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Psychological and psychiatric issues in urinary and fecal incontinence.
J Urol. 2011 Apr; 185(4):1432-6.JU

Abstract

PURPOSE

We provide an overview of the psychological and psychiatric aspects of nocturnal enuresis, urinary and fecal incontinence. Clinical behavioral disorders and subclinical psychological symptoms are reviewed. Aspects of screening, assessment, counseling and in severe cases treatment are outlined, and recommendations are formulated.

MATERIALS AND METHODS

Relevant publications on psychological and psychiatric aspects are reviewed. The recommendations passed several rounds of consensus finding, and were circulated among International Children's Continence Society members and external experts.

RESULTS

In addition to subclinical effects on self-esteem, quality of life and distress, the rate of comorbid clinical behavioral disorders is increased. In fact, 20% to 30% of children with nocturnal enuresis, 20% to 40% with daytime urinary incontinence and 30% to 50% with fecal incontinence fulfill the criteria for ICD-10 or Diagnostic and Statistical Manual of Mental Disorders IV psychiatric disorders. These concomitant disturbances require assessment and counseling, and in severe cases treatment. They have a negative effect on compliance and outcome if not addressed and left untreated.

CONCLUSIONS

Because the comorbidity rate is high, screening for psychological symptoms is recommended for all children in all settings with enuresis and/or daytime urinary and/or fecal incontinence. Standardized, validated questionnaires are recommended. In addition to clinical observation and history, a short screening questionnaire can be used as a first step. If problem behaviors are present a longer broadband questionnaire is recommended. If problem items in the clinical range are noted, a full child psychiatric or psychological assessment is recommended.

Authors+Show Affiliations

Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany. alexander.von.gontard@uks.euNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21349549

Citation

von Gontard, Alexander, et al. "Psychological and Psychiatric Issues in Urinary and Fecal Incontinence." The Journal of Urology, vol. 185, no. 4, 2011, pp. 1432-6.
von Gontard A, Baeyens D, Van Hoecke E, et al. Psychological and psychiatric issues in urinary and fecal incontinence. J Urol. 2011;185(4):1432-6.
von Gontard, A., Baeyens, D., Van Hoecke, E., Warzak, W. J., & Bachmann, C. (2011). Psychological and psychiatric issues in urinary and fecal incontinence. The Journal of Urology, 185(4), 1432-6. https://doi.org/10.1016/j.juro.2010.11.051
von Gontard A, et al. Psychological and Psychiatric Issues in Urinary and Fecal Incontinence. J Urol. 2011;185(4):1432-6. PubMed PMID: 21349549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychological and psychiatric issues in urinary and fecal incontinence. AU - von Gontard,Alexander, AU - Baeyens,Dieter, AU - Van Hoecke,Eline, AU - Warzak,William J, AU - Bachmann,Christian, Y1 - 2011/02/23/ PY - 2010/08/11/received PY - 2011/2/26/entrez PY - 2011/2/26/pubmed PY - 2011/5/27/medline SP - 1432 EP - 6 JF - The Journal of urology JO - J Urol VL - 185 IS - 4 N2 - PURPOSE: We provide an overview of the psychological and psychiatric aspects of nocturnal enuresis, urinary and fecal incontinence. Clinical behavioral disorders and subclinical psychological symptoms are reviewed. Aspects of screening, assessment, counseling and in severe cases treatment are outlined, and recommendations are formulated. MATERIALS AND METHODS: Relevant publications on psychological and psychiatric aspects are reviewed. The recommendations passed several rounds of consensus finding, and were circulated among International Children's Continence Society members and external experts. RESULTS: In addition to subclinical effects on self-esteem, quality of life and distress, the rate of comorbid clinical behavioral disorders is increased. In fact, 20% to 30% of children with nocturnal enuresis, 20% to 40% with daytime urinary incontinence and 30% to 50% with fecal incontinence fulfill the criteria for ICD-10 or Diagnostic and Statistical Manual of Mental Disorders IV psychiatric disorders. These concomitant disturbances require assessment and counseling, and in severe cases treatment. They have a negative effect on compliance and outcome if not addressed and left untreated. CONCLUSIONS: Because the comorbidity rate is high, screening for psychological symptoms is recommended for all children in all settings with enuresis and/or daytime urinary and/or fecal incontinence. Standardized, validated questionnaires are recommended. In addition to clinical observation and history, a short screening questionnaire can be used as a first step. If problem behaviors are present a longer broadband questionnaire is recommended. If problem items in the clinical range are noted, a full child psychiatric or psychological assessment is recommended. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/21349549/Psychological_and_psychiatric_issues_in_urinary_and_fecal_incontinence_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2010.11.051?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -