Abstract
We describe 66 children (32 girls, 33 boys) from 51 families with an average age of 6.6 years (range, 0.9 to 16.5 years, all but 5 prepubertal) diagnosed by a multidisciplinary team as having environmental growth failure. In 67% the patients lived in families with 3 or more children, but in 73% it was the first or the second born child. 45% of the parents were divorced, in 31% the father was unemployed.
In 56 children the birth weight was known and only in 29% it had been above 3000 g; 21% were premature, 29% had features of a low-birth-weight-syndrome (including four with Russell-Silver-Syndrome); the average birth weight was 2786 g.
In all patients the predominant reason for referral was short stature or growth failure. In 28% psychosocial dwarfism had been suspected, and in a further 29% social or emotional problems were known to the referring physician but not suspected as the aetiology of the growth failure. Social services were already involved in 60% at presentation.
At the first presentation and during the attendance of our clinic additional signs leading to the suspicion of psycho-social dwarfism were found; 42% behavior problems, 54% eating problems, 26% soiling, 18% nocturnal enuresis, and 12% deliberately wetting. During the observation period assessment revealed that 27 of our patients had occult sexual or physical abuse (group A), in 15 patients (group B) such abuse was highly suspected, but in 23 patients (group C) only emotional deprivation could be related to growth failure. In group A. behavior problems, bizarre eating habits, soiling and nocturnal enuresis was more common than in group C.
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Stanhope, R., Hamill, G., Skuse, D. et al. CLINICAL EXPERIENCE OF PSYCHO-SOCIAL DWARFISM. Pediatr Res 33 (Suppl 5), S55 (1993). https://doi.org/10.1203/00006450-199305001-00312
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DOI: https://doi.org/10.1203/00006450-199305001-00312