to 9 years. Mean (+/-SD) age of children with PA (n = 9) was 7.8 (+/-1.3) years; of children with on-time adrenarche (n = 20), 8.0 (+/-1.2) years. Methods and Measures: Serum and saliva samples were collected for measureme nt of hormone concentrations. Questionnaires, tests, and interviews were co mpleted by children and parents. Results: Compared with the on-time group, the PA group had significantly hi gher concentrations of adrenal androgens, estradiol, thyrotropin, and corti sol. By parent report on the Diagnostic Interview Schedule for Children, 4 children (44%) met diagnostic criteria for psychological disorders (primari ly anxiety disorders). The PA group also had more self-reported depression and parent-reported behavior problems and lower scores on various intellige nce tests. Conclusions: Although PA is considered a normal variation of pubertal devel opment that warrants no medical intervention, PA presents with significant psychosocial problems. Children with PX may need psychological evaluation a nd follow-up. Future studies should confirm these findings with a larger sa mple and examine the long-term ramifications of this early presenting abnor mality.