title: Social, educational and vocational outcomes in patients with childhood-onset and young-adult-onset growth hormone deficiency.
abstract: OBJECTIVE
  Hypopituitarism diagnosed in childhood, adolescence and young adulthood has the potential to affect growth and somatic development. Less is known about the impact of such a diagnosis on other aspects of development.
  
  
  METHODS
  An analysis of the KIMS database (Pfizer International Metabolic Database) was performed to explore social, educational and vocational outcomes of adult patients diagnosed in childhood, adolescence and young adulthood compared with adult-onset controls.
  
  
  METHODS
  A total of 2952 adult patients diagnosed with hypothalamic pituitary conditions before the age of 25 were divided into two groups: childhood-onset [<16 years (CO)] (n = 1782) and young-adult-onset [16 to <25 years (YAO)] (n = 1170). A total of 1617 adult patients diagnosed with a nonfunctioning pituitary adenoma at the age of 25 or older formed the adult-onset control group (AO).
  
  
  METHODS
  KIMS Patient Life Situation Form which provided information on social, educational and vocational outcomes.
  
  
  RESULTS
  Compared with the AO control group, CO and YAO patients were between 4·5 and 8·0 times more likely to live with their parents in adulthood; CO and YAO patients were also less likely to live in partnership and to have children. The impact on educational and vocational outcomes was less marked than on social outcomes with no significant differences compared with the AO control group. Educational and vocational outcomes showed the lowest level in male and female CO and YAO patients who had been previously diagnosed with a brain tumour.
  
  
  CONCLUSIONS
  Social outcomes were more affected than educational and vocational outcomes. Although CO patients are more adversely affected, YAO patients were also failing to achieve social milestones. This has consequences for the delivery of endocrine care in both paediatric and adult services.
authors.affiliation: Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: M Tanya
authors.initials: MT
authors.lastname: Mitra
authors.affiliation: Pfizer Endocrine Care, Sollentuna, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Jönsson
authors.affiliation: Pfizer Endocrine Care, Sollentuna, Sweden.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Åkerblad
authors.affiliation: Manchester Academic Health Sciences Centre, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Clayton
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Kołtowska-Häggström
authors.affiliation: Barts and the London School of Medicine, Queen Mary University of London, London, UK.
authors.forename: Márta
authors.initials: M
authors.lastname: Korbonits
authors.affiliation: Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: Toogood
authors.affiliation: Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors.forename: Helena
authors.initials: H
authors.lastname: Gleeson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001932:Brain Neoplasms; D002648:Child; D016208:Databases, Factual; D004522:Educational Status; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000523:psychology*; D008297:Male; D066252:Sociological Factors; D014829:Vocational Education; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone