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Puberteit en puberteitsstoornissen: biologische regulatie, psychologische ontwikkeling en behandeling

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Tijdschrift voor kindergeneeskunde

Abstract

Puberty is a very important phase of development in adolescents. Physical as well as psychosocial changes prepare them for the adult role. With respect to the endocrine aspects, puberty appears to be a phase in a continuum of brain development starting during the fetal period. In the last decades, puberty seems to start earlier, although progression of puberty is slower. Pubertal disorders not only may have their consequences on psychosocial development, but also on final height. Central precocious puberty, mostly seen in girls, has a more progressive pattern than physiologic puberty; it may result in impaired final height and problems of the child with age-matched peers. Delayed puberty and hypogonadotropic hypogonadism may induce isolation and negative self-esteem of the teenager.

This paper focuses on the physiologic regulation of pubertal development, endocrine as well as psychosocial aspects. In addition, underlying mechanisms, consequences and possible interventions in case of pubertal disorders are discussed.

Samenvatting

De puberteit is een ingrijpende ontwikkelingsfase op de weg naar volwassenheid, zowel in lichamelijk opzicht als wat betreft de psychologische problematiek. Endocrinologisch gezien is de puberteit de laatste fase van een centrale ontwikkeling die startte in de foetale periode. In de afgelopen decennia is er een trend van steeds vroeger optreden van de eerste ontwikkeling van de geslachtskenmerken. De progressie van de puberteit is echter langzamer, zodat de menarcheleeftijd niet vroeger valt. Stoornissen wat betreft de timing van de puberteit kunnen leiden tot psychosociale problemen. Kinderen met pubertas praecox zijn aanvankelijk lang ten opzichte van leeftijdgenoten, maar uiteindelijk zijn ze vaak aan de kleine kant; daarnaast ontstaan door de puberteitskenmerken vaak relationele problemen. Verlate puberteit kan leiden tot stress in die zin, dat de adolescent (dit geldt vooral voor jongens) zich isoleert van leeftijdgenoten. Dit artikel gaat in op de fysiologie van de puberteit, zowel wat betreft hormonale regulatie als wat betreft psychosociale aspecten. Verder worden de oorzaken, gevolgen en mogelijke interventies bij puberteitsstoornissen besproken.

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    Henriette A. Delemarre-van de Waal

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  1. Henriette A. Delemarre-van de Waal
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  2. Jaap Huisman
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H.A. Delemarre-van de Waal, afdeling Kindergeneeskunde en J. Huisman, afdeling Medische psychologie, vu medisch centrum, Postbus 7057, 1007 MB Amsterdam.

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Delemarre-van de Waal, H.A., Huisman, J. Puberteit en puberteitsstoornissen: biologische regulatie, psychologische ontwikkeling en behandeling. KIND 69, 145–151 (2001). https://doi.org/10.1007/BF03061347

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