Annotation: Night Wetting in Children: Psychological Aspects

Butler, Richard J.

doi:10.1111/1469-7610.00342

Cited by 62 publications

(55 citation statements)

References 75 publications

(153 reference statements)

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“…Epidemiological studies have shown NE to be among the commonest disorders in school-age children. In European countries enuresis has been reported to occur in 9-19% of children at 5 years old, in 7-22% at 7 years and in 5-13% at 10 years [1]. A similar value has been reported in children in eastern countries [2].…”

Section: Introductionsupporting

confidence: 66%

Nocturnal enuresis in the adolescent: a neglected problem

Nappo

Gado²,

Chiozza

et al. 2002

BJU International

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Objective To assess the features of adolescent bedwetters, as few data are available on enuresis in this age group. Patients and methods A specific database for adolescents and young adults was created with the collaboration of various specialists (paediatricians, urologists, gynaecologists, psychiatrists). Questions focused on family and personal history, stressful events, age of attaining urinary and fecal control, characteristics of enuresis (primary vs secondary, monosymptomatic vs enuresis associated with daytime urinary symptoms), school performance, diagnostic examination and physical examinations, and treatment and its response. Results Data were collected from 107 enuretic adolescents (mean age 15.3 years, median 14, range 13-23; 63 males and 44 females). A positive family history for enuresis was recorded in 82%. Enuresis was primary in 79 patients (74%), secondary in 28 (26%), monosymptomatic in 76 (71%) and associated with daytime urinary symptoms in 31 (29%). In males monosymptomatic enuresis was significantly more frequent than in females ( P < 0.01). Urinary tract infections were reported by 13 patients, all females; eating disorders (anorexia, polyphagia) were present in six. In 85 patients (80%) enuresis was considered severe ( ≥ three nights/week). Of the 107 patients, 27 (20%) had never consulted a doctor about their problem and 43 (40%) had received no therapy; 66 received desmopressin monotherapy, with a good response (half the number of wet nights) in 44 (79%). There was no relation between response to desmopressin and gender, age, type and severity of enuresis or positive family history of enuresis. Eight patients were provided with a nocturnal alarm but this was not tolerated by two. Altogether, 25 patients refused any therapy or did not comply with the given therapy. Conclusions Enuresis can persist into adolescence and be a significant problem; 80% of these patients had severe enuresis and 31% also had associated daytime urinary symptoms, with 40% receiving no previous therapy. The treatment of enuresis can be particularly difficult at this age; 22% of patients did not respond to desmopressin and 23% had low compliance with the given therapy. Enuresis in adolescents requires further study; hopefully more enuretic children will receive adequate treatment before reaching adolescence.

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Section: Introductionsupporting

confidence: 66%

Nocturnal enuresis in the adolescent: a neglected problem

Nappo

Gado²,

Chiozza

et al. 2002

BJU International

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“…Possible reason for this condition was considered to be lower endurance of parents. In a study of Butler et al, they stated that parents of enuretic children can be extremely guarding and even some of them could be angry and prefer punishment for coping with enuresis (10). In the study of Sapi et al, they stated that all of enuretic children were exposed to domestic violence and detected physical punishment in 48.5% (11).…”

Section: Discussionmentioning

confidence: 99%

Methods and Rates of Punishment Implemented by Families to Enuretic Children in Turkey

et al. 2013

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Purpose: Nocturnal enuresis is a serious health problem affecting a significant portion of the population. In this study, we investigated the frequency of punishment methods in nocturnal enuresis (NE) in Turkey and its relationship with other parameters. Materials and Methods: A total of 501 children (301 boys and 200 girls) who were admitted to our outpatient clinic due to nocturnal enuresis were included in the study. Mean age was 9.39 years (range 5-18). Prepared questionnaire form inquiring educational status of the family, frequency and implementation and duration of punishment methods was applied to patients and families. Results: At least one punishment method was applied to 291 (58.1%) of children with NE. Punishment methods of parents were detected as condemnation (257 patients, 51.3%), depriving desires of the child (120 patients, 23.9%), humiliating the child in the presence of other children (113 patients, 22.6%), reprimanding-threatening with punishment (203 patients, 40.5%). This application was found to continue for longer than 1 year in 52% of punished children. Families graduated of high school and above were found to use punishment methods significantly more than others. Conclusion: According to the results of our study, a quite high proportion of enuretic children were detected to be exposed to punishment methods. Even, some parents consider that these methods are a part of nocturnal enuresis treatment. We, the doctors, should endeavor more for raising awareness of the community in order to diminish this worrisome behavior.

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“…These 2 clinical entities occur mainly in girls, [1][2][3] as manifestations of nonneuropathic bladder-sphincter dysfunction (NNBSD), and have always been associated with behavior problems; the International Classification of Diseases, 10th Revision, lists both "enuresis of nonorganic origin" and "urinary incontinence of nonorganic origin" in the category of mental and behavioral disorders. 4,5 For primary monosymptomatic nocturnal enuresis (MNE), this association has been studied quite extensively, [6][7][8][9][10][11][12] and in terms of temperament, emotional stress, and anxiety, most studies indicate that children with MNE are not different from those without. The only specific links between MNE and behavior problems belong to the domain of secondary nocturnal enuresis.…”

mentioning

confidence: 99%

Behavior Profiles in Children With Functional Urinary Incontinence Before and After Incontinence Treatment

Bael

Winkler²,

Lax

et al. 2008

Pediatrics

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Since the 1980s, urinary incontinence and bed-wetting started to be seen as functional problems, with behavioral problems secondary to the bed-wetting. Behavioral problems in bed-wetting is studied extensively, but much less has been studied regarding behavioral problems in functional incontinence. What This Study AddsAbnormal behavior scores in children with functional incontinence were studied prospectively, before and after treatment for incontinence, as part of a randomized controlled trial. ABSTRACTOBJECTIVE. The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence. METHODS.A total of 202 children with nonneuropathic bladder-sphincter dysfunction were enrolled in the European Bladder Dysfunction Study, in branches for urge syndrome (branch 1) and dysfunctional voiding (branch 2); 188 filled out Achenbach's Child Behavior Checklist before treatment and 111 after treatment. Child Behavior Checklist scales for total behavior problems were used along with subscales for externalizing problems and internalizing problems.RESULTS. After European Bladder Dysfunction Study treatment, the total behavior problem score dropped from 19% to 11%, the same prevalence as in the normative population; in branch 1 the score dropped from 14% to 13%, and in branch 2 it dropped from 23% to 8%. The prevalence of externalizing problems dropped too, from 12% to 8%: in branch 1 it was unchanged at 10%, and in branch 2 it dropped from 14% to 7%. The decrease in prevalence of internalizing problems after treatment, from 16% to 14%, was not significant.CONCLUSION. More behavioral problems were found in dysfunctional voiding than in urge syndrome, but none of the abnormal scores related to the outcome of European Bladder Dysfunction Study treatment for incontinence. With such treatment, both the total behavior problem score and the score for externalizing problems returned to normal, but the score for internalizing problems did not change. The drops in prevalence are statistically significant only in dysfunctional voiding. F UNCTIONAL URINARY INCONTINENCE is a leading symptom of both urge syndrome and dysfunctional voiding. These 2 clinical entities occur mainly in girls, 1-3 as manifestations of nonneuropathic bladder-sphincter dysfunction (NNBSD), and have always been associated with behavior problems; the International Classification of Diseases, 10th Revision, lists both "enuresis of nonorganic origin" and "urinary incontinence of nonorganic origin" in the category of mental and behavioral disorders. 4,5 For primary monosymptomatic nocturnal enuresis (MNE), this association has been studied quite extensively, [6][7][8][9][10][11][12] and in terms of temperament, emotional stress, and anxiety, most studies indicate that children with MNE are not different from those without. The only specific links between MNE and behavior problems belong to the domain of secondary...

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Annotation: Night Wetting in Children: Psychological Aspects

Cited by 62 publications

References 75 publications

Nocturnal enuresis in the adolescent: a neglected problem

Nocturnal enuresis in the adolescent: a neglected problem

Methods and Rates of Punishment Implemented by Families to Enuretic Children in Turkey

Behavior Profiles in Children With Functional Urinary Incontinence Before and After Incontinence Treatment

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