Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
Compr Psychiatry. 2021 Jan;104:152208. doi: 10.1016/j.comppsych.2020.152208. Epub 2020 Sep 30.
Primary monosymptomatic nocturnal enuresis (PMNE) is a common distressing condition to children and parents. This study aimed to determine frequencies, severities and characteristics of behavioral problems with PMNE.
This cross-sectional study included 80 children with PMNE (age: 12.58 ± 1.24 yrs.; boys = 58, girls = 22) and 60 healthy children. Behavioral symptoms were assessed by Strength and Difficulties Questionnaire (SDQ).
This study included 80 children (boys/girls ratio = 2.64:1) with PMNE. They had mean age of 12.58 ± 1.24 yrs. The majority (70%) had good response to medical treatment. Compared to controls, children with enuresis had higher frequencies of emotional, conduct and hyperactivity-inattention symptoms and peer relationship and prosocial problems and higher total (P = 0.001) and different subscales' scores of SDQ. There was an overlap of behavioral problems in 52.2% of children with nocturnal enuresis. Compared to children without behavioral symptoms, children with behavioral symptoms were significantly older at age at presentation (P = 0.046) regardless of gender, residence and type or response to medications. Multiple regression analysis showed that emotional [β = 0.053 (95%CI = 0.037-0.084), P = 0.024] and hyperactivity-inattention symptoms [β = 0.063 (95%CI = 0.028-0.097), P = 0.001] were significantly associated with enuresis independent to other problems.
PMNE is associated with higher risk of behavioral problems particularly emotional and hyperactivity-inattention symptoms indicating externalizing and internalizing problems, therefore, the importance of early non-pharmacological or/and drug interventions. The comorbid behavioral disorders should be treated separately according to evidence-based recommendations to prevent persistence of enuresis and the development of psychiatric disorders in the future.
原发性单症状性夜遗尿（PMNE）是一种常见的令儿童和家长苦恼的疾病。本研究旨在确定 PMNE 患儿的行为问题的发生频率、严重程度和特征。
本横断面研究纳入了 80 例 PMNE 患儿（年龄：12.58±1.24 岁；男 58 例，女 22 例）和 60 例健康儿童。采用长处和困难问卷（SDQ）评估行为症状。
本研究纳入了 80 例（男/女比例=2.64:1）PMNE 患儿。他们的平均年龄为 12.58±1.24 岁。大多数（70%）患儿对药物治疗有良好反应。与对照组相比，遗尿患儿的情绪、品行和多动/注意缺陷症状以及同伴关系和亲社会问题的发生率更高，SDQ 的总分（P=0.001）和不同分量表的评分也更高。52.2%的遗尿患儿存在行为问题重叠。与无行为症状的患儿相比，有行为症状的患儿无论性别、居住地和药物类型或反应如何，在就诊时的年龄均显著更大（P=0.046）。多元回归分析显示，情绪[β=0.053（95%CI：0.037-0.084），P=0.024]和多动/注意缺陷症状[β=0.063（95%CI：0.028-0.097），P=0.001]与遗尿独立相关，而与其他问题无关。
PMNE 与行为问题风险增加相关，尤其是情绪和多动/注意缺陷症状，表明存在外向和内向问题，因此需要早期进行非药物或/和药物干预。根据循证建议，应分别治疗共患的行为障碍，以防止遗尿持续存在和未来精神障碍的发展。
