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Specific behavioral comorbidity in a large sample of children with functional incontinence: Report of 1,001 cases.
Neurourol Urodyn. 2015 Nov; 34(8):763-8.NU

Abstract

AIMS

Psychological comorbidity among children with functional incontinence is high: 20-30% of children with nocturnal enuresis (NE), 20-40% of those with daytime urinary incontinence (DUI) and 30-50% of those with fecal incontinence (FI) have clinically relevant comorbid disorders. The aim of this study was to analyze specific comorbid behavioral symptoms for different subtypes of incontinence in a large group of children.

METHODS

All 1,001 consecutive children and adolescents (67.5% boys) with a mean age of 8.5 years presented at a tertiary outpatient department between 2004 and 2011 were examined with a full pediatric and child psychiatric assessment. Prevalence of different subforms of incontinence and associated behavioral symptoms were analyzed. The internalizing, externalizing, and total problem scores of the Child Behavior Checklist (CBCL) were evaluated.

RESULTS

Of all children, 70.1% (702 children) had NE, 36.1% (361 children) had DUI, and 36.8% (368 children) were affected by FI. More than 43% of all children had clinically relevant psychological symptoms (CBCL total score, cut-off at 90th percentile). Children with non-retentive FI had highest rates of clinically relevant psychological symptoms (58.8%). Children with combined subtypes of incontinence (any combination of NE, DUI, and FI) were more affected by psychological comorbidities than children with isolated subtypes (NE or DUI or FI).

CONCLUSIONS

Children with incontinence have high rates of comorbid behavioral symptoms-three to six times higher than norms. Especially children with FI and combined subtypes of incontinence were affected. As behavioral symptoms and disorders will interfere with incontinence treatment, a general screening is recommended.

Authors+Show Affiliations

Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25111368

Citation

von Gontard, Alexander, et al. "Specific Behavioral Comorbidity in a Large Sample of Children With Functional Incontinence: Report of 1,001 Cases." Neurourology and Urodynamics, vol. 34, no. 8, 2015, pp. 763-8.
von Gontard A, Niemczyk J, Weber M, et al. Specific behavioral comorbidity in a large sample of children with functional incontinence: Report of 1,001 cases. Neurourol Urodyn. 2015;34(8):763-8.
von Gontard, A., Niemczyk, J., Weber, M., & Equit, M. (2015). Specific behavioral comorbidity in a large sample of children with functional incontinence: Report of 1,001 cases. Neurourology and Urodynamics, 34(8), 763-8. https://doi.org/10.1002/nau.22651
von Gontard A, et al. Specific Behavioral Comorbidity in a Large Sample of Children With Functional Incontinence: Report of 1,001 Cases. Neurourol Urodyn. 2015;34(8):763-8. PubMed PMID: 25111368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Specific behavioral comorbidity in a large sample of children with functional incontinence: Report of 1,001 cases. AU - von Gontard,Alexander, AU - Niemczyk,Justine, AU - Weber,Michaela, AU - Equit,Monika, Y1 - 2014/08/11/ PY - 2014/02/24/received PY - 2014/06/03/accepted PY - 2014/8/12/entrez PY - 2014/8/12/pubmed PY - 2016/8/4/medline KW - Child Behavior Checklist KW - behavioral comorbidity KW - children KW - constipation KW - daytime urinary incontinence KW - fecal incontinence KW - nocturnal enuresis KW - non-retentive fecal incontinence KW - urge incontinence KW - voiding postponement SP - 763 EP - 8 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 34 IS - 8 N2 - AIMS: Psychological comorbidity among children with functional incontinence is high: 20-30% of children with nocturnal enuresis (NE), 20-40% of those with daytime urinary incontinence (DUI) and 30-50% of those with fecal incontinence (FI) have clinically relevant comorbid disorders. The aim of this study was to analyze specific comorbid behavioral symptoms for different subtypes of incontinence in a large group of children. METHODS: All 1,001 consecutive children and adolescents (67.5% boys) with a mean age of 8.5 years presented at a tertiary outpatient department between 2004 and 2011 were examined with a full pediatric and child psychiatric assessment. Prevalence of different subforms of incontinence and associated behavioral symptoms were analyzed. The internalizing, externalizing, and total problem scores of the Child Behavior Checklist (CBCL) were evaluated. RESULTS: Of all children, 70.1% (702 children) had NE, 36.1% (361 children) had DUI, and 36.8% (368 children) were affected by FI. More than 43% of all children had clinically relevant psychological symptoms (CBCL total score, cut-off at 90th percentile). Children with non-retentive FI had highest rates of clinically relevant psychological symptoms (58.8%). Children with combined subtypes of incontinence (any combination of NE, DUI, and FI) were more affected by psychological comorbidities than children with isolated subtypes (NE or DUI or FI). CONCLUSIONS: Children with incontinence have high rates of comorbid behavioral symptoms-three to six times higher than norms. Especially children with FI and combined subtypes of incontinence were affected. As behavioral symptoms and disorders will interfere with incontinence treatment, a general screening is recommended. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/25111368/Specific_behavioral_comorbidity_in_a_large_sample_of_children_with_functional_incontinence:_Report_of_1001_cases_ DB - PRIME DP - Unbound Medicine ER -