[Psychological and psychiatric aspects of nocturnal enuresis and functional urinary incontinence].Urologe A. 2004 Jul; 43(7):787-94.U
Psychological factors play an important role in nocturnal enuresis and functional urinary incontinence. The comorbidity of enuresis/urinary incontinence and clinical mental disorders as well as subclinical psychological symptoms is reviewed. In epidemiological as well as clinical studies, 20-40% of all children with nocturnal enuresis have a manifest clinical disorder-two to four times higher than nonwetting children. Children with secondary nocturnal enuresis and voiding postponement carry the highest risk for a mental disorder and those with urge incontinence and primary monosymptomatic nocturnal enuresis the lowest.Internalizing disorders (such as depressive and anxiety disorders) are less common than externalizing ones (such as ADHD). In addition, subclinical emotional and behavioral symptoms are common. These will often recede upon attaining dryness and self-esteem can increase. General screening for psychological symptoms and disturbances is recommended.