Growth Hormone Treatment of Short Stature: Status of the Quality of Life Rationale

Abstract

The unlimited availability of biosynthetic human growth hormone (rhGH) has contributed to the disassociation of the treatment of short stature from its causes. The rationale for treatment has traditionally rested upon the assumption that short stature, in the extreme, may constitute a physical disability, and otherwise represents a significant psychosocial burden for the individual. This review summarizes what is known about the psychosocial aspects of short stature and the quality of life benefits of rhGH treatment. Stereotypes and assumptions about short stature are evaluated in light of empirical findings. Problems of psychosocial adjustment are relatively common in the general population. Because of the salience of short stature, and its potential to serve as a lightning rod to divert attention from other factors interfering with a healthy psychological adaptation, the clinician must be watchful of misattributions for ongoing problems, or unrealistic predictions of the benefits of taller stature. For these reasons, the clinician should consider incorporating a psychosocial component in the diagnostic evaluation to broaden potential treatment recommendations. Finally, studies of factors influencing family decisions regarding factors for and against rhGH therapy provide important clues to how clinicians might enhance the informed consent process.

Short Stature in a Population-Based Cohort: Social, Emotional, and Behavioral Functioning

“…However, parents may be misattributing these difficulties to short stature when actually they are related to other stressors. 3 Previous studies reported that short children have higher rates of behavioral difficulties and lower social competency, compared with children of normal stature. [4][5][6] However, interpretation of those studies was limited by several factors.…”

Idiopathic short stature: Clinical-diagnostic criteria

“…Áàaeàíîþ âòî-ðèííîþ ìåòîþ º äîñÿãíåííÿ íîðìàëüíîãî çðîñòó ùå ó äèòèíñòâ³. ˳êàð³ ìàþòü íàäàòè ÷åñíó òà ðåàë³ñòè÷íó îö³íêó ìîaeëèâîñòÿì ³ ïåðñïåêòèâàì ë³êóâàííÿ òà ìîaeëèâèì ïåðåøêîäàì [19][20][21].…”

GH-IGF-IGFBP Axis and Metabolic Profile in Short Children Born Small for Gestational Age

“…Short children have reported to experience juvenilization and more teasing. Reports on health-related quality of life, the subjective perception of health, have been inconclusive (Sandberg & Colsman, 2005). More recently, a large British population study found that adult short stature may be associated with a reduction in health-related quality of life on five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) (Christensen et al, 2007).…”