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. 2016 Apr 20;11(4):e0153953.
doi: 10.1371/journal.pone.0153953. eCollection 2016.

Associations between Psychological Problems and Quality of Life in Pediatric Short Stature from Patients' and Parents' Perspectives

Julia Hannah Quitmann  1 , Monika Bullinger  1 , Rachel Sommer  1 , Anja Christine Rohenkohl  1 , Neuza Maria Bernardino Da Silva  1   2
Affiliations

Associations between Psychological Problems and Quality of Life in Pediatric Short Stature from Patients' and Parents' Perspectives

Julia Hannah Quitmann et al. PLoS One. .

Abstract

Short stature has been associated with psychosocial impairments, but whether treatments and achieved height impact on health-related quality of life (HrQoL) and psychological functioning of children/adolescents is still controversial. This study aimed to examine the effects of height deviation and treatment status on psychosocial adaptation outcomes and to identify clinical and psychosocial determinants of internalizing/externalizing problems in a large cohort of short statured children/adolescents from seven European countries. Participants were 345 children aged 8-18 years with a clinical diagnosis of short stature and 421 parents of 4-18 year-old patients. Children and parents reported on psychological problems (Strengths and Difficulties Questionnaire), generic (KIDSCREEN) and condition-specific HrQoL (QoLISSY). According to analyses of covariance, children/adolescents with current short stature presented more parent-reported internalizing problems and lower self- and parent-reported condition-specific HrQoL, compared to patients with an achieved height above -2SD. Treated children self-reported better HrQoL than the untreated group. Hierarchical regression analysis showed that, rather than height-related clinical variables, children's sex, younger age and poorer HrQoL were the best predictors of psychological problems, explaining 39% of the variance in patient- and 42% in parent-reported internalizing problems, and 22% of the variance in patient- and 24% in parent-reported externalizing problems. Treatment status also moderated the negative links between patient-reported HrQoL and internalizing problems, explaining 2% of additional variance. These results suggest that children with current short stature are at greater risk for internalizing problems. Routine assessment of HrQoL in pediatric healthcare may help identify children for referral to specialized psychological assessment and intervention.

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Conflict of interest statement

Competing Interests: The authors have the following interests. The project was funded by Pfizer Ltd. and the authors were provided funding for its conduct. No funding was received for the writing of this paper. It was the original QoLISSY project that was funded by Pfizer and conducted in collaboration with our center and four additional centers in Europe. Centers were compensated for their involvement but in no case for any publications derived from the research itself. This analysis was researcher initiated, planned and processes and although the authors, namely Monika Bullinger, Rachel Sommer, Anja Rohenkohl and Julia Quitmann, were provided funding for the conduct of the original study, we received no compensation for the writing of this manuscript. As with other publications using QoLISSY data, Pfizer, namely Dr. Andreas Pleil, provided a courtesy review and the inclusion of any comments, suggestions, or changes of any kind are at the complete discretion of the authors. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors

Figures

Fig 1
Fig 1
The moderating effect of treatment status on the association between (1A) patient-reported generic HrQoL and internalizing problems; and (1B) patient-reported condition-specific HrQoL and internalizing problems.
See this image and copyright information in PMC

References

    1. Barlow J.H. and Ellard D.R., The psychosocial well-being of children with chronic disease, their parents and siblings: an overview of the research evidence base. Child: Care, Health and Development, 2006. 32(1): p. 19–31. - PubMed
    1. Sandberg D.E. and Colsman M., Growth hormone treatment of short stature: status of the quality of life rationale. Hormone Research, 2005. 63(6): p. 275–83. - PubMed
    1. Sandberg D. and Gardner M., Short stature: Is it a psychosocial problem and does changing height matter? Pediatric Clinics of North America, 2015. 62: p. 963–982. 10.1016/j.pcl.2015.04.009 - DOI - PubMed
    1. Hwang J. and Seo J., Parent's perception about child's height and psychopatholgy in community children with relatively short stature. Annals of Pediatric Endocrinology & Metabolism, 2015. 20: p. 79–85. - PMC - PubMed
    1. Batty G.D., et al., Height, wealth, and health: an overview with new data from three longitudinal studies. Economics & Human Biology, 2009. 7(2): p. 137–52. - PubMed

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