PSYCHOSOCIAL OUTCOME OF CHILDREN EVALUATED FOR SHORT STATURE

Objective: To assess the psychosocial functioning of adults who were e valuated as children for short stature and were not treated with human growth hormone.Design: Inception cohort study. Setting: Hospital-base d pediatric endocrinology clinic. Participants: From 1975 to 1980, med ical record review indicated that 181 of the children referred to our clinic for concerns about short stature were nongrowth hormone deficie nt. In 1992 and 1993, we were able to recruit 35 of these patients for a follow-up study. Eligible subjects were at least 18 years of age at the time of follow-up. Main Outcome Measures: Standardized self-repor t questionnaires assessed various domains of psychosocial adjustment. Also, a brief test of intellectual functioning was administered and su bjects underwent a semistructured in-person interview to evaluate prag matic functioning and experiences associated with short stature. Resul ts: Few significant differences between the study sample and standardi zation samples were found on measures of psychosocial and intellectual functioning. Within group childhood height during the first evaluatio n appointment was not significantly associated with most adult measure s of psychosocial adjustment. Shorter adult stature was significantly associated with lower educational achievement, lower self-esteem, and greater emotional distress. Conclusions: The absence of significant ps ychosocial distress or impairment in these subjects brings into questi on one basis for hormonal treatment for nongrowth hormone deficient sh ort stature; that short stature in childhood is likely to lead to psyc hological dysfunction in adulthood. The results, however, also suggest that shorter stature in adulthood may constitute a psychosocial stres sor, increasing vulnerability across several domains.