Growth hormone deficiency, bullying victimization, and associations with treatment status: a pediatric case–control study

OBJECTIVE: Short stature affects approximately 3% of children and often leads to psychosocial challenges, including peer bullying. While growth hormone therapy effectively treats physical aspects of growth hormone deficiency, its protective effects against bullying victimization remain understudied. METHODS: This case-control study included 317 children aged 9-18 years: 108 newly diagnosed with growth hormone deficiency (untreated), 103 receiving growth hormone treatment (≥1 year), and 106 healthy controls. Participants completed the Olweus Bully/Victim Questionnaire, Rosenberg Self-Esteem Scale, Revised Child Anxiety and Depression Scale, and Strengths and Difficulties Questionnaire. Demographic and clinical data were collected through standardized interviews and medical records. RESULTS: Bullying victimization rates differed significantly among groups (p = .005). Newly diagnosed children showed the highest victimization rate (34.3%), followed by treated children (24.3%) and controls (15.1%). Treated children demonstrated significantly lower depressive affect scores (1.17 ± 0.95) compared to newly diagnosed children (2.2 ± 1.19, p = .001) and higher prosocial behavior scores (8.06 ± 2.09 vs. 7.08 ± 2.27, p = .001). Among treated children, bullying victims showed significantly compromised psychological functioning compared to non-victims, including lower self-esteem (27.52 ± 6.0 vs. 31.12 ± 5.44, p = .005) and higher anxiety-depression scores (48.88 ± 19.78 vs. 35.13 ± 23.81, p = .008). CONCLUSIONS: Growth hormone therapy is associated with reduced peer bullying victimization in children with growth hormone deficiency. The stepwise pattern observed across treatment groups suggests that treatment status relates to psychosocial outcomes extending beyond physical growth. These findings support early diagnosis and comprehensive care approaches addressing both endocrine and psychosocial aspects of growth hormone deficiency.