Physical health of mothers with HIV/AIDS and the mental health of their children

A longitudinal study was conducted on the psychological well-being of 81 young children (mean age = 8.8 years) living with mothers with AIDS or HIV-infected mothers with symptomatic disease. The relationship between mothers' physical health and children's psychological well-being was investigated. The children were assessed at seven time points over approximately 6 years. Individual growth models were estimated for children's depression, anxiety, and aggressiveness in relation to: mothers' viral load (medical records) and physical functioning, number of HIV-related physical symptoms, and medical visits due to illness (self-report). Results showed significant linear declines in children's depression, anxiety, and aggressiveness over time. Lower levels of physical functioning and more physical symptoms among mothers were associated with higher levels of children's depression, anxiety, and aggressiveness at baseline. Lower levels of physical functioning and more physical symptoms among mothers were associated with initially high but more rapidly decreasing levels of depression among children. However, mothers who began the study in better health appear to have changed in health more quickly than mothers who began the study in poorer health. Thus, stability in mothers' health appears to be associated with a more rapid improvement in children's mental health over time. Our findings suggest that the measures representing observable levels of, and changes in, mothers' health that are most likely to be directly experienced by themselves and their children are the measures that are most predictive of changes in children's mental health over time.     

Depression und Angst bei Müttern von Kleinkindern

Background. In comparison mothers of small children more often show signs of depressive moods or of increased anxiety. Thus pediatricans will have to deal with this problem. To such aim we studied the level of anxiety and depression in mothers, who asked for pediatric advice. Methods. The study was performed in three different groups: elemental care examinations in healthy children (Vorsorgeuntersuchungen), outpatient sick children and inpatient pediatric patients. Demographic variables were registered and subsequently groups of mothers at risk for either conditions were identified. 210 consecutive mothers answered all three tests distributed: Becks depression questionnaire, state-trait-anxiety questionnaire, discriminating anxiety as a personal trait or as a mental state together with a demographic questionnaire. Results. In 4.2% of all women we found clinically relevant signs of depression; in 10%, levels of situative anxiety were statistically higher then the mean levels determined. Increased anxiety states were significantly higher in unemployed mothers and in mothers with inpatient children suffering from severe diseases. Anxiety traits were found significantly higher in divorced and single mothers, mothers an a low family budget and o lower educational level. Depression scores as well were found higher in single mothers, mothers without job qualifications and mothers of low income groups. Conclusions. Thus we recommend the pediatrician to look for signs of depression and increased anxiety in the risk groups mentioned in order to deal with these conditions properly.     

Physiological markers of anxiety are increased in children of abused mothers

Background: A growing number of studies indicate that low income, African American men and women living in urban environments are at high risk for trauma exposure, which may have intergenerational effects. The current study employed psychophysiological methods to describe biomarkers of anxiety in children of traumatized mothers. Methods: Study participants were recruited from a highly traumatized urban population, comprising mother–child pairs (n = 36) that included school‐age children. Mothers were assessed for childhood abuse with the Childhood Trauma Questionnaire, as well as symptoms of depression and posttraumatic stress disorder (PTSD). The children were measured for dark‐enhanced startle responses and heart‐rate variability. Results: Dark‐enhanced startle was found to be higher in children whose mothers had high levels of childhood physical abuse, as compared to children whose mothers had low levels of physical abuse. During the habituation phase of the startle experiment, children whose mothers had high levels of childhood emotional abuse had higher sympathetic system activation compared to children of mothers with low emotional abuse. These effects remained significant after accounting for maternal symptoms of PTSD and depression, as well as for the child’s trauma exposure. Conclusion: These results demonstrate that children of mothers who have history of childhood physical and emotional abuse have higher dark‐enhanced startle as well as greater sympathetic nervous system activation than children of mothers who do not report a history of childhood physical and emotional abuse, and emphasize the utility of physiological measures as pervasive biomarkers of psychopathology that can easily be measured in children.     

癫患儿父母心理健康状况调查分析

目的调查了解癫患儿父母心理健康状况.方法采用临床症状自评量表(SCL-90)对一组癫患儿父母的心理状态进行评定,在父母间进行比较,并与对照组、全国常模进行比较.结果癫患儿父母SCL-90总分以焦虑、抑郁、躯体化、恐怖4个因子分值明显高于常模及对照组(P＜0.01),人际敏感、敌对2个因子分值明显低于全国常模及对照组(P＜0.01),母亲组焦虑、抑郁、躯体化、恐怖因子分值明显高于父亲组(P＜0.01),提示癫患儿父母存在不良的心理状态,母亲尤为严重,临床医生在治疗癫患儿时应重视其家长尤其是母亲心理的帮助与支持.     

Prevalence of maternal depression and its relationship to ADL skills in children with developmental delay

To determine the prevalence of maternal affective symptoms in children with developmental problems compared to a control group, and to examine their relationship to the child's Activities of Daily Living (ADL), socialization skills and behaviour.

Methodology:

This study examined prospectively the prevalence of symptoms of maternal depression, maternal anxiety, stress and adverse life events in 65 mothers whose children were attending a Child Development Clinic. ADL and socialization skills were measured using the Vinelands Adaptive Behaviour Scales, and behaviour using a checklist.

Results:

Symptoms of maternal depression ( P =0.04), maternal anxiety ( P =0.01) and number of adverse life events ( P =0.03) were increased in the study compared to control mothers. Presence of maternal symptoms was unrelated to ADL or socialization skills though was associated with increased behavioural symptoms in the child.

Conclusion:

Affective disturbance in mothers of children with developmental problems are common and should be addressed as part of a comprehensive assessment of such children.     

原发性纤毛运动障碍患儿及其父母焦虑抑郁影响因素分析

背景：国外文献报道原发性纤毛运动障碍（PCD）患儿更易焦虑、抑郁,我国尚无PCD患儿及家长焦虑、抑郁状况的报道。 目的：探讨PCD患儿及家长焦虑、抑郁现状及影响因素。 设计：病例对照研究。 方法：以确诊的>7岁PCD患儿及家长分别为PCD儿童组和PCD父母组;以确诊的哮喘患儿及家长分别为哮喘儿童组和哮喘父母组,以健康儿童及家长分别为对照儿童组和对照父母组,采用焦虑性情绪障碍筛查表(SCARED)和抑郁量表(CDI) 评价儿童焦虑和抑郁状况,以焦虑自评量表(SAS)、流调用抑郁自评量表(CES D)评价父母的焦虑和抑郁状况,以Zarit负担量表评估PCD患儿父母照顾负担。分析PCD患儿及家长焦虑和抑郁的影响因素。 主要结局指标：PCD患儿及家长焦虑、抑郁的发生率和影响因素。 结果：PCD儿童组38例、哮喘儿童组76例和对照儿童组76名;PCD父母组、哮喘父母组和对照父母组均为82名。PCD儿童组焦虑发生率和SCARED得分高于哮喘儿童组和对照儿童组（P<0.05）,3组儿童CDI得分及抑郁发生率比较差异均无统计学意义（P≥0.05）;父母焦虑发生率、CES D得分和抑郁发生率PCD组高于哮喘组和对照组（P均<0.05）,哮喘组与对照组差异均无统计学意义（P均≥0.05）。父母SAS得分PCD组与哮喘组差异无统计学意义。PCD患儿母亲焦虑发生率、抑郁发生率、CES D评分、SAS评分和Zarit得分均高于父亲（P均<0.05）。多因素二元Logistic回归分析显示,7~17岁PCD患儿,男孩较女孩易发生焦虑,规律气道护理是避免焦虑和抑郁发生的保护因素;4~17岁PCD患儿父母,受教育程度高、有稳定职业、患儿规律运动是避免焦虑发生的保护因素,受教育程度高、患儿近1年住院频率＜1次、患儿规律运动是避免抑郁发生的保护因素,Zarit负担量表得分高是焦虑和抑郁发生的危险因素。 结论：PCD患儿焦虑发生率较高,受性别和气道护理情况影响。PCD患儿父母焦虑、抑郁发生率较高,受职业、受教育程度、照顾负担、患儿运动情况及患儿近1年住院频率影响。     

癫(癎)患儿抑郁情绪及影响因素

目的 观察癫(癎)患儿的抑郁状态,并探讨患儿的焦虑、个性以及监护人的焦虑、抑郁和个性等对患儿抑郁的影响.方法 采用儿童抑郁自评量表(DSRS)、儿童社交焦虑量表(SASC)、Beck抑郁自评问卷(BDI)、焦虑自评量表(SAS)以及儿童和成人艾森克个性问卷(EPQ),对95例癫(癎)患儿及其监护人的抑郁、焦虑、个性的4个维度进行评分,同时与118例上呼吸道感染患儿(对照组)的抑郁状态进行比较.结果 癫(癎)患儿DSRS得分较对照组儿童高、13～15岁病例组患儿得分较同年龄段对照组高,差异均有统计学意义(Pa＜0.05),而癫(癎)患儿的抑郁水平与性别无关,不同年龄段病例组患儿DSRS得分比较差异无统计学意义.病例组患儿DSRS得分与儿童SASC及儿童EPQ N量表得分呈正相关、与E量表得分呈负相关(Pa＜0.005),与P量表和L量表得分无相关关系(Pa＞0.05);与监护人BDI、SAS及成人EPQ P量表得分呈正相关(Pa＜0.05),与监护人N、E、L量表得分无相关关系(Pa＞0.05).监护人文化程度相同,病例组和对照组儿童DSRS得分比较,差异无统计学意义(P＞0.05);监护人文化程度不同,病例组患儿DSRS得分有统计学差异(P＜0.05),且监护人文化程度为小学及以下者癫(癎)患儿的抑郁水平高于监护人为本科/大专者,差异有统计学意义(P＜0.05).监护人职业相同,病例组和对照组儿童DSRS得分差异无统计学意义(Pa＞0.05).监护人职业不同,无论工人、农民或行政人员等,病例组患儿DSRS得分差异无统计学意义(Pa＞0.05).患儿为局限性发作或全面性发作、有无影像学异常、病程长短不同,其儿童DSRS得分差异无统计学意义(Pa＞0.05).结论 癫(癎)患儿抑郁水平较健康儿童高,且与患儿年龄、患儿和监护人的焦虑或抑郁水平、某些个性特征及监护人文化程度相关.     

白血病患儿及其父母心理特点调查分析

目的探讨初诊及长期无病生存白血病患儿的情绪、自我意识特征及其父母的情绪特点。方法选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表和Piers-Harris儿童自我意识量表分别对40例初诊白血病、20例长期无病生存白血病和50例正常对照儿童进行评定,同时采用焦虑自评量表、抑郁自评量表对两组白血病儿童的父母进行心理测评。结果白血病患儿的焦虑和抑郁总分均显著高于正常对照组(P值分别为0.028和0.045);其中长期无病生存组患儿在躯体化/惊恐、广泛性焦虑和社交恐怖分量表评分明显高于正常对照组(P值分别为0.002、0.019、0.001和0.000)。初诊组患儿在社交恐怖分量表得分亦显著高于正常对照组(P=0.004),在学校恐怖分量表得分显著低于正常对照组(P=0.020)。总体白血病患儿的自我意识总分低于正常对照组(P=0.003),其中长期无病生存组在焦虑、合群、幸福与满足分量表得分显著低于正常对照组(P值分别为0.041、0.037和0.037),但自我意识总分与正常对照组相比差异无显著性(P=0.581);而初诊白血病组患儿在自我意识总分及行为、智力与学校情况、躯体外貌与属性、焦虑分量表得分显著低于正常对照组(P值分别为0.007、0.001、0.005、0.031和0.001)。白血病组父母焦虑和抑郁得分均显著高于我国常模组(P0.001),其中初诊白血病组父母的焦虑和抑郁症状检出率显著高于长期无病生存组(P值分别为0.015和0.032)。患儿父母的焦虑和抑郁得分有明显的相关性(r=0.95,P0.001),但与患儿的焦虑、抑郁及自我意识得分均无显著相关性(P0.05)。结论白血病患儿及其父母较正常对照组有更多的焦虑和抑郁情绪,白血病患儿的自我意识降低。因此,应重视对白血病患儿及其父母进行心理辅导及治疗。     

ע��ȱ�ݶද�ϰ��������Ǻ��������������Ϊ�ص���о�

??Objective??To estimate the occurrence of attention deficit hyperactivity disorder comorbiding anxiety and depression and to compare the behavior characteristics of ADHD with and without anxiety or depression. Methods??A total of 105 children with ADHD meeting DSM-4 diagnostic criteria aged from 8 to 14 years were involved in this study. They were evaluated with the Screen for Child Anxiety Related Emotional Disorders??SCARED???? Depression Self-Rating Scale for Children??DSRSC?? by self-report and Achenbach’s Child Behavior Checklist ??CBCL?? by their parents. Another 66??without diagnosis of ADHD?? children aged from 8-14 years who were selected from a school as a control group were evaluated too??according to SCARED and DSRSC?? a ormal group ??43 children?? was selected from control group for analysis. Results??Thirty-nine of 105 children with ADHD compared to 13 of 66 controls scored at or beyond the clinical cut off ??25 points?? of SCARED score . Thirty-three of 105 children with ADHD compared to 10 of 66??15.2%?? controls reached the threshold??15 points?? of DSRSC of Chinese Norm ??χ2 = 5.704??P = 0.017??. In ADHD group 16 of 105??15.2%?? ADHD children comorbid both anxiety and depression??but none in controls. In ADHD children?? all scores of social ability were lower while all CBCL behavior scores were higher than normal controls except somaticcomplaint?? ADHD with anxiety had higher score in somatic complaint??ADHD with depression had higher score in anxious/depressed and ADHD with both anxiety and depression had higher score in Withdrawn?? somatic complaint?? Anxious/Depressed?? thought problems??attention problems andinternalizing problems than ADHD without anxiety and depression. Conclusion??The children with ADHD have high occurrence of comorbidity ofanxiety and depression. Children comorbided both anxiety and depression have more behavior and internalizing problems?? which implies that there is a need for further mental health services for this population.     

Psychosocial implications of Thalassemia Major

BACKGROUND: Many causes including the chronicity of disease, burden of treatment modalities, morbidities, and the expectation of early death resulting from the disease complications, may lead to psychosocial burden in Thalassemia Major (TM) patients. METHODS: A total of 38 patients with TM and their mothers were recruited to evaluate the psychosocial burden as well as to disclose whether the psychological status of the patients contribute to the compliance with the therapy or to the contrary. Demographic and disease variables were obtained. Child Behavior Check-list (CBCL) was completed by the mothers of the patients. A detailed psychiatric interview based on the 4th edition of the Diagnostic and Statistical Manual diagnostic criteria was performed for each patient. Symptom Distress Checklist 90 (SCL-90) scale was given to all mothers for evaluating their psychopathology. RESULTS: Although CBCL scores remained between the normal ranges, desferrioxamine mesylate (DFO)-compliant patients and the patients with lower ferritin values had significantly higher scores. A total of 24% of the patients had a psychiatric diagnosis including major depression, anxiety disorder, tic disorder, and enuresis nocturnal. The psychiatric diagnosis was significantly higher in the patients who were compliant with desferrioxamine compared with the non-compliant group (P = 0.007). The SCL-90 scores indicated that the mothers who had a child with good adherence to DFO had higher scale scores than the mothers with a poor adherent child. CONCLUSIONS: The increase risk of psychosocial and behavioral problems in thalassemics and their parents indicated the importance of a lifelong psychosocial support for the prevention of mental health issues. The patients and their parents, who were more conscious of the illness, were more worried but more compliant with the therapy and need stronger psychiatric support.     

注意缺陷多动障碍共患焦虑和抑郁情况及其行为特点的研究

评估注意缺陷多动障碍（ADHD）患儿共患焦虑和抑郁情况,同时探讨共患疾病对其行为的影响特点。方法　2007-2009年在中南大学湘雅二医院儿童精神卫生专科门诊收集105例ADHD患儿,年龄8～14岁,均符合DSM-IV诊断标准,但不存在对立违抗障碍、品行障碍和抽动障碍。于某学校选取66名同年龄段,无ADHD、对立违抗障碍、品行障碍和抽动障碍的学生作对照组。对所有研究对象采用ADHD诊断量表、Achenbach儿童行为量表（CBCL） 、儿童焦虑性情绪障碍筛查表（SCARED）、儿童抑郁障碍自评量表（DSRSC）进行评定,对照组儿童经SCARED、DSRSC评定后选择正常的43名作为正常对照组用于分析。结果　105例ADHD中39例（37.1%）共患焦虑,66名对照组中13例（19.7%）共患焦虑,两者间差异有统计学意义（χ2 = 5.829,P = 0.016）。ADHD共患抑郁者33例31.4%）,对照组10例（15.2%）,差异有统计学意义（χ2 = 5.704,P = 0.017）。ADHD同时共患焦虑与抑郁者16例（15.2%）,对照组中未发现共患焦虑与抑郁者。ADHD患儿CBCL社会能力得分均低于对照组,行为问题得分除躯体主诉外均显著高于正常对照组,差异有统计学意义（分别P = 0.000～0.010、P = 0.000～0.007）。ADHD单纯共患焦虑组CBCL躯体主诉得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD单纯共患抑郁组CBCL焦虑/抑郁得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD同时共患焦虑与抑郁组CBCL退缩、躯体主诉、焦虑/抑郁、思维问题、注意问题和内化性问题均显著高于单纯ADHD组,差异有统计学意义（P < 0.05）。结论　ADHD患儿有较高的抑郁和焦虑共患情况,同时共患抑郁与焦虑的ADHD患儿存在更多的行为问题,需要更多的精神卫生服务。     

Maternal outcomes of a randomized controlled trial of a community-based support program for families of children with chronic illnesses.

BACKGROUND: Parents of children with chronic illnesses are at high risk for secondary mental health problems, such as anxiety and depression. OBJECTIVE: To evaluate maternal outcomes of a support intervention for families of children with selected chronic illnesses. DESIGN: A randomized controlled clinical trial design with repeated measures 1 year apart. SETTING: A community-based family support intervention linked to subspecialty and general pediatric clinics and practices in a metropolitan area. PARTICIPANTS: A population-based sample of 193 mothers of children aged 7 to 11 years; the children were diagnosed as having diabetes, sickle cell anemia, cystic fibrosis, or moderate to severe asthma. About 15% of the persons contacted refused to participate in the research, and 14% of the families were lost to follow-up. INTERVENTION: The 15-month intervention, the Family-to-Family Network, was designed to enhance mothers' mental health by linking mothers of school-aged children with selected chronic illnesses with mothers of older children with the same condition. The program included telephone contacts, face-to-face visits, and special family events. MAIN OUTCOME MEASURES: Beck Depression Inventory score and the Psychiatric Symptom Index. RESULTS: Maternal anxiety scores for participants in the experimental group decreased during the intervention period for all diagnostic groups and for the total group; scores for the control group increased (F = 5.07, P =.03). In multiple regression analyses, the intervention group was a significant predictor of posttest anxiety scores (P =.03). Effects were greater for mothers with high baseline anxiety (P<.001) and for those who were themselves in poor health (P<.01). CONCLUSIONS: A family support intervention can have beneficial effects on the mental health status of mothers of children with chronic illnesses. This type of intervention can be implemented in diverse pediatric settings.     

Differences Between Children of Depressed and Non-depressed Mothers: Locus of Control, Anxiety and Self-esteem: a Research Note

Fifty-six mothers (26 depressed and 30 non-depressed) and their children were assessed on three measures: locus of control, anxiety and self-esteem. T-tests of results indicated significant differences between the groups of mothers across all three measures. There were significant differences between the two groups of children on state anxiety, total score on the self-esteem measure and social self-esteem, with the children of non-depressed mothers being lower on state anxiety and showing higher levels of self-esteem. Other aspects of self-esteem and locus of control did not show significant differences between the groups. A correlation matrix revealed that trait anxiety in the children of depressed mothers was significantly correlated with the mothers' depression, but not the mothers' anxiety. An analysis of discriminant functions found that a more anxious mood state and feelings of fear and worry were associated with the children of the depressed mothers.     

Emotional reactions of children to isolation in a cancer hospital

Emotional reactions of 123 hospitalized children and their mothers were evaluated during standard isolation with limited visitation and during peninsula isolation with visitation only through glass partitions. Self-report surveys and behavioral observations by nurses indicated that (1) patients and parents in both isolation facilities had overall high levels of hospital-related anxiety and depression which varied with the patient's chronologic age; and (2) parents of preschool children had more negative opinions toward peninsula isolation than did parents of older children. These results confirm the need for psychologically supportive programs for the families of children being treated for catastrophic diseases.     

Children and mothers at clinics: who is disturbed?

One hundred and eighty one white children aged 6 to 11 years who were attending medical outpatient clinics with their mothers were studied to assess the prevalence of psychological disturbance in the children, and anxiety and depression in the mothers. Teachers were also asked to assess the children independently using the Rutter scales. Mothers assessed 70 (39%) of the children as being disturbed, 20 of whom were also assessed as being disturbed by their teachers. A further 15 children were assessed as being disturbed by their teachers but not by their mothers. Thirty five (19%) of the mothers assessed themselves as anxious and two as depressed using the hospital anxiety and depression scale. Anxious and depressed mothers were significantly more likely to assess their child as being disturbed. In contrast, the teachers'' assessments of the children were not affected by the mental state of the mothers. These findings confirm that mothers'' perceptions of their children are modified by their own moods.     

Anxiety and depression in mothers related to severe malformation of the heart of the child and foetus

The aim of the study was to assess levels of anxiety and depression in three groups: pregnant mothers referred to foetal cardiology, subdivided into those with a confirmed diagnosis and those for which no abnormality was detected, and mothers who had a child with a heart malformation. Psychological status was measured between 6 and 10 months after diagnosis using the Hospital Anxiety and Depression scale in 108 females. Levels of anxiety were higher in the two groups with a confirmed diagnosis in the antenatal period or after birth (62%) than in those who were screened positively but in whom no abnormality was found (30%) ( p = 0:0055). Anxiety was the highest in young females who had a foetus with a heart malformation. Depression scores were higher in those who had a child with heart malformation (18%) than in the other two groups (5%). Mothers who terminated a pregnancy after diagnosis remained depressed long after the event. Younger mothers may be especially vulnerable to mood problems associated with a traumatic obstetric experience.     

Does childhood anxiety evoke maternal control? A genetically informed study

Background: Despite theoretical and empirical support for an association between maternal control and child anxiety, few studies have examined the origins of this association. Furthermore, none use observer‐ratings of maternal control within a genetically informative design. This study addressed three questions: 1) do children who experience maternal control report higher anxiety levels than those who do not?; 2) to what extent do genetic and environmental factors influence maternal control and child anxiety?; 3) to what extent do genetic and environmental factors influence the associations between child anxiety and maternal control? Method: Five hundred and thirty 8‐year‐old children (from 265 twin pairs) and their mothers were observed participating in an ‘etch‐a‐sketch’ task from which maternal control was rated. Children rated their anxiety using the Screen for Child Anxiety Related Emotional Disorders. Results: Children who experienced maternal behaviour rated as ‘extreme control’ reported higher anxiety levels than those who did not. Maternal control was highly heritable (A = .63), high self‐rated anxiety less so (h²_g = .36). The overlap between high child anxiety and maternal control was primarily due to shared genetic factors. Conclusions: These results suggest that maternal control is likely to have been elicited by children with high levels of anxiety.     

Depression in mothers and behaviour problems with their preschool children

A follow-up study of 224 families of a birth cohort of 272 families in a multi-ethnic poor socio-economic municipality in Melbourne when the children were 4 years old showed that 27% of the mothers were depressed. There was no difference in the depression rate between Australian-born and immigrant mothers, a finding in marked contrast to the first year of the study when the depression rate was significantly higher in those immigrant mothers who had been in Australia for less than 3 years, were unable to speak English and who did not have an extended family or close friends. Depression in this group of mothers was attributed to resettlement problems, which over a period of three years had ameliorated. At 4 years the most important factor associated with depression in both Australian-born and immigrant mothers was the quality of marital relationships. Lack of an intimate support relationship made mothers more vulnerable to the stresses of child care and rearing, home-making and life events. In Australian-born mothers only, another significant factor in vulnerability to depression, was their early childhood experiences of being reared in a disruptive home or in an institution and of being unwanted. In immigrant mothers, but not in Australian-born mothers, life events were significantly correlated with depression. The depressed mothers, both Australian-born and immigrant, perceived their 4 year old children to have significantly more behavioural problems than mothers who were not depressed.     

Short stature in children with sickle cell anemia correlates with alterations in the IGF-I axis

Children with sickle cell anemia (SCA) frequently have short stature. We propose that alterations in the IGF-I axis are involved in their growth failure. We investigated the IGF-I axis in children with SCA and height below the 25th percentile (n = 15) and compared it with that of children with SCA and height above the 50th percentile (n = 7). IGF-I and IGFBP-3 levels were assessed by RIA. IGFBP-3 proteolysis was assessed by a protease activity assay and by Western immunoblots. IGF-I and IGFBP-3 SDS were low for both groups. In the short statured patients, IGF-I SDS correlated with height velocity SDS (p = 0.018). IGFBP-3 SDS, when corrected for bone age, decreased with age (p = 0.0054). IGFBP-3 was proteolyzed in both groups although the short statured patients had lower levels of absolute intact IGFBP-3 when compared with the normally growing group (p = 0.028). We demonstrated that children with SCA have abnormalities in the IGF-I axis, which worsen with age.