Duel Barry P, Steinberg-Epstein Robin, Hill Maryann, Lerner Marc
Antoci Center for Pediatric Urology and Nephrology, UC Irvine Medical Center, University of California, Irvine, Orange, 92868, USA.
J Urol. 2003 Oct;170(4 Pt 2):1521-3; discussion 1523-4. doi: 10.1097/01.ju.0000091219.46560.7b.
Physicians treating attention deficit-hyperactivity disorder (ADHD) have long had the clinical impression that these children suffer disproportionately from voiding dysfunction and incontinence. However, no data exist to confirm this suspicion. In an attempt to investigate this clinical finding, we administered a survey asking about any functional bladder symptoms to a group of children with ADHD and a control group without ADHD.
The Dysfunctional Voiding Symptom Survey (DVSS) was administered to a group of children being treated for rigorously diagnosed ADHD and a control group without ADHD. The DVSS consists of 10 questions that assess daytime incontinence, nocturnal enuresis, constipation, urgency, voiding frequency and dysuria, each scored from 0 to 4 (0-never, 1-almost never, 2-less than half the time, 3-about half the time, 4-almost every time) for a maximum total score of 40 (severest symptoms). Scores for patients and controls were compared for each question and in aggregate. Boys and girls underwent separate statistical analysis. An additional eleventh question assesses recent stressful events within the family.
The patient group included 23 boys and 5 girls, and the control group 10 boys and 12 girls. Children with ADHD of both sexes had statistically significant higher overall DVSS scores. Boys had significant differences on several questions. Due to the small number of girls, there were no statistically significant differences on individual questions.
Children with ADHD have significantly higher rates of incontinence, constipation, urgency, infrequent voiding, nocturnal enuresis and dysuria than those without ADHD. Further study is needed to discern the cause of this difference and develop appropriate treatment strategies.
长期以来，治疗注意力缺陷多动障碍（ADHD）的医生在临床上一直认为，这些儿童排尿功能障碍和尿失禁的情况格外严重。然而，尚无数据证实这一怀疑。为了调查这一临床发现，我们对一组患有ADHD的儿童和一组未患ADHD的对照组儿童进行了一项关于膀胱功能症状的调查。
对一组经严格诊断为ADHD正在接受治疗的儿童和一组未患ADHD的对照组儿童进行功能性排尿症状调查（DVSS）。DVSS由10个问题组成，评估白天尿失禁、夜间遗尿、便秘、尿急、排尿频率和排尿困难，每个问题的评分从0到4（0 - 从不，1 - 几乎从不，2 - 少于一半时间，3 - 大约一半时间，4 - 几乎每次），总得分最高为40分（最严重症状）。对患者和对照组每个问题的得分以及总分进行比较。男孩和女孩分别进行统计分析。另外第十一个问题评估家庭中近期的应激事件。
患者组包括23名男孩和5名女孩，对照组包括10名男孩和12名女孩。患有ADHD的男女儿童的DVSS总分在统计学上显著更高。男孩在几个问题上有显著差异。由于女孩数量较少，个别问题上没有统计学上的显著差异。
与未患ADHD的儿童相比，患有ADHD的儿童尿失禁、便秘、尿急、排尿不频繁、夜间遗尿和排尿困难的发生率显著更高。需要进一步研究以查明这种差异的原因并制定适当的治疗策略。
