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Psychogenic dwarfism

**Psychogenic dwarfism**
*Classification & external resources*
ICD-10	E34.3

Psychogenic dwarfism, also known as Psychosocial dwarfism,^[1] Psychosocial short stature, Stress dwarfism, or Kaspar Hauser Syndrome^[2] (after the first person it was identified in) is a growth disorder that is observed between the ages of 2 and 15, caused by extreme emotional deprivation or stress.

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The symptoms include decreased growth hormone (GH) secretion, very short stature, weight that is inappropriate for the height, and immature skeletal age. This disease is a progressive one, and as long as the child is left in the stressing environment, his or her cognitive abilities continue to degenerate. It is often seen in feral children and in children kept in abusive, confined conditions for extended lengths of time. It can cause the body to completely stop growing but is generally considered to be temporary; regular growth will resume when the source of stress is removed.

Etiology

Children with psychogenic dwarfism have extremely low levels of growth hormone. These children possibly have a problem with growth hormone inhibiting hormone (GHIH) or growth hormone releasing hormone (GHRH). The children could either be unresponsive to these hormones or too sensitive.

Children that have psychogenic dwarfism exhibit signs of failure to thrive. Even though they appear to be receiving adequate nutrition, they do not grow and develop normally compared to other children of their age.

An environment of constant and extreme stress causes psychogenic dwarfism. Stress releases hormones in the body such as epinephrine and norepinephrine, engaging what is known as the 'fight or flight' response. The heart speeds up and the body diverts resources away from processes that are not immediately important; in psychogenic dwarfism, the production of growth hormone (GH) is thus affected. As well as lacking growth hormone, children with psychogenic dwarfism exhibit gastrointestinal problems due to the large amounts of epinephrine and norepinephrine, resulting in their bodies lacking proper digestion of nutrients and further affecting development.

While the cure for psychogenic dwarfism is questionable, some studies show that placing the child affected with the disease in a foster or group home increases growth rate and socialization skills.

Cases

Peter Pan author JM Barrie suffered from psychogenic dwarfism, according to some.^[3]

Many apparent cases of psychogenic dwarfism were apparent in the twentieth century, around the time of World War II. Two orphanages were run in close proximity; one orphanage was run by a woman who did not pay attention to the children and the other was run by a woman who showed the children love and attention. Growth rates at the latter orphanage were higher than at the first, due mainly to how the woman nurtured and nourished the children's need for love and companionship^{[citation needed]}.

Another case is a child who was admitted to a hospital with an extremely low weight. One nurse overtook his care and he began to rapidly gain weight and his growth hormone levels increased while the nurse was over his care. The child was so dependent on the nurse emotionally that when she left, his levels returned to that of what they were when he was admitted to the hospital, and once she returned, they stabilized once more^[4]

When a police raid in 1987 released the children held by an Australian cult known as The Family, one twelve year old girl weighed under 20 kg (44 lbs) and was under 120 cm (4 ft) tall. She grew 11 cm (4 in) in the following year and her growth hormone levels returned to normal ^[5].

References

^ Duché DJ (2002). "[Consequences of family violence on children's health]" (in French). Bull. Acad. Natl. Med. 186 (6): 963–9; discussion 969–70. PMID 12587335.
^ NEJM -- The Kaspar Hauser Syndrome of "Psychosocial Dwarfism": Deficient Statural, Intellectual, and Social Growth Induced by Child Abuse. Retrieved on 2007-12-07.
^ The ascent of Pan. Retrieved on 2007-12-07.
^ Sapolsky, Robert M. Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases, and Coping. New York: W.H. Freeman and Company, 1998Template:Primary Source needed.
^ Hamilton-Byrne, S. (1995) Hierarchies of organisation within cults The Skeptic 15(3): 26 [1]

I Won't Grow Up: The Causes of Psychogenic Dwarfism by Karen Munoz at Bryn Mawr

Sarr M, Job JC, Chaussain JL, Golse B (1987). "[Psychogenic growth retardation. Critical study of diagnostic data]" (in French). Arch. Fr. Pediatr. 44 (5): 331–8. PMID 2441679.

v • d • e Endocrine pathology: endocrine diseases (E00-35, 240-259)
Thyroid	Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome
Pancreas	Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome
Parathyroid	Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary)
Pituitary	Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease/Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome
Adrenal	Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (due to 21-hydroxylase deficiency) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism
Gonads	ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - testicular dysfunction (5-alpha-reductase deficiency) - general (Hypogonadism, Delayed puberty, Precocious puberty)
Other	Autoimmune polyendocrine syndrome - Carcinoid syndrome - Short stature (Laron syndrome, Psychogenic dwarfism) - Gigantism - Androgen insensitivity syndrome - Progeria - Multiple endocrine neoplasia (1, 2)

Categories: Growth disorders | Human height

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Psychogenic_dwarfism". A list of authors is available in Wikipedia.