Effect Of Primary Caregiver Mental Health Status On Treatment Outcomes Of Central Precocious Girls

Objective: The aim of this study is to analyze the mental health status of primary caregivers of central precocious puberty(CPP)girls and to explore their effect on the treatment outcomes of CPP girls.Method: From August 2021 to December 2022,60 pairs of the primary caregivers and the girls who were diagnosed as CPP and received Gonadotropin-releasing hormone analogue(Gn RHa)treatment were recruited in the Department of North Jiangsu People’s Hospital.The data of primary caregivers of CPP girls were collected by scale survey and questionnaire collection.The primary caregiver was assessed twice by the Generalized anxiety disorders-7(GAD-7 scale)and Patient health questionnaire-9(PHQ-9 scale)at the begining of their children’s therapy and one year of treatment,and they were grouped according to the first scale score.Those with GAD-7 score < 5 were classified into non-anxiety group and those with GAD-7 score ≥5 were categorized into anxiety group.Those with PAH-9 score< 5 were classified into non-depression group and those with PAH-9 score ≥5 were divided into depression group.By comparing the difference of treatment effect between the group with or without anxiety and the group with or without depression,the influence of the main caregiver’s psychological status on the treatment effect of children was discussed.Results:(1)At the initial of treatment,the incidence of anxiety in the main caregivers of60 CPP girls was 53.3%(32/60),the incidence of depression was 46.7%(28/60),and43.3%(26/60)of the main caregivers of CPP girls had anxiety and depression at the same time.(2)There were no statistically significant differences in the parenting categories,age,marital status,family monthly income,occupational status and family residence of the main caregivers between the non-anxiety group and the anxiety group(P > 0.05),but there were statistically significant differences in education level(P<0.05).The main caregivers of the non-anxiety group had a higher ratio of bachelor’s degree or higher level of education,while the anxiety group had more low education level,mainly high school,technical secondary school or junior college.The general situations of non-depression group and the depression group were similar to these of the group with and without anxiety.(3)During the 1 year treatment of CPP girls,anxiety and depression were significantly relieved in the main caregivers,the incidence of anxiety decreased from53.3%(32/60)to 13.3%(7/60),and the incidence of depression declined from 46.7%(28/60)to 13.3%(9/60).The incidence of both anxiety and depression decreased from43.3%(26/60)to 8.3%(5/60).The average score of GAD-7 scale of primary caregivers decreased from 5.5 to 2.0,and the difference was statistically significant(P< 0.001).The average score of PHQ-9 decreased from 4.0 to 1.0(P < 0.001).(4)After 1 year of treatment,the GV,PAH and ΔPAH were significantly higher in the group of children whose primary caregivers were anxious before the treatment than those without anxiety,and the differences had statistically significance(P < 0.05).GAD-7 scale score was positively correlated with PAH and ΔPAH at one year of treatment(P < 0.05).There was weakly correlated with PAH(r=0.490)and ΔPAH(r=0.318)at one year of treatment.There was no correlation between the GAD-7score and GV(r=0.171,P > 0.05)and PAH before first treatment(r=0.213,P > 0.05).(5)After 1 year of treatment,the PAH and ΔPAH of the children in the group of children with primary caregiver depression before the treatment were significantly higher than those in the group without depression,and the difference was statistically significant(P < 0.05).PHQ-9 scale score was positively correlated with PAH andΔPAH at one year of treatment(P < 0.05).There was weakly correlated with PAH(r=0.439)and ΔPAH(r=0.292)at one year of treatment.There was no correlation between GV(r=0.089,P > 0.05)and PAH before the treatment(r=0.185,P > 0.05).Conclusion:(1)Half of the primary caregivers of CPP girls have anxiety and depression,and most of them are mild anxious and depressive.(2)Those with higher education level primary caregivers were less likely to have negative emotions,while those with lower education level were more likely to have negative emotions.(3)With the 1 year treatment of the children,the negative emotions of the main caregivers were improved,and the scores of GAD-7 and PHQ-9 scales were significantly lower than the beginning.(4)The treatment outcomes of children with mild anxiety and depression in their primary caregivers before treatment are better than those whose caregivers without negative emotions.