The psychological burden of short stature has been addressed by the literature over many years, starting with earlier publications about the impact of short stature on psychological functioning and the role of adaption. However, this research approach rarely considered the view of short stature persons themselves. With the introduction of the quality of life concept into medicine, and pediatric endocrinology, the question arose how wellbeing and function can be assessed from both, the patient´s and parent´s point of view.
The psychosocial stress that can be caused by the awareness of height disparity can have a detrimental effect upon the child that can persist into adult life. Secondary psychological consequences can also occur when the negative social stereotype of short stature affects how the child is treated by others. The way others respond to the child and his or her selfperception will in turn influence the child´s behaviour and self-esteem and may contribute to the child being bullied in school. Therefore, the self-perception of height is an important determinant of children´s self-image and shapes their interactions with the people they meet.
Attempts to measure the social and psychological consequences of short stature have proven difficult. Short-stature can have serious psychological consequences in the form of stigmatisation, social isolation and juvenilisation. Because short stature can act as an ´easy´ explanation for psycho-social problems the clinician should consider incorporating a psychosocial component in their diagnostic evaluation to broaden potential treatment recommendations.
Risk factors potentially affecting psychosocial adaption among those with short stature include male gender, the presence of a younger but taller sibling, being perceived and treated as younger than chronological age, lower intelligence, and lower family socioeconomic status. As many of these constitute ´risk factors´ for children with average stature, they are not specific for those with short stature. Thus it remains unclear, why some children with short stature develop psychologically well and others do not.
