Zimet G D, Owens R, Dahms W, Cutler M, Litvene M, Cuttler L
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.
Arch Pediatr Adolesc Med. 1997 Oct;151(10):1017-23. doi: 10.1001/archpedi.1997.02170470051010.
To assess the psychosocial functioning of adults who were evaluated as children for short stature and were not treated with human growth hormone.
Inception cohort study.
Hospital-based pediatric endocrinology clinic.
From 1975 to 1980, medical record review indicated that 181 of the children referred to our clinic for concerns about short stature were non-growth hormone deficient. 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.
Standardized self-report questionnaires assessed various domains of psychosocial adjustment. Also, a brief test of intellectual functioning was administered and subjects underwent a semistructured in-person interview to evaluate pragmatic functioning and experiences associated with short stature.
Few significant differences between the study sample and standardization samples were found on measures of psychosocial and intellectual functioning. Within-group childhood height during the first evaluation appointment was not significantly associated with most adult measures of psychosocial adjustment. Shorter adult stature was significantly associated with lower educational achievement, lower self-esteem, and greater emotional distress.
The absence of significant psychosocial distress or impairment in these subjects brings into question one basis for hormonal treatment for non-growth hormone deficient short stature; that short stature in childhood is likely to lead to psychological dysfunction in adulthood. The results, however, also suggest that shorter stature in adulthood may constitute a psychosocial stressor, increasing vulnerability across several domains.
评估儿童期因身材矮小接受评估但未接受人生长激素治疗的成年人的心理社会功能。
队列起始研究。
医院儿科内分泌门诊。
1975年至1980年，病历审查表明，因身材矮小问题转诊至我们门诊的181名儿童并非生长激素缺乏。1992年和1993年，我们成功招募了其中35名患者进行随访研究。符合条件的受试者在随访时至少18岁。
标准化的自我报告问卷评估心理社会适应的各个领域。此外，进行了一项简短的智力功能测试，并对受试者进行了半结构化的面对面访谈，以评估实际功能以及与身材矮小相关的经历。
在心理社会和智力功能测量方面，研究样本与标准化样本之间几乎没有显著差异。首次评估时儿童期身高在组内与大多数成人心理社会适应测量指标无显著关联。成年后身材较矮与教育成就较低、自尊较低和情绪困扰较大显著相关。
这些受试者不存在明显的心理社会困扰或损害，这对非生长激素缺乏性身材矮小的激素治疗依据之一提出了质疑；即儿童期身材矮小可能会导致成年期心理功能障碍。然而，研究结果也表明，成年后身材较矮可能构成一种心理社会应激源，增加在多个领域的易感性。
