A prospective investigation of quality of life and psychological well-being after the discontinuation of GH treatment in adolescent patients who had GH deficiency during childhood

Some patients given growth-promoting therapy for GH deficiency in childhood will remain GH deficient in their adult lives and hence could benefit from continued GH replacement therapy. This longitudinal study sought to assess whether quality of life declines after GH discontinuation in late adolesce nce, and whether differences can be discerned in quality of life in patient s whose GH deficiency persists into adulthood and those whose GH secretory capacity falls within normal ranges. Forty patients, aged 16-21 yr at basel ine, were assessed over a 2-yr period commencing with discontinuation of GH therapy. Twenty-one patients were assigned to a GH deficiency group, and 1 9 were assigned to a GH-sufficient group. Quality of life assessments were made using the Nottingham Health Profile, Psychological General Well-Being Index, and Mood Adjective Check List Measures. Visual analog assessment of personality and affect and cognitive function tests were performed. The Moo d Adjective Check List and visual analog assessments identified between-gro up and temporal changes in a limited number of the various personality doma ins assessed. The Psychological General Well-Being Index assessment indicat ed greater baseline impairment in the GH deficiency group than in the GH-su fficient group in overall score and in the domains of depression and genera l health. There was also a between-group difference in anxiety score at the 2-yr assessment, with the GH deficiency group having greater anxiety. Meas urement of cognitive factors failed to reveal differences between groups. These results indicate that the discontinuation of GH therapy in late adole scence does not risk an immediate decline in the perceived quality of life detectable with the Nottingham Health Profile and Psychological General Wel l-Being Index measures. However, differences detected with the Mood Adjecti ve Check List and visual analog assessments hint at clinically significant changes in the life experiences of adolescents discontinued from GH for whi ch traditional measures may lack sensitivity.