A Case-comparison Study of the Characteristics of Children with a Short Stature Syndrome Induced by Stress (Hyperphagic Short Stature) and a Consecutive Series of Unaffected “Stressed” Children

Abstract

Recently a type of growth failure (Hyperphagic Short Stature) has been described, in which there is potentially reversible severe impairment of growth hormone secretion, in association with excessively high levels of psychosocial stress. This condition is a variant of the disorder formerly known as Psychosocial Dwarfism. In the present study we compared children with Hyperphagic Short Stature (N=25, aged 9.04 years±3.78, 72% male) and a closely matched sample with normal height, drawn from comparably stressful family circumstances (N=25, aged 10.61±3.04, 60% male). Measures of the psychosocial environment, anthropometry, and developmental history from infancy were obtained. Many symptoms thought previously to be characteristics of psychosocial dwarfism were found to be nonspecific stress responses. Hypotonia (p<.05), enuresis/encopresis (p<.01), and sleep cycle disruption (p<.05) did differentiate the groups. Growth, appetite, and sleep are all influenced by hypothalamic nuclei, suggesting hypothalamic pathology could account for most of the clinical features of Hyperphagic Short Stature.