Early Puberty in Girls Linked with Depression / Antisocial Behavior in Adulthood


Several animal studies, and basically all
of human experience have taught us that puberty is a particularly difficult stage of life
psychologically. A new study appearing in the journal Pediatrics
now suggests that early puberty in girls can lead to depression and anti-social behavior
well into adulthood, suggesting that the difficulties of those teenage years are far from fleeting. Researchers led by Dr. Jane Mendle at Cornell
used data from the National Longitudinal Study of Adolescent Health, a nationally representative
survey study which ran from 1994 to 2008. More than 10,000 girls, average age 16 years,
were interviewed at the start of the study and followed into their late 20’s. Over that span, they were asked about depressive
and antisocial symptoms. They also reported the date of their first
period, which is a proxy for pubertal development. The average girl reported the onset of menarche
at around 12 years, but there was a wide distribution, with about 10% of girls reporting a first
period at age ten or younger. The study showed that a younger age of menarche
was associated with greater depressive symptoms in the later teen years. Perhaps more interestingly, it showed that
younger age at menarche was associated with more depressive symptoms even as the women
approached 30 years of age. In an elegant analysis, the authors went on
to show that the driver of that elevated depression rate in later adulthood was the depression
in the teenage years. In other words, girls who develop early are
more likely to get depressed as teenagers, and that depression may set the tone for decades
to come. Now there are some factors here that were
unaccounted for, body weight being a major one. Overweight and obese girls go through puberty
earlier, and body weight is a risk factor for depression. I asked Dr. Mendle about this potential confounder. “We know that people treat girls who look
very physically mature different from girls who do not look physically mature and that
is not purely attributable to weight. We know that parents do it and we know that
teachers do it. There is also not any good evidence that weight
would be influencing the antisocial and externalizing behaviors that were seen”. Clinically, whether early puberty is a sign
of other stressors or a cause of distress in itself might not matter. If early puberty is associated with depression,
the implication is that pediatricians should start screening for depression earlier in
girls who develop earlier. The United States Preventative Services Task
Force currently recommends screening for depression starting at age 12. For some girls, an even earlier intervention
may have long-lasting effects.

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