Psychological criteria for treating children with idiopathic short stature.

The role of psychological criteria in guiding treatment decisions about growth hormone (GH) replacement in idiopathic short stature (ISS) is a current topic of debate. This summary discusses findings about the impact of short stature in terms of observer-rated and patient-reported psychological outcomes. Although a literature review did not provide conclusive evidence for differences in psychological status between short children and children of normal height in the general population, patients and parents, when probed, reported issues, especially in the social domain. Studies do not clearly suggest that the diagnosis of ISS or GH deficiency is related to impaired psychological functioning; they also do not imply that height is the only determinant of psychological status. Similarly, results on treatment-related changes in psychological status are equivocal. Assessment of psychological status should be included in future research and in the current clinical care of patients with ISS. Accumulating evidence suggests that assessment of psychological criteria may become a factor in guiding treatment decisions in patients with ISS.