Incontinence and headache in preschool children

Abstract

Aims Headaches in preschool children are associated with behavioral and gastrointestinal symptoms. As the co‐occurrence with incontinence is not known in young children, the aim of the study was to examine associations of headache, psychological symptoms and nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in a population‐based sample of preschool children. Methods All preschool children of a defined geographical area were examined at school‐entry. Parents completed a 22‐item questionnaire, including 14 headache, 4 incontinence, and 25 items of the Strength and Difficulties Questionnaire (SDQ). Five hundred eighty‐five children (50.4% males) with a mean age of 5.8 years were included. Results In total, 27.2% of all children had headaches. 15.7% had secondary and 11.3% primary headaches. Five children had migraine and five tension‐type headaches, while all others were unclassifiable. 9.4% of children had incontinence (7.7% NE; 2.4% DUI, 1.2% FI) and 4.0% constipation. The rates of incontinence did not differ between children with primary and those without headache for NE (12.9% vs 7.5%), DUI (3.1% vs 2.7%) or FI (3.0% vs 1.0%), but for constipation (12.1% vs 2.6%). Incontinent children had significantly more behavioral and externalizing symptoms, children with headache more internalizing problems. Primary headache was a significant predictor for internalizing, while constipation and FI were predictors for externalizing symptoms. Conclusions This population‐based study showed that headache is associated with constipation, but not with incontinence in preschool children. Headache and incontinence are common risk factors for specific psychological symptoms and should be assessed in clinical practice.

Incontinence and sleep disturbances in young children: A population‐based study

“…This low rate might be due to parental apprehension to address psychological problems during the school‐entry examination, as they may fear that this could have an influence on recommendations on the type of schooling. Again, this trend has been apparent in other studies attached to the school‐entry appraisal by community pediatricians 19 . However, parents did report both higher rates of conduct problems and of prosocial behavior than would be expected (again, 10% would reflect norm values at a cut‐off at the 90th percentile).…”

“…This is the first study to analyze the associations between incontinence, behavioral and sleep problems in preschool children. These young children had high rates of incontinence, only slightly higher than other population‐based studies of comparable design and age‐group 19 . Possibly, parents were more open to respond to questions regarding incontinence when also asked about sleep problems, which are stressful for some parents.…”

“…Again, this trend has been apparent in other studies attached to the school‐entry appraisal by community pediatricians. 19 However, parents did report both higher rates of conduct problems and of prosocial behavior than would be expected (again, 10% would reflect norm values at a cut‐off at the 90th percentile). In addition, children with DUI and FI had more behavioral problems, which is in congruence with many other studies showing that children with NE are least affected by psychological symptoms compared to other types of incontinence.…”

“…These young children had high rates of incontinence, only slightly higher than other populationbased studies of comparable design and age-group. 19 Possibly, parents were more open to respond to questions regarding incontinence when also asked about sleep problems, which are stressful for some parents. The rate of total behavioral problems was lower than the norm values of 10%.…”

“…The rate of total behavioral problems was lower than the norm values of 10%. 19 This low rate might be due to parental apprehension to address psychological problems during the school‐entry examination, as they may fear that this could have an influence on recommendations on the type of schooling. Again, this trend has been apparent in other studies attached to the school‐entry appraisal by community pediatricians.…”