{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:10:37Z","timestamp":1778764237501,"version":"3.51.4"},"reference-count":23,"publisher":"Walter de Gruyter GmbH","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2016-0425_s_999_w2aab2b8c29b1b7b1aab1c16b1Aa\">\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>The objective of the study was to determine the stress levels of girls with central precocious puberty (CPP) before and during treatment with a long-acting gonadotropin-releasing hormone agonist (GnRHa).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2016-0425_s_998_w2aab2b8c29b1b7b1aab1c16b2Aa\">\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>The Child Stress Scale (CSS) was used for 10 unrelated girls with CPP before and after the first year of GnRHa treatment. The CSS is divided into four subscales (physical, psychological, psychological with depressive component and psychophysiological reactions). Through a quantitative analysis, it is possible to classify stress into four stages: alarm, resistance, near-exhaustion and exhaustion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2016-0425_s_997_w2aab2b8c29b1b7b1aab1c16b3Aa\">\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>At diagnosis, 90% of the girls showed stress levels scores at the alarm or resistance stage on at least one subscale, mostly in terms of physical and psychological reactions. The mean total stress score was significantly higher before when compared to after GnRHa treatment (43.4\u00b115.6 vs. 28.9\u00b19.7; p&lt;0.05). The mean stress scores obtained in all subscales, except the one on psychophysiological reactions, were significantly higher before GnRHa treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2016-0425_s_996_w2aab2b8c29b1b7b1aab1c16b4Aa\">\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Higher stress levels were a common finding in girls with CPP before treatment. The significant stress level reduction after pubertal suppression reinforces the idea that sexual precocity is a stressful condition in children. The CSS might be a useful tool for psychological assessment of patients with CPP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2016-0425","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T13:19:57Z","timestamp":1496409597000},"page":"657-662","source":"Crossref","is-referenced-by-count":19,"title":["Assessment of stress levels in girls with central precocious puberty before and during long-acting gonadotropin-releasing hormone agonist treatment: a pilot study"],"prefix":"10.1515","volume":"30","author":[{"given":"Tais A.S.","family":"Menk","sequence":"first","affiliation":[{"name":"Division of Psychology of Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"In\u00e1cio","sequence":"additional","affiliation":[{"name":"Division of Psychology of Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delanie B.","family":"Macedo","sequence":"additional","affiliation":[{"name":"Unidade de Endocrinologia do Desenvolvimento \u2013 Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da Universidade de S\u00e3o Paulo e Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42 , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle S.","family":"Bessa","sequence":"additional","affiliation":[{"name":"Unidade de Endocrinologia do Desenvolvimento \u2013 Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da Universidade de S\u00e3o Paulo e Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42 , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana C.","family":"Latronico","sequence":"additional","affiliation":[{"name":"Unidade de Endocrinologia do Desenvolvimento \u2013 Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da Universidade de S\u00e3o Paulo e Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42 , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berenice B.","family":"Mendonca","sequence":"additional","affiliation":[{"name":"Unidade de Endocrinologia do Desenvolvimento \u2013 Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da Universidade de S\u00e3o Paulo e Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42 , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinicius Nahime","family":"Brito","sequence":"additional","affiliation":[{"name":"Unidade de Endocrinologia do Desenvolvimento \u2013 Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da Universidade de S\u00e3o Paulo e Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42 , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,5,23]]},"reference":[{"key":"2022053105153416062_j_jpem-2016-0425_ref_001_w2aab2b8c29b1b7b1ab2b1b1Aa","doi-asserted-by":"crossref","unstructured":"Latronico AC, Brito VN, Carel JC. 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