TY - JOUR
T1 - Growth hormone therapy and short stature-related distress
T2 - A randomized placebo-controlled trial
AU - Shemesh-Iron, Moran
AU - Lazar, Liora
AU - Lebenthal, Yael
AU - Nagelberg, Nessia
AU - Tenenbaum, Ariel
AU - Ezra, Revital
AU - Leffler, Nir
AU - Yackobovitch-Gavan, Michal
AU - Schoenberg-Taz, Michal
AU - Phillip, Moshe
N1 - Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Context: Growth hormone (GH) treatment of short healthy children is based on the belief that short stature is associated with psychosocial problems and a diminished quality of life. Objective: To determine the impact of GH therapy on psychosocial well-being and the ability of psychological metrics to define short stature-related distress. Methods: Sixty prepubertal boys with idiopathic short stature (age: 10.0 ± 1.4 years, height-SDS: −2.38 ± 0.3) were enrolled in this 4-year intervention study (1-year double-blinded, randomized, placebo-controlled [GH/placebo-2:1] and 3-year open-labelled GH therapy). Explicit (conscious/voluntary) psychological metrics (Pediatric Quality of Life Inventory [PedsQL], Silhouette Apperception Test [SAT], Rosenberg Self-Esteem Scale [RSES], Child Behavior Checklist [CBCL]) and implicit (unconscious/involuntary) psychological metrics (Single-Category Implicit Association Test for height [SC-IAT-H], Height Perception Picture Test [HPPT]). Psychosocial evaluations were performed at study entry, after 1 and 4 years. Results: At study entry, PedsQL of boys with idiopathic short stature was lower than Israeli norms (P = 0.001). After 1-year blinded intervention, only the GH-treated boys improved their actual and anticipated adult height perception (SAT, P < 0.001 and P = 0.022) with reduced short stature-related distress (SC-IAT-H, P < 0.001). At study end, RSES and SC-IAT-H improved significantly (P < 0.001), with no change in PedsQL and CBCL. Conclusions: Our finding of improved psychosocial functioning only in the GH-treated boys after 1-year blinded intervention suggests that it was the GH therapy, rather than being enrolled in a clinical trial, which contributed to the outcome. Long-term open-labelled GH treatment significantly improved height perception and self-esteem. Future studies are needed to fully assess the relevance of complementing the routinely used explicit self-report measures with the implicit measures.
AB - Context: Growth hormone (GH) treatment of short healthy children is based on the belief that short stature is associated with psychosocial problems and a diminished quality of life. Objective: To determine the impact of GH therapy on psychosocial well-being and the ability of psychological metrics to define short stature-related distress. Methods: Sixty prepubertal boys with idiopathic short stature (age: 10.0 ± 1.4 years, height-SDS: −2.38 ± 0.3) were enrolled in this 4-year intervention study (1-year double-blinded, randomized, placebo-controlled [GH/placebo-2:1] and 3-year open-labelled GH therapy). Explicit (conscious/voluntary) psychological metrics (Pediatric Quality of Life Inventory [PedsQL], Silhouette Apperception Test [SAT], Rosenberg Self-Esteem Scale [RSES], Child Behavior Checklist [CBCL]) and implicit (unconscious/involuntary) psychological metrics (Single-Category Implicit Association Test for height [SC-IAT-H], Height Perception Picture Test [HPPT]). Psychosocial evaluations were performed at study entry, after 1 and 4 years. Results: At study entry, PedsQL of boys with idiopathic short stature was lower than Israeli norms (P = 0.001). After 1-year blinded intervention, only the GH-treated boys improved their actual and anticipated adult height perception (SAT, P < 0.001 and P = 0.022) with reduced short stature-related distress (SC-IAT-H, P < 0.001). At study end, RSES and SC-IAT-H improved significantly (P < 0.001), with no change in PedsQL and CBCL. Conclusions: Our finding of improved psychosocial functioning only in the GH-treated boys after 1-year blinded intervention suggests that it was the GH therapy, rather than being enrolled in a clinical trial, which contributed to the outcome. Long-term open-labelled GH treatment significantly improved height perception and self-esteem. Future studies are needed to fully assess the relevance of complementing the routinely used explicit self-report measures with the implicit measures.
KW - explicit psychological metrics
KW - growth hormone therapy
KW - idiopathic short stature
KW - implicit psychological metrics
KW - psychosocial assessment
KW - psychosocial functioning
KW - self-esteem
UR - http://www.scopus.com/inward/record.url?scp=85062694597&partnerID=8YFLogxK
U2 - 10.1111/cen.13944
DO - 10.1111/cen.13944
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C2 - 30721549
AN - SCOPUS:85062694597
SN - 0300-0664
VL - 90
SP - 690
EP - 701
JO - Clinical Endocrinology
JF - Clinical Endocrinology
IS - 5
ER -