Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children

Abstract

Externalizing disorders as attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are common in children with nocturnal enuresis (NE), daytime urinary incontinence (DUI) and faecal incontinence (FI). We examined the prevalence rates of ADHD, ODD and incontinence in a defined geographical area and analysed the association between externalizing disorders and subtypes of incontinence. 1,676 parents of children who were presented at the mandatory school-entry medical examination completed a questionnaire with all DSM-IV items of ADHD, ODD and six questions regarding incontinence. 50.2% were male and mean age was 5.7 years. 9.1% had at least one subtype of incontinence (8.5% had NE, 1.9% DUI and 0.8% FI). Boys were significantly more affected by incontinence overall, NE, FI and ADHD than girls. 6.4% had ADHD, 6.2% had ODD and 2.6% were affected by ADHD and ODD. 10.3% of the children with incontinence had ADHD and 10.3% ODD. Children with FI were significantly more affected by externalizing disorders (50%) than children with isolated NE (14.5%), children with DUI (9.5%) and continent children (9.5%). Children with incontinence, especially those with FI, are at much higher risk of externalizing disorders. An additional effect of children with both ADHD and ODD having higher rates of incontinence than children with only one disorder could not be found. However, these children represent a high-risk group with lower compliance to treatment and worse outcome. Therefore, screening not only for ADHD but also for ODD should be implemented for all children with incontinence.

Prevalence of lower urinary tract symptoms in children and adolescents diagnosed with attention deficit hyperactivity disorder

“…Sintomas de TDO são mais comuns em crianças com IU diurna. 13,27 Em concordância com a literatura, o presente estudo constatou que as crianças que apresentavam associação de TDO e TDAH tinham taxa maior de IU diurna isolada ou com enurese. Como o comportamento opositor está presente na maioria das situações diárias e afeta a vida familiar, Von Gontard et al 13 reportaram que estudos longitudinais são necessários para uma possível análise de associação causal e possíveis fatores de risco entre sintomas de TDO e tipos específicos de incontinência (IU diurna com micções infrequentes).…”

Sex Differences in the Prevalence of Oppositional Defiant Disorder During Middle Childhood: a Meta-Analysis

“…This is an important investigation for several reasons. First, much of the published literature reports no statistically significant sex difference in ODD prevalence (e.g., Angold et al 2002;Cohen et al 1993;Leung et al 2008;López-Villalobos et al 2014;Mishra et al 2014;Niemczyk et al 2014;Park et al 2014;Simonoff et al 1997), thus clarity on whether one exists is needed. Second, confirming the male:female prevalence ratio of ODD invites speculation about, and offers potential avenues for, research into the aetiology and maintenance of the disorder (Aleman et al 2003;Zahn-Waxler et al 2008).…”

Mental disorders in children and adolescents with lower urinary tract dysfunction

“…Understanding this pathophysiological correlation and the importance of treating psychiatric comorbidities are key steps lower urinary tract dysfunction: 56% of the children postponing voiding had clinical-range scores in the CBCL versus 24% of the children with urinary incontinence. 15 In a group of preschoolers, Niemczyk et al 19 saw externalizing disorders in 14.5% of the individuals with monosymptomatic nocturnal enuresis, whereas children with diurnal incontinence and continent children had similar prevalence rates (9.5%).…”