Psychiatric Observations in Adolescent Girls Lacking Ovarian Function

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Abstract
In this preliminary study, 7 adolescent girls with a diagnosis of ovarian dysgenesis were observed from a psychiatric point of view. Our general findings are as follows. The major concerns of these patients involved feelings about their abnormal height and weight, as well as feelings about their sexual and reproductive functions, including menstruation. Of these concerns, those pertaining to their short stature seemed to play the most important role in determining the distorted concept of their body image and the confused sense of identity that some of these girls displayed. This was especially noticeable in the group of patients with a height of under 55 in. The patients adjusted to their abnormal endocrine development in the following ways. Those who were shortest tended to defend themselves against the painful awareness of their condition by a sweeping form of denial that affected their general attitude and behavior. This showed itself in the overcompliant, passive, and inhibited manner. Other mechanisms of defense included rationalization, regression, distortion, repression, and somatization. The personalities of the girls' mothers appeared to play an important role in influencing the means by which these girls adjusted to their medical abnormality. Psychiatric interviews were helpful in selecting the time for starting hormone treatment. They were also of use in helping some patients accept the endocrine therapy, and particularly the resulting menstruation, through discussion of their fears and misconceptions.