Growth Hormone Treatments may Increase Depression Risk in Some GHD, ISS Patients

Statistics show that about one in 4,000 to 10,000 children have growth hormone deficiency, a partial or total health problem in which the pituitary gland fails to produce adequate amounts of growth hormone. Certain treatments can help increase height among these short, otherwise healthy children. However, a recent study with findings presented Monday at the meeting of the International Society of Endocrinology and the Endocrine Society in Chicago found that many who experience treatment benefits may become more depressed and withdrawn over time.

"Daily injections, frequent clinic visits and repeated discussions about height might exacerbate instead of improve psychosocial concerns in children with idiopathic short stature (ISS) who are otherwise healthy, and give them no cognitive improvements," said lead author Emily C. Walvoord, MD, associate professor of clinical pediatrics at the Indiana University School of Medicine in Indianapolis, in a news release.

Previous research has suggested that subtle cognitive problems seen in adults with growth hormone deficiency (GHD) may also occur in children with GHD, but may also improve with treatment.

In the study, researchers assessed 41 children with GHD and ISS between the ages of 6 and 16. All of the participants were required to take a series of tests that examined their cognitive functioning. Their parents were also asked to determine their child's emotional and behavioral functioning based on a questionnaire.

The children were then assigned to either a group that was treated with growth hormone or one that was part of the untreated control group, following a 9 to 12 month period. After this time frame, the children in both groups were retested.

So far, 41 children have been involved in initial testing and 28 have had follow up testing. Among these participants, researchers have found no significant differences in cognitive patterns between GHD and ISS children from their first test to their retest.

However, researchers discovered that overall, depression and withdrawal symptoms in the treated GHD and ISS children have worsened when compared to the untreated ISS participants.

"This novel study of the cognitive and emotional effects of GH therapy in children with GHD and ISS compared to untreated short children raises concerns that, despite improvements in height, these children may not achieve psychosocial benefits," Dr. Walvoord concluded.