Short normal stature and psychosocial disadvantage: a critical review of the evidence.

摘要: Physicians and parents alike are under increasing pressure to identify treat short stature, but intervention implies the presence of some pathology, physical or psychological, that can be corrected. Where there is true GH deficiency, argument for replacement uncontroversial. It less compelling where 'insufficiency' diagnosed. In case short, otherwise normal, child indications therapy even clear. Short per se, clearly not a disease, in spite perception by practitioners rate growth such children abnormal. stature is, however, commonly perceived associated with social psychological disadvantage, yet many these misperceptions about challenged. A critical review literature pertaining psychosocial correlates uncovers much flawed evidence. Most importantly, belief, widely held paediatricians, likely significantly disadvantaged, has been founded largely on data from clinic-referred samples. studies, real (or perceived) behavioural academic problems overly represented. Publications arising inevitably lead an increase demand treatment both those who previously had no concern. contrast, well controlled, prospective population-based study suggest essential normality normal child. Parents should reassured findings. absence clear must therefore, most cases, deemed cosmetic, raising issues as ethics so-called "plastic endocrinology".