Yousefichaijan Parsa, Khosrobeigi Ali, Salehi Bahman, Taherahmadi Hassan, Shariatmadari Fakhreddin, Ghandi Yazdan, Alinejad Saeed, Farhadiruzbahani Fateme
Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
Department of Student Research Committee, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
J Pediatr Neurosci. 2016 Jul-Sep;11(3):197-199. doi: 10.4103/1817-1745.193371.
Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive-compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE).
In this case-control study, we evaluated 186 children aged 6-17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1-3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale.
The difference in compulsion was significant ( = 0.021), whereas the difference in obsession was significant between the two groups ( = 0.013). The most common symptom in CKD children with compulsion was silent repetition of words.
Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE.
遗尿症的定义为，年龄至少5岁的儿童每周至少两次将尿液反复排到衣服或床上，且持续至少3个月。该行为并非仅由某种物质的直接生理效应或一般躯体疾病所致。日间遗尿指白天尿床，而清醒及夜间遗尿指睡眠期间排尿。原发性遗尿发生于从未整夜持续干爽的儿童，继发性遗尿指在至少6个月干爽后再次出现尿床。单纯症状性遗尿无相关日间症状，而非单纯症状性遗尿（更常见）通常至少有一项轻微的日间症状。单纯症状性遗尿很少与显著的潜在器质性异常相关。强迫症（OCD）是一种慢性致残性疾病，其特征为患者几乎无法控制的重复性仪式化行为。本研究的目的是调查强迫症与非单纯症状性夜间遗尿（NMNE）之间的关系。
在这项病例对照研究中，我们评估了在伊朗阿拉克阿米尔卡比尔医院儿科门诊就诊的186名6 - 17岁儿童。对照组包括93名健康儿童，病例组包括93名年龄和性别匹配的1 - 3期慢性肾脏病（CKD）儿童。然后，使用儿童耶鲁-布朗强迫症量表评估儿童的行为状态。
两组之间强迫症状的差异具有显著性（P = 0.021），而强迫观念的差异也具有显著性（P = 0.013）。CKD患儿中最常见的强迫症状是默默重复词语。
与健康儿童相比，强迫观念和强迫行为在NMNE患儿中更常见。观察到的强迫观念与NMNE之间的相关性使得对NMNE患儿进行心理咨询成为必要。
