Psychological Criteria for Treating Children with Idiopathic Short Stature

Abstract

The role of psychological criteria in guiding treatment decisions about growth hormone (GH) replacement in idiopathic short stature (ISS) is a current topic of debate. This summary discusses findings about the impact of short stature in terms of observer-rated and patient-reported psychological outcomes. Although a literature review did not provide conclusive evidence for differences in psychological status between short children and children of normal height in the general population, patients and parents, when probed, reported issues, especially in the social domain. Studies do not clearly suggest that the diagnosis of ISS or GH deficiency is related to impaired psychological functioning; they also do not imply that height is the only determinant of psychological status. Similarly, results on treatment-related changes in psychological status are equivocal. Assessment of psychological status should be included in future research and in the current clinical care of patients with ISS. Accumulating evidence suggests that assessment of psychological criteria may become a factor in guiding treatment decisions in patients with ISS.

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

“…It is well known that body shape improved after GH replacement therapy [2,3,4]. In concordance with our findings, previous studies showed a better QoL in GH-treated children compared to untreated children with short stature with a focus on behavioral functioning [11,14,27,28].…”

“…First, QoL models identify physical, emotional, mental, social, and behavioral aspects of well-being and functioning [1,2,3,4]. These models are not only dependent on clinical characteristics of the respective health condition and its treatment, but also on personal characteristics, such as health behavior, self-efficacy, or coping, and on societal aspects such as living conditions, or access to health care not analyzed in our study.…”

“…The subjective perspective of functioning and well-being is inherent in the concept of health-related QoL [1,2,3,4]. QoL is a multidimensional construct pertaining to essential components of well-being and functioning as perceived by the child or adolescent [1,2,3,4].…”

“…The subjective perspective of functioning and well-being is inherent in the concept of health-related QoL [1,2,3,4]. QoL is a multidimensional construct pertaining to essential components of well-being and functioning as perceived by the child or adolescent [1,2,3,4]. The multidimensional concept of health-related QoL expands the view on health beyond somatic indicators to include the patients’ subjective perspective on the physical, psychological, social, and functional aspects of health [5,6].…”

A pilot study of growth hormone administration in boys with predicted adult short stature and near-ending growth

“…The principle and modalities of rhGH administration to healthy children prone to become very short adults remain debated [6,7,26,33]. Despite an extensive Pubmed search including recent reviews [5,9,[13][14][15]], we have not been able to find studies dealing specifically with the start of rhGH administration at the very end of puberty in ISS.…”