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Age-Related Perception of Stature, Acceptance of Therapy, and Psychosocial Functioning in Human Growth Hormone-Treated Girls with Turner’s Syndrome¹

Department of Pediatrics, University of Brussels (C.H., J.P.C.), Brussels; the Department of Pediatrics, University of Ghent (M.C.), Ghent; the Department of Pediatrics, University of Louvain (P.M.), Brussels; and the Department of Pediatrics, University of Liege (J.P.B.), Liege; and the Belgian Study Group for Pediatric Endocrinology (K.L., D.X.H.), Belgium

Address all correspondence and requests for reprints to: Prof. J. P. Bourguignon, Division of Pediatric and Adolescent Medicine, University of Liege, Centre Hospitalier Universitaire Sart Tilman, B-4000 Liege, Belgium.

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 SD score: +1.2, +1.5, and +1.1, respectively). The effect was less marked in terms of growth norms for normal girls, particularly in group B (+0.5 SD score). Height was perceived as a problem by most patients, except in the youngest 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 of relation to growth response during therapy. The GH injections were fairly well accepted by all patients, except those younger than 6 yr. In all patients, expected adult height was unrealistic and became more realistic with age, whereas no consistent changes were observed in relation to growth response to GH therapy. The Child Behavior Checklist revealed elevated mean scores at the behavioral subscales of attention problems (group A and B), social problems, withdrawal, and anxiety-depression (most obviously in group B). No significant changes were seen during GH therapy. In group C, an elevated mean social problem score at the Youth Self Report and a low mean social self-esteem score at the Self-Esteem Inventory were observed before therapy and showed a significant improvement during 2 yr of GH treatment. These results, however, might be biased due to an increase in social desirability during therapy. We conclude that the perception of height, acceptance of GH therapy, and psychosocial functioning in girls with Turner’s syndrome show important differences between age groups, with only slight changes observed during GH therapy.