was significantly below expected levels, even though target height predictions had been achieved ( Clopper et al., 1986; Mitchell et al., 1986). Thus, a biomedical success was not correlated with positive psychosocial outcomes. Consequently, one important next step in research is systemically to assess the effect of combined multimodal therapies on the QOL of patients with GHD (psychological and medical). This approach to comprehensive care necessitates that treatment protocols include measures that screen for problems such as anxiety or depression that are associated with GHD early in the treatment program and institute interventions that are appropriate to these problems. The long-term goal is to provide comprehensive care that enhances the QOL of this group of patients who are struggling with very difficult problems.
The authors acknowledge the important contributions made to the work described in this chapter by Louis E. Underwood MD, Richard R. Clopper ScD, Patricia T. Siegel PhD, Clarissa S. Holmes, PhD, Manuel E. Tancer MD, Catherine E. Stoppani RN, Peter G. Compton MA, Linda M. Nicholas MD, Susan G. Silva PhD, and Ann J. Johanson MD. Holly Franklin was helpful in preparing early drafts of the various papers prepared by our group, and Doris Friend completed the final versions.
Bjork, S., Jonsson, B., Westphal, O., & Levin, J. E. ( 1989). "Quality of life of adults with growth hormone deficiency: A controlled study". Acta Paediatrica Scandinavica, 356 (Suppl), 55-59.
Burman, P., Hetta, J., Wide, L., Manssan, J. E., Ekman, R., & Karlsson, FA. ( 1995). "Quality of life in adults with growth hormone (GH) deficiency: Response to treatment with recombinant human GH in a placebo-controlled 21-month trial". Journal of Clinical Endocrinology and Metabolism, 80, 3585-3590.
Clopper, R. R., MacGillivray, N. H., Mazur, T., Voorhess, M. L., & Mills, B. J. ( 1986). "Post-treatment follow-up of growth hormone deficient patients: Psychosocial status". In B. Stabler, L. E. Underwood (Eds.), Slow grows the child (pp. 73-82). Hillsdale, NJ: Lawrence Erlbaum Associates.
Dean, H. J., McTaggart, T. L., Fish, D. G., & Friesen, H. G. ( 1986). "Long-term social follow-up of growth hormone deficient adults treated with growth hormone during childhood". In B. Stabler & L. E. Underwood (Eds.), Slow grows the child (pp. 73-82) Hillsdale NJ: Lawrence Erlbaum Associates.
Dean, H. J. ( 1990). "Demographic outcome of growth hormone deficient adults". In C. S. Holmes (Ed.) Psychoneuroendocrinology: Brain, behavior and hormonal interactions (pp. 79-91). New York: Springer-Verlag.
Dimsdale, J. E., & Baum, A. (Eds.) ( 1995). Quality.of life in behavioral medicine research. Hillsdale, NJ.: Lawrence Erlbaum Associates.