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Incontinence in children with treated attention-deficit/hyperactivity disorder.
J Pediatr Urol. 2015 Jun; 11(3):141.e1-6.JP

Abstract

INTRODUCTION

Attention-deficit/hyperactivity disorder (ADHD) and incontinence (nocturnal enuresis, daytime urinary incontinence and fecal incontinence) are common disorders in childhood. Both disorders are strongly associated with each other.

OBJECTIVE

ADHD can affect compliance to incontinence therapy in a negative way; it can also affect outcome. The aim of the present study was to assess the prevalence of incontinence, age of bladder and bowel control, and psychological symptoms in children having treatment for ADHD compared to a control group.

STUDY DESIGN

Forty children having treatment for ADHD (75% boys, mean age 11.4 years) and 43 matched controls (60.5% boys, mean age 10.7 years) were assessed. Their parents filled out questionnaires to assess: child psychopathology (Child Behavior Checklist), incontinence (Parental Questionnaire: Enuresis/Urinary Incontinence; Encopresis Questionnaire - Screening Version) and symptoms of the lower urinary tract (International-Consultation-on-Incontinence-Questionnaire - Pediatric Lower Urinary Tract Symptoms). The ICD-10 diagnoses and children's IQ were measured by standardized instruments (Kinder-DIPS, Coloured Progressive Matrices/Standard Progressive Matrices).

RESULTS

Rates of incontinence in the ADHD group (5% nocturnal enuresis, 5% daytime urinary incontinence, 2.5% fecal incontinence) did not differ significantly from incontinence rates in the control group (4.7% daytime urinary incontinence). More children in the ADHD group had Child Behavior Checklist scores in the clinical range. Further ICD-10 disorders were present in eight children with ADHD and in one control child. More children with ADHD had delayed daytime and nighttime bladder control, as well as delayed bowel control, than the controls.

DISCUSSION

The present study showed that if children are treated for their ADHD, according to standard practice guidelines, incontinence rates are similar to those without ADHD. More children with ADHD reached continence at a later age than the controls, which could be an indicator of maturational deficits in the central nervous system. Additionally, children with ADHD showed higher rates of clinically relevant psychological symptoms.

CONCLUSION

This study provides further information of the association between ADHD and incontinence. Treatment of ADHD may be associated with positive effects on incontinence outcomes. Therefore, children with ADHD should always be screened for incontinence problems and children with incontinence problems should also be screened for ADHD if symptoms of hyperactivity, inattention and/or impulsivity are also present.

Authors+Show Affiliations

Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany. Electronic address: justine.niemczyk@uks.eu.Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany.Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany.Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25863677

Citation

Niemczyk, J, et al. "Incontinence in Children With Treated Attention-deficit/hyperactivity Disorder." Journal of Pediatric Urology, vol. 11, no. 3, 2015, pp. 141.e1-6.
Niemczyk J, Equit M, Hoffmann L, et al. Incontinence in children with treated attention-deficit/hyperactivity disorder. J Pediatr Urol. 2015;11(3):141.e1-6.
Niemczyk, J., Equit, M., Hoffmann, L., & von Gontard, A. (2015). Incontinence in children with treated attention-deficit/hyperactivity disorder. Journal of Pediatric Urology, 11(3), e1-6. https://doi.org/10.1016/j.jpurol.2015.02.009
Niemczyk J, et al. Incontinence in Children With Treated Attention-deficit/hyperactivity Disorder. J Pediatr Urol. 2015;11(3):141.e1-6. PubMed PMID: 25863677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incontinence in children with treated attention-deficit/hyperactivity disorder. AU - Niemczyk,J, AU - Equit,M, AU - Hoffmann,L, AU - von Gontard,A, Y1 - 2015/03/12/ PY - 2014/10/08/received PY - 2015/02/24/accepted PY - 2015/4/13/entrez PY - 2015/4/13/pubmed PY - 2016/3/29/medline KW - Attention-deficit/hyperactivity disorder KW - Daytime urinary incontinence KW - Delayed bladder and bowel control KW - Enuresis KW - Fecal incontinence KW - Functional incontinence SP - 141.e1 EP - 6 JF - Journal of pediatric urology JO - J Pediatr Urol VL - 11 IS - 3 N2 - INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) and incontinence (nocturnal enuresis, daytime urinary incontinence and fecal incontinence) are common disorders in childhood. Both disorders are strongly associated with each other. OBJECTIVE: ADHD can affect compliance to incontinence therapy in a negative way; it can also affect outcome. The aim of the present study was to assess the prevalence of incontinence, age of bladder and bowel control, and psychological symptoms in children having treatment for ADHD compared to a control group. STUDY DESIGN: Forty children having treatment for ADHD (75% boys, mean age 11.4 years) and 43 matched controls (60.5% boys, mean age 10.7 years) were assessed. Their parents filled out questionnaires to assess: child psychopathology (Child Behavior Checklist), incontinence (Parental Questionnaire: Enuresis/Urinary Incontinence; Encopresis Questionnaire - Screening Version) and symptoms of the lower urinary tract (International-Consultation-on-Incontinence-Questionnaire - Pediatric Lower Urinary Tract Symptoms). The ICD-10 diagnoses and children's IQ were measured by standardized instruments (Kinder-DIPS, Coloured Progressive Matrices/Standard Progressive Matrices). RESULTS: Rates of incontinence in the ADHD group (5% nocturnal enuresis, 5% daytime urinary incontinence, 2.5% fecal incontinence) did not differ significantly from incontinence rates in the control group (4.7% daytime urinary incontinence). More children in the ADHD group had Child Behavior Checklist scores in the clinical range. Further ICD-10 disorders were present in eight children with ADHD and in one control child. More children with ADHD had delayed daytime and nighttime bladder control, as well as delayed bowel control, than the controls. DISCUSSION: The present study showed that if children are treated for their ADHD, according to standard practice guidelines, incontinence rates are similar to those without ADHD. More children with ADHD reached continence at a later age than the controls, which could be an indicator of maturational deficits in the central nervous system. Additionally, children with ADHD showed higher rates of clinically relevant psychological symptoms. CONCLUSION: This study provides further information of the association between ADHD and incontinence. Treatment of ADHD may be associated with positive effects on incontinence outcomes. Therefore, children with ADHD should always be screened for incontinence problems and children with incontinence problems should also be screened for ADHD if symptoms of hyperactivity, inattention and/or impulsivity are also present. SN - 1873-4898 UR - https://www.unboundmedicine.com/medline/citation/25863677/Incontinence_in_children_with_treated_attention_deficit/hyperactivity_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-5131(15)00082-0 DB - PRIME DP - Unbound Medicine ER -