Psychological effects of withdrawal of growth hormone therapy from adults with growth hormone deficiency.

Objective: Growth hormone (GH) is known to be required for physical well-being. Whilst it is also widely believed to be important for quality of life (QoL) and psychological health, there is less supportive evidence. The objective of this study was to investigate the psychological effects of discontinuation of GH replacement from adults with severe GH deficiency (GHD). Design: A double-blind, placebo-controlled trial in which GH replacement therapy was discontinued for 3 months from 12 of 21 GH-deficient adults, where 9 continued with GH replacement. Patients: GH-treated adults (10 men, 11 women), all with severe GHD (peak GH Measurements: Semi-structured interviews were given at baseline and end-point plus questionnaires that included a new hormone-deficiency specific, individualised, QoL questionnaire (HDQoL), the General Well-being Index (GWBI), the Well-being Questionnaire (W-BQ12), Short-Form 36 health status questionnaire (SF-36), the Nottingham Health Profile NHP) and the General Health Questionnaire (GHQ). Results: Three months after baseline the serum total IGF-I of placebo-treated patients fell from normal, age related levels (mean 26.6 ± 13.2 nmol/ L) to levels indicative of severe GHD (11.6 ± 6.6 nmol/ L) (P Conclusion: Withdrawal of GH-treatment from adults with severe GHD has detrimental psychological effects