Background: The purpose of this study was to determine the physical and psychosocial impact of gynecomastia and its severity on adolescents seeking treatment as compared with healthy adolescent males.
Methods: The following surveys were administered to adolescents with gynecomastia and healthy male controls, aged 12 to 21 years: Short Form-36 Version 2, the Rosenberg Self-Esteem Scale, and the Eating Attitudes Test-26. Demographic variables were compared between the two groups, and controls were administered a short chest symptoms survey. Linear regression models, unadjusted and adjusted for body mass index category, were fit to determine the effect of case status and graded severity of gynecomastia on survey score.
Results: Forty-seven patients with gynecomastia and 92 male control subjects participated in this study. There was no difference in mean age between the groups, although patients with gynecomastia had a significantly higher body mass index. Gynecomastia subjects had three lower Short Form-36 domain and Rosenberg Self-Esteem Scale scores independent of body mass index category as compared with controls, although there was no difference in Eating Attitudes Test-26 scores between the groups. Graded gynecomastia severity had no effect on survey scores, all independent of body mass index category.
Conclusions: Gynecomastia has a significant negative impact on primarily the psychosocial well-being of affected adolescent patients, specifically in regard to social functioning, mental health, and self-esteem. Psychosocial impact was not affected by graded severity of disease. Health care providers and patients should be aware of the psychosocial impairments associated with gynecomastia and consider early treatment for adolescents suffering from this condition, regardless of severity.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
From the Adolescent Breast Clinic, the Department of Plastic and Oral Surgery, and the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital and Harvard Medical School.
Received for publication July 13, 2012; accepted September 12, 2012.
Disclosure: The authors have no financial relationships or interests or commercial associations relevant to this article to disclose.
This work was supported by THE PLASTIC SURGERY FOUNDATION.
Brian I. Labow, M.D.; Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, Mass. 02115, firstname.lastname@example.org