- Psychogenic dwarfism
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ICD10 = ICD10|E|34|3|e|20
dwarfism, also known as Psychosocial dwarfism,cite journal |author=Duché DJ |title= [Consequences of family violence on children's health] |language=French |journal=Bull. Acad. Natl. Med. |volume=186 |issue=6 |pages=963–9; discussion 969–70 |year=2002 |pmid=12587335 |doi=] Psychosocial short stature, Stress dwarfism, or Kaspar HauserSyndromecite web |url=http://content.nejm.org/cgi/content/short/331/15/1031 |title=NEJM -- The Kaspar Hauser Syndrome of "Psychosocial Dwarfism": Deficient Statural, Intellectual, and Social Growth Induced by Child Abuse |accessdate=2007-12-07 |format= |work=] (after the first person it was identified in) is a growth disorderthat 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 childrenand 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.
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
epinephrineand 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.
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 companionshipFact|date=July 2007.
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 [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, 1998Primary Source needed|September 2007.]
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. [Hamilton-Byrne, S. (1995) Hierarchies of organisation within cults "The Skeptic" 15(3): 26 [http://www.skeptics.com.au/journal/1995/3.pdf] ]
J. M. Barriemay have suffered from psychogenic dwarfism. His brother died when Barrie was six years old, and his mother – mourning the loss of her favorite child – neglected him for a time afterward. He was famously shorter than average (about five feet), and his marriage was reportedly never consummated, prompting speculation that he was physically immature. [ [http://www.csfb.com/thoughtleaderforum/2002/sapolsky_sidecolumn Robert M. Sapolsky "Why Zebras Don't Get Ulcers: Stress, Disease & Coping", 2002] ] He is most famous for his story of Peter Pan, the boy who never grew up.
* [http://www.feralchildren.com/en/dwarfism.php Psychosocial dwarfism] from FeralChildren.com
* [http://serendip.brynmawr.edu/bb/neuro/neuro01/web3/Munoz.html I Won't Grow Up: The Causes of Psychogenic Dwarfism] by Karen Munoz at Bryn Mawr
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