AGE-RELATED PERCEPTION OF STATURE, ACCEPTANCE OF THERAPY, AND PSYCHOSOCIAL FUNCTIONING IN HUMAN GROWTH HORMONE-TREATED GIRLS WITH TURNERS-SYNDROME

This study evaluated the perception of stature, acceptance of therapy, and psychosocial functioning in relation to age at onset and time on treatment during 2 yr of GH therapy in 31 girls with Turner's syndrome grouped by age (group A: 3.7-5.8 yr, n = 9; group B: 7.2-11.8 yr, n = 13; group C: 12.5-16.4 yr, n = 9). The growth response after 2 yr was significant in the 3 groups when calculated in terms of growth norms for untreated Turner girls (mean increase in height so score: +1.2, +1 .5, and +1.1, respectively). The effect was less marked in terms of gr owth norms for normal girls, particularly in group B (+0.5 sn score). Height was perceived as a problem by most patients, except in the youn gest girls at the start of treatment (group A) and in the majority of the adolescents after 2 yr of GH therapy (group C), without evidence o f relation to growth response during therapy. The GH injections were f airly well accepted by all patients, except those younger than 6 yr. I n all patients, expected adult height was unrealistic and became more realistic with age, whereas no consistent changes were observed in rel ation to growth response to GH therapy. The Child Behavior Checklist r evealed elevated mean scores at the behavioral subscales of attention problems (group A and B), social problems, withdrawal, and anxiety-dep ression (most obviously in group B). No significant changes were seen during GH therapy. In group C, an elevated mean social problem score a t the Youth Self Report and a low mean social self-esteem score at the Self-Esteem Inventory were observed before therapy and showed a signi ficant improvement during 2 yr of GH treatment. These results, however , might be biased due to an increase in social desirability during the rapy. We conclude that the perception of height, acceptance of GH ther apy, and psychosocial functioning in girls with Turner's syndrome show important differences between age groups, with only slight changes ob served during GH therapy.