Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.
Neurourol Urodyn. 2020 Sep;39(7):1985-1993. doi: 10.1002/nau.24451. Epub 2020 Jul 20.
Children with nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are at risk for behavioral problems, overweight, and obesity. The aim of this study was to analyze the specific behavioral and weight comorbidity in subtypes of incontinence.
A total of 1638 consecutive patients presented to a tertiary incontinence clinic from 2012 to 2018 was examined prospectively according to ICCS criteria. Behavioral symptoms were measured with the Child Behavior Checklist (CBCL). Psychiatric disorders were diagnosed according to ICD-10 criteria. Weight categories were calculated according to WHO recommendations.
The mean age was 7.8 years, 67% of patients were male. Fifty-seven percent had NE (n = 934), 33% DUI (n = 547), and 40% FI (n = 656). Boys had significantly higher rates of NE and FI than girls. Of all children, 39.2% (n = 539) had a clinically relevant CBCL total score. A total of 28.3% (n = 463) had an ICD-10 psychiatric diagnosis, mainly ODD and ADHD, and 28.6% (n = 463) were overweight or obese. Boys were more often affected by behavioral symptoms, psychiatric disorders, and overweight/obesity. Children with NE had the highest rate of overweight/obesity. Except for primary nonmonosymptomatic NE, subtypes of incontinence did not differ regarding behavioral symptoms and weight categories. However, overweight/obesity was significantly associated with behavioral and psychiatric parameters.
Behavioral symptoms and psychiatric disorders, as well as overweight/obesity are important risk factors associated with incontinence, but the interaction between these factors is complex. In clinical settings, all children with incontinence should be screened with behavioral questionnaires. Also, weight should be measured, and overweight/obesity should be addressed.
患有夜间遗尿症（NE）、日间尿失禁（DUI）和粪便失禁（FI）的儿童存在行为问题、超重和肥胖的风险。本研究的目的是分析失禁亚型中特定的行为和体重共病。
2012 年至 2018 年，共有 1638 例连续患者按照 ICCS 标准前瞻性检查，他们在一家三级失禁诊所就诊。使用儿童行为检查表（CBCL）测量行为症状。根据 ICD-10 标准诊断精神障碍。根据世界卫生组织的建议计算体重类别。
平均年龄为 7.8 岁，67%的患者为男性。57%的患者患有 NE（n=934），33%的患者患有 DUI（n=547），40%的患者患有 FI（n=656）。男孩的 NE 和 FI 发生率明显高于女孩。在所有儿童中，39.2%（n=539）有临床相关的 CBCL 总分。共有 28.3%（n=463）患有 ICD-10 精神障碍诊断，主要是 ODD 和 ADHD，28.6%（n=463）超重或肥胖。男孩更容易出现行为症状、精神障碍和超重/肥胖。患有 NE 的儿童超重/肥胖的发生率最高。除原发性非单一症状性 NE 外，不同类型的失禁在行为症状和体重类别方面没有差异。然而，超重/肥胖与行为和精神参数显著相关。
行为症状和精神障碍以及超重/肥胖是与失禁相关的重要危险因素，但这些因素之间的相互作用很复杂。在临床环境中，所有患有失禁的儿童都应使用行为问卷进行筛查。此外，还应测量体重，并解决超重/肥胖问题。
