Transdiagnostic psychiatric disorder risk associated with early age of menarche: A latent modeling approach

Abstract

Background Earlier age of pubertal maturation in females is associated with increased risk for mental health problems in adolescence, compared with on-time or later maturation. However, most investigations of pubertal timing and mental health consider risk for individual disorders and fail to account for comorbidity. A latent-modeling approach using a large, nationally representative sample could better explain the transdiagnostic nature of the consequences of early-onset puberty. Methods Data on age of menarche and mental disorders were drawn from a population-representative sample of adolescents (n=4925), ages 13–17. Confirmatory factor analysis was used to fit four latent disorder categories: distress, eating, and externalizing, and fear disorders. Timing of menarche included those with earlier (age <=10, age 11) and later age of onset (age 13, 14+), relative to those with average timing of menarche (age 12). Associations between timing of menarche and latent disorders were estimated in a structural equation model (SEM), adjusted for age, income, race, parent marital status, BMI, and childhood adversity. Results The measurement model evidenced acceptable fit (CFI= 0.91; RMSEA= 0.02). Onset of menarche before age 11 was significantly associated with distress disorders (coefficient=0.096; p<.0001), fear disorders (coefficient=0.09; p<.0001), and externalizing disorders (coefficient=0.039; p=0.049) as compared to on-time or late menarche. No residual associations of early menarche with individual disorders over and above the latent disorders were observed. Conclusion The latent modeling approach illuminated meaningful transdiagnostic psychiatric associations with early timing of menarche. Biological processes initiated at puberty can influence cognitive and affective processes as well as social relationships for adolescents. Under developmentally normative conditions, these changes may be adaptive. However, for those out of sync with their peers, researchers and clinicians should recognize the potential for these processes to influence liability to a broad array of psychopathological consequences in adolescence.

Transdiagnostic psychiatry: a systematic review

“…The vast majority of non‐interventional studies (79%) were cross‐sectional, and only 21% longitudinal. There was a large variability in study sample size, ranging from 15 participants in the smallest study to 91,199 in the largest (median: 148 participants).…”

“…Some studies used comorbid (as opposed to primary) diagnoses to validate the transdiagnostic construct. In about one third of studies (28%), the boundaries between primary and secondary diagnoses were not completely clear.…”

The genetic relationship between female reproductive traits and six psychiatric disorders

“…For instance, early or late maternal AFB is associated with offspring's risk to schizophrenia (SCZ) 4 , bipolar disorder (BIP) 8 , attentiondeficit/hyperactivity disorder (ADHD) 7 , autism spectrum disorder (ASD) 9 and depression 10 in offspring. Age at menopause and menarche also tend to be correlated with the risk of adverse mental health outcomes in offspring [11][12][13][14] .…”

“…It would be interesting, for example, to estimate the extent of shared genetic architecture between reproductive traits and a wider range of psychiatric disorders. This would elucidate the latent relationship underlying the epidemiological observations of a phenotypic association between psychiatric disorders and reproductive traits 13,14 , which in turn contributes to improving reproductive health in women.…”

Abnormal features of human self-domestication in bipolar disorder

“…Considering another aspect of neoteny, evidence is mixed as to whether age at menarche is delayed (Bisaga et al, 2002) or not significantly different (Dunjic-Kostic et al, 2016) in women with BD compared to healthy controls (Williams et al, 2007; Tondo et al, 2017). (Further complicating the picture, girls with early menarche experience higher rates of BD and other psychiatric conditions (Platt et al, 2017). ) Age of menarche in women with BD appears to indicate the course of the disorder, with being strongly correlated with irritable temperament scores and inversely correlated with depressive and cyclothymic scores as well as duration of depressive episodes (Kesebir et al, 2013).…”