Association between puberty timing and mental sub-health and its gender differences in junior middle school students

  Objective  To describe the distribution of mental sub-health in junior middle school students, and to explore the association between puberty timing and mental sub-health and gender difference in the association.

  Methods  Totally 8 560 junior middle school students were recruited with stratified cluster sampling in 4 cities across China for a self-administered anonymous questionnaire survey conducted between October and December 2015. Puberty timing of the students were assessed with scores of Pubertal Development Scale (PDS) and mental sub-health status was assessed with the Multidimensional Sub-Health Questionnaire for Adolescents (MSQA).

  Results  Among the 8 013 students with valid response, the detection rate of mental sub-health was 15.81%, with a significantly higher rate among the girl students than among the boy students (17.54% vs. 14.09%, χ² = 17.86; P < 0.001); the detection rate of emotional symptoms was 17.08% and the rate of girl students was significantly higher than that of body students (22.14% vs. 17.08%, χ² = 32.54; P < 0.001); and the detection rate of behavioral problems and social adaptation symptoms were 23.11% and 12.25% and there were no significant gender difference in the rates (both P > 0.05). Multivariable logistic regression analysis revealed that the early puberty timing in both the boy and girl students was associated with high levels of mental sub-health and emotional symptoms, behavioral symptoms and social adaptation problems. There was no association between delayed puberty timing and mental sub-health in boy students but delayed puberty timing was associated with the alleviated mental sub-health in girl students (odds ratio OR = 0.73, P < 0.01). In boy students, perceived delayed puberty timing was associated with high levels of mental sub-health (OR = 1.58), emotional symptoms (OR = 1.68), behavioral symptoms (OR = 1.58), and social adaptation problems (OR = 1.50) (all P < 0.01); while in the girl students, perceived delayed puberty timing was associated with increased behavioral symptoms (OR = 1.31, P < 0.01).

  Conclusion  Puberty timing is significantly related to mental sub-health in junior middle school students and the association differs by gender. Attention should be paid to advanced or delayed puberty timing among junior middle school students for the promotion of mental health in the students.