Psychogenic dwarfism

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Overview
Psychogenic dwarfism, also known as Psychosocial dwarfism, Psychosocial short stature or Stress dwarfism is a growth disorder that is observed between the ages of 2 and 15, caused by extreme emotional deprivation or stress.

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.

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.

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.