Durmaz Onur, Kemer Serkan, Mutluer Tuba, Bütün Elif
Department of Psychiatry, Van Military Hospital, Van, Turkey.
Department of Pediatrics, Van Military Hospital, Van, Turkey.
J Pediatr Urol. 2017 Feb;13(1):62.e1-62.e6. doi: 10.1016/j.jpurol.2016.06.018. Epub 2016 Aug 24.
The etiology of primary nocturnal enuresis (PNE) is not fully understood, but multifactorial factors have been associated with PNE. Parental factors, including attitudes to PNE, disciplinary behaviors, and psychiatric comorbidities in parents have been related to etiology of PNE, outcomes and the quality of life in children with enuresis.
We examined the psychopathology in mothers of children diagnosed with monosymptomatic PNE(MoPNE) compared with mothers of non-enuretic children (MoNEC) in terms of personality characteristics, early traumatic experiences, and psychiatric symptom evaluation.
The study included 44 mothers of children diagnosed with PNE and 45 mothers of non-enuretic children who were randomly selected from the population applying to the pediatric outpatient clinic. Individuals were assessed through psychometric questionnaires, including the Eysenck Personality Questionnaire Revised Abbreviated (EPQR-A), the Symptom Checklist-90 (SCL-90-R), and the Childhood Trauma Questionnaire (CTQ), in addition to a sociodemographic form including 9 structured "yes/no" questions that evaluated intrafamilial relationships, as well as mothers' perceptions of enuresis and its treatment.
The median age of enuretic children was 7 (6, 9.5) (25th, 75th) years in the study population. The rates of history of enuresis in childhood were 26.7% in the MoPNE group (n = 12) and 6.7% in the MoNEC group (n = 3; p = 0.011). There were significant differences between the groups for the subscales of somatization, anxiety, obsessive-compulsive behavior, depression, interpersonal sensitivity, psychoticism, hostility, phobic anxiety, additional items, and the general psychopathology index in the SCL-90-R scores (p < 0.05). Meanwhile, there was no significant difference for the subscale of paranoid ideation (p = 0.070). There were statistically significant results for the subscales of sexual abuse, physical neglect, and total score in CTQ scale, while the personality dimensions evaluated using the EPQR-A resulted in significant differences in the E and L subscales (p < 0.05) (Table).
Our study showed that psychiatric symptomatology and childhood traumatic experiences were considerably higher in mothers of children with PNE. This study highlights the importance of evaluating PNE not only from a biological aspect, but also in terms of psychosocial factors, including assessment of the mother's mental status.
原发性夜间遗尿症（PNE）的病因尚未完全明确，但多种因素与之相关。父母因素，包括对PNE的态度、管教行为以及父母的精神共病，都与PNE的病因、结局以及遗尿症患儿的生活质量有关。
我们比较了诊断为单纯性夜间遗尿症（MoPNE）患儿的母亲与非遗尿症患儿的母亲（MoNEC）在人格特征、早期创伤经历和精神症状评估方面的精神病理学情况。
该研究纳入了44名诊断为PNE患儿的母亲和45名非遗尿症患儿的母亲，这些母亲是从前往儿科门诊就诊的人群中随机选取的。除了一份包含9个结构化“是/否”问题的社会人口学表格，评估家庭内部关系以及母亲对遗尿症及其治疗的看法外，还通过心理测量问卷对个体进行评估，这些问卷包括艾森克人格问卷修订简版（EPQR - A）、症状自评量表90（SCL - 90 - R）和儿童创伤问卷（CTQ）。
研究人群中遗尿症患儿的中位年龄为7（6，9.5）（第25百分位数，第75百分位数）岁。MoPNE组（n = 12）儿童期遗尿症病史发生率为26.7%，MoNEC组（n = 3）为6.7%（p = 0.011）。SCL - 90 - R评分中，两组在躯体化、焦虑、强迫行为、抑郁、人际敏感、精神病性、敌对、恐惧焦虑、附加项目以及总体精神病理学指数等分量表上存在显著差异（p < 0.05）。同时，偏执观念分量表无显著差异（p = 0.070）。CTQ量表中的性虐待、身体忽视分量表及总分有统计学显著结果，而使用EPQR - A评估的人格维度在E和L分量表上有显著差异（p < 0.05）（表）。
我们的研究表明，PNE患儿母亲的精神症状和童年创伤经历明显更高。本研究强调了评估PNE不仅要从生物学角度，还要从心理社会因素方面进行，包括评估母亲的精神状态。
