切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2019, Vol. 15 ›› Issue (02) : 192 -197. doi: 10.3877/cma.j.issn.1673-5250.2019.02.011

所属专题: 专题评论 文献

论著

性早熟女性患儿及其母亲的心理功能评估
王淼1, 宋小宇1, 高宇1, 李学超1,()   
  1. 1. 秦皇岛市妇幼保健院儿科,河北 066000
  • 收稿日期:2018-12-17 修回日期:2019-03-18 出版日期:2019-04-01
  • 通信作者: 李学超

Evaluation of psychological function of children with precocious puberty and their mothers

Miao Wang1, Xiaoyu Song1, Yu Gao1, Xuechao Li1,()   

  1. 1. Department of Pediatrics, Maternal & Child Care Center of Qinghuangdao, Qinhuangdao 066000, Shandong Province, China
  • Received:2018-12-17 Revised:2019-03-18 Published:2019-04-01
  • Corresponding author: Xuechao Li
  • About author:
    Corresponding author: Li Xuechao, Email:
  • Supported by:
    Science and Technology Research and Development Plan Project of Qinhuangdao City(201602A210)
引用本文:

王淼, 宋小宇, 高宇, 李学超. 性早熟女性患儿及其母亲的心理功能评估[J]. 中华妇幼临床医学杂志(电子版), 2019, 15(02): 192-197.

Miao Wang, Xiaoyu Song, Yu Gao, Xuechao Li. Evaluation of psychological function of children with precocious puberty and their mothers[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(02): 192-197.

目的

探讨采取不同量表评估法,对性早熟患儿及其母亲的心理功能评估的价值。

方法

选择2016年3月至2018年1月,在秦皇岛市妇幼保健院儿科就诊的70例女性受试儿为研究对象,按照其是否合并性早熟及其性早熟类型,将其分为中枢性性早熟(CPP)组(n=24)、肾上腺功能早现(PA)组(n=22)和青春期早期发育正常(ENP)组(n=24)3组。所有受试儿及其母亲在初诊后2周内,采用不同量表进行心理功能评估。对于年龄≥6.0岁的受试儿,采用自我报告的方式进行心理功能评估,使用的量表包括《儿童抑郁量表》(CDI)和《哈特儿童感知能力量表》(Harter量表);对于年龄为1.5~5.0岁的受试儿,采用家长报告的方式进行心理功能评估,采用的量表为《儿童行为量表》(CBCL)。对纳入研究受试儿母亲的心理功能评估,采用"李克特量表"5点测量法(Likert量表),《抑郁、焦虑和压力量表》(DASS)和《积极和消极情绪时间表》(PANAS)进行心理功能评估。本研究遵循的程序通过秦皇岛市妇幼保健院医学伦理委员会的审查与批准(批准文号:医科伦审2016第61号),所有受试儿监护人均签署临床研究知情同意书。

结果

①3组受试儿母亲分娩时年龄及受试儿晚出方式构成比比较,差异均无统计学意义(P>0.05)。但是,3组受试儿年龄比较,差异有统计学意义(P<0.05)。②3组受试儿CDI总分、Harter量表的4个子项目和CBCL的2个子项目得分分别比较,差异均无统计学意义(P>0.05)。③对CPP组、PA组和ENP组3组受试儿母亲的心理功能评估结果显示,受试儿母亲的DASS中,抑郁子项目得分分别为(3.9±0.5)分、(4.7±0.8)分和(1.2±0.3)分,紧张子项目得分分别为(8.7±2.6)分、(10.9±3.0)分和(4.9±0.5)分,3组受试儿母亲上述得分分别比较,差异均有统计学意义(F=6.184、P=0.035,F=7.228、P=0.014)。对这2个项目的得分进一步进行两两比较结果显示,PA组受试儿母亲的得分,均高于ENP组,并且差异均有统计学意义(t=6.322、P=0.021,t=7.356、P=0.013)。此外,3组受试儿母亲的DASS压力子项目得分、Likert量表5个项目得分和PANAS 2个子项目得分分别总体比较,差异均无统计学意义(P>0.05)。

结论

PA女性患儿母亲抑郁和紧张程度较高。在诊断时,心理压力不是对女性性早熟患儿进行治疗的明确指征。

Objective

To explore the psychological function of children with precocious puberty and their mothers.

Methods

From March 2016 to January 2018, 70 grils who visited the Department of Pediatrics of Maternal & Child Care Center of Qinghuangdao were selected into this study. They were divided into 3 groups according to whether they were complicated with precocious puberty, central precocious puberty (CPP) group (n=24), premature adrenarche (PA) group (n=22) and early normal puberty (ENP) group (n=24). All the 70 girls and their mothers were assessed with scales within 2 weeks after their first visits. Children older than 6.0 years were assessed by self-report of Childrens Depression Inventory (CDI) and Harter Pictorial Scale of Perceived Competence (Harter scale), and children aged 1.5-5.0 years old were assessed by parent report of Child Behavior Checklist (CBCL). Mothers′ psychological functions were assessed by using 5-Point Likert Scale, Depression, Anxiety and Stress Scale (DASS), and Positive and Negative Affect Schedule (PANAS). The procedure of this study was consistent with ethical standard established by the committee of investigation in human beings of Maternal & Child Care Center of Qinghuangdao [Approval No. 2016(61)]. All the guardians of the girls signed clinical research informed consents.

Results

①There were no significant differences among 3 groups in age at delivery of mothers and modes of delivery (P>0.05). However, there was a statistically significant difference among 3 groups in the aspect of age (P<0.05). ②There were no significant differences among 3 groups in the aspects of total scores of CDI, 4 sub-items of Harter scale and 2 sub-items of CBCL (P>0.05). ③The psychological function evaluation results of mothers of 3 groups were as follows. The depression sub-item scores in DASS of CPP group, PA group and ENP group were (3.9±0.5) scores, (4.7±0.8) scores and (1.2±0.3) scores, respectively, and the tension sub-item scores were (8.7±2.6) scores, (10.9±3.0) scores and (4.9±0.5) scores, respectively. The differences among 3 groups were statistically significant (F=6.184, P=0.035; F=7.228, P=0.014). Further comparison showed that the scores of PA group were higher than those of ENP group, and the differences were statistically significant (t=6.322, P=0.021; t=7.356, P=0.013). While there were no significant differences among 3 groups in the aspects of the scores of stress sub-items in DASS, scores of 5 items of Likert scale and 2 items of PANAS of mothers (P>0.05).

Conclusions

The mother of female PA children has higher depression and tension. Psychological pressure is not an indication for the treatment of precocious puberty.

表1 3组受试儿母亲分娩时年龄及其娩出方式构成比比较
表2 3组受试儿心理功能评估得分比较(分,±s)
表3 3组受试儿母亲心理功能评估得分比较(分,±s)
[1]
Tirumuru SS, Arya P, Latthe P, et al. Understanding precocious puberty in girls [J]. Obstet Gynaecol, 2012, 14(2): 121-129.
[2]
刘兆祥,伍学焱. 特发性中枢性性早熟基因研究进展[J]. 中华医学杂志,2015, 95(2): 156-158.
[3]
Bridges NA, Christopher JA, Hindmarsh PC, et al. Sexual precocity: sex incidence and aetiology [J]. Arch Dis Child, 1994, 70(2): 116-118.
[4]
Chaplin TM, Niehaus C, Gonçalves SF. Stress reactivity and the developmental psychopathology of adolescent substance use [J]. Neurobiol Stress, 2018, 9(1): 133-139.
[5]
Platt JM, Colich NL, McLaughlin KA, et al. Transdiagnostic psychiatric disorder risk associated with early age of menarche: a latent modeling approach [J]. Compr Psychiatry, 2017, 79: 70-79.
[6]
Trepanier L, Juster RP, Marin MF, et al. Early menarche predicts increased depressive symptoms and cortisol levels in Quebec girls ages 11 to 13 [J]. Dev Psychopathol, 2013, 25(4 Pt 1): 1017-1027.
[7]
Ehrhardt AA, Meyer-Bahlburg HF. Psychosocial aspects of precocious puberty [J]. Horm Res, 1994, 41(Suppl 2): 30-35.
[8]
Galvao TF, Silva MT, Zimmermann IR, et al. Pubertal timing in girls and depression: a systematic review [J]. J Affect Disord, 2014, 155: 13-19.
[9]
Mrug S, Elliott MN, Davies S, et al. Early puberty, negative peer influence, and problem behaviors in adolescent girls [J]. Pediatrics, 2014, 133(1): 7-14.
[10]
Swaiss HH, Khawaja NM, Farahid OH, et al.Effect of gonadotropin-releasing hormone analogue on final adult height among Jordanian children with precocious puberty [J]. Saudi Med J, 2017, 38(11): 1101-1107.
[11]
Sayarifard F, Imcheh FB, Badri S, et al. Growth hormone utilization review in a pediatric primary care setting [J]. J Res Pharm Pract, 2017, 6(1): 40-43.
[12]
Eriksson C, Kimber B, Skoog T. Design and implementation of RESCUR in Sweden for promoting resilience in children: a study protocol [J]. BMC Public Health, 2018, 18(1): 1250.
[13]
中华医学会儿科学分会内分泌遗传代谢学组.中枢性(真性)性早熟诊治指南[J].中华儿科杂志,2007, 45(6): 426-427.
[14]
郑荣秀,刘戈力.女童性早熟的临床诊断程序[J].实用儿科临床杂志,2011,26(8): 557-560.
[15]
洪忻,李解权,梁亚琼,等.儿童抑郁量表中文版在中学生中的信效度分析[J]. 中国学校卫生,2012,33(10): 1182-1185.
[16]
丁雪辰,刘俊升,李丹,等. Harter儿童自我知觉量表的信效度检验[J].中国临床心理学杂志,2014,22(2): 251-255.
[17]
Xhrouet-Heinrichs D, Lagrou K, Heinrichs C, et al. Longitudinal study of behavioral and affective patterns in girls with central precocious puberty during long-acting triptorelin therapy [J]. Acta Paediatr, 1997, 86(8): 808-815.
[18]
吴永泽,王文绢.不同应答等级对likert式量表特性的影响[J].中国慢性病预防与控制,2010,18(2): 215-217.
[19]
谢家树,刘姗,Yang CY,et al. 社会与情绪健康量表(中学版)中文版修订[J].中国临床心理学杂志,2017,25(6): 1012-1016.
[20]
Kim EY, Lee MI. Psychosocial aspects in girls with idiopathic precocious puberty [J]. Pshchiatr Investig, 2012, 9(1): 25-28.
[21]
潘婷婷,丁雪辰,桑标,等. 正负性情感量表儿童版(PANAS-C)的信效度初探[J].中国临床心理学杂志,2015,23(3): 397-400.
[22]
Kaplowitz PB, Backeljauw PF, Allen DB. Toward more targeted and cost-effective gonadotropin-releasing hormone analog treatment in girls with central precocious puberty [J]. Horm Res Paediatr, 2018, 90(1): 1-7.
[23]
Schoelwer MJ, Donahue KL, Didrick P, et al. One-year follow-up of girls with precocious puberty and their mothers: do psychological assessments change over time or with treatment? [J]. Horm Res Paediatr, 2017, 88(5): 347-353.
[24]
Sontag-Padilla LM, Dorn LD, Tissot A, et al. Executive functioning, cortisol reactivity, and symptoms of psychopathology in girls with premature adrenarche[J]. Dev Psychopathol, 2012, 24(1): 211-223.
[1] 马敏榕, 李聪, 周勤. 宫颈癌治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 497-504.
[2] 林昌盛, 战军, 肖雪. 上皮性卵巢癌患者诊疗中基因检测及分子靶向药物治疗[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 505-510.
[3] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[4] 周东杰, 蒋敏, 范海瑞, 高玲玲, 孔祥, 卢丹, 王丽萍. 非编码RNA在卵泡发育成熟中作用及其机制的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 387-393.
[5] 陈荟竹, 郭应坤, 汪昕蓉, 宁刚, 陈锡建. 上皮性卵巢癌"二元论模型"的分子生物学研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 394-402.
[6] 韩春颖, 王婷婷, 李艳艳, 朴金霞. 子宫内膜癌患者淋巴管间隙浸润预测因素研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 403-409.
[7] 刘艳艳, 谭曦, 彭雪. 妊娠合并膀胱低度恶性潜能乳头状尿路上皮肿瘤并文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 212-218.
[8] 魏权, 张燊, 陈慧佳, 邹姮, 胡丽娜. 女性生殖道微生物群与辅助生殖技术相关性研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 151-155.
[9] 胡欧婵, 黄仲英. 不明原因复发性流产患者的治疗研究现状与展望[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 16-22.
[10] 尤琳, 蔡振伟, 乔荆. Turner综合征临床研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 634-639.
[11] 张晓芳, 王平. 阴道黑色素瘤诊疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 621-626.
[12] 高坎坎, 钟华敏, 谢永强, 邓秋连, 高飞, 王洁琳, 龙燕. 女性泌尿生殖道支原体感染及其耐药率分析[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 569-576.
[13] 赵春桃, 梁峰雪, 杨瑞敏, 陈云璇, 陈曦, 焦桂清. 三维盆底超声预测产妇发生盆腔脏器脱垂的价值及影响因素[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 606-614.
[14] 陈雨婷, 杨烨, 谢奇君, 凌秀凤. 女性不孕不育相关疾病患者的生殖道微生物组成异常研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 615-620.
[15] 孙环蕊, 张若鹏. 复发性流产与肠道微生物群失衡[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 506-511.
阅读次数
全文


摘要