Improvements in Behaviour and Self-Esteem following Growth Hormone Treatment in Short Prepubertal Children

Abstract

Background/Aims: To evaluate effects of growth hormone (GH) treatment on behaviour and psychosocial characteristics in short-stature children. Methods: 99 referred prepubertal non-familiar short-stature children (32 GH deficiency; 67 idiopathic short stature) aged 3–11 years, randomized to fixed or individual GH doses and their parents completed questionnaires (Child Behaviour Checklist, Birleson Depression Self-Report Scale, Abbreviated Parent-Teacher Questionnaire, I Think I Am, Well-Being Visual-Analogue Scales for Short-Stature Children) at baseline (BL) and after 3, 12, and 24 months. Results: At BL, children showed higher levels of internalizing behaviour (p < 0.001), lower levels of externalizing behaviour (p < 0.006) and self-esteem (p < 0.001) compared to reference values. During GH treatment, behavioural measures (p < 0.001) and depression (p < 0.01) changed towards the mean of the population within the first 3 months and remained improved to 24 months. Self-esteem improved at all time points (p < 0.001), and in all subgroups, as did well-being dimensions stability and mood (p < 0.05). Multiple regression analysis showed that greater improvements were related to lower BL value, height gain, higher maximal GH value, being older, and being male. Conclusion: On GH treatment, prepubertal short children significantly improved on behavioural, depression, and psychosocial evaluations over a 2-year period of GH treatment. Most change occurred within the first 3 months, which highlights this short period as important not only for growth and metabolic changes but also for behaviour and psychosocial improvements following GH treatment.

Health-Related Quality of Life in Short Children Born Small for Gestational Age: Effects of Growth Hormone Treatment and Postponement of Puberty

“…This is in line with previous studies, showing on average lower intelligence and more behaviour, social functioning, school competence and attention problems in short SGA children [24,25,26,27,28]. During GH treatment, improvement of intelligence, behaviour and self-perception has been described in short SGA children [28], as well as improvement of behaviour and self-esteem in short children with GH deficiency and idiopathic short stature [29,30]. According to a recent systematic review, however, data on HRQoL before and during GH treatment in short children are lacking [11].…”

Quality of Life in Children and Adolescents with Growth Hormone Deficiency: Association with Growth Hormone Treatment

“…An increase of self-esteem has also been reported in a previous study of GH treatment of GHD children [27]. This increase may be caused by the increased growth velocity under treatment, the happiness to have reached the 10th percentile starting from below the 3rd percentile, or the effect of receiving services and being understood and supported.…”

When Do Short Children Realize They Are Short? Prepubertal Short Children’s Perception of Height during 24 Months of Catch-Up Growth Hormone Treatment

“…Our recent research has emphasized the importance of trying to individualize the GH dosing according to responsiveness [11] in order to achieve optimal and safe attainment of the target height [12,13]. The study design and results of the clinical trial have been reported elsewhere [13,14,15]. Subjects and their parents in four of the centers completed psychosocial evaluations at study start, and after 3, 12 and 24 months of GH treatment.…”

“…The study population included girls 3–10 years of age and boys 3–11 years at study start with height SDS no greater than –2 SDS compared to the population norms and 1 SDS or more below MPH (MPH SDS ). Further details of the study sample can be found in our previous publications [13,15]. …”