de Carvalho Mrad Flávia Cristina, da Silva Gabriel Sesana, de Souza Rodrigues Geyce Kelly, Bastos Netto José Murillo, Lima Eleonora Moreira, Carvalho Tânia Antunes, Dutra Melissa Faria, de Bessa Junior José, de Almeida Vasconcelos Mônica Maria
Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil.
Universidade Federal de Juiz de Fora, School of Medicine, Urology Department, Brazil; Faculdade de Ciências Médicas de Juiz de Fora e Maternidade Therezinha de Jesus, Urology Department, Brazil.
J Pediatr Urol. 2022 Jun;18(3):350.e1-350.e6. doi: 10.1016/j.jpurol.2022.02.003. Epub 2022 Feb 12.
Enuresis prevalence is approximately 5-15% in children aged 6-7 years. The presence of attention deficit hyperactivity disorder (ADHD) in enuretic children is associated with 3 times greater risk of persistent enuresis. The Multimodal Treatment Study for ADHD (MTA) Swanson, Nolan, and Pelham version IV (SNAP-IV) is one of the most used instruments to evaluate ADHD symptoms, but it is a time-consuming questionnaire.
This study aims to compare the accuracy of an easy questionnaire named Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) to MTA-SNAP-IV in identifying ADHD symptoms in children and adolescents with enuresis.
ADHD symptoms screening was performed by applying SSIPPE and MTA-SNAP-IV in 160 children and adolescents with enuresis, aged 6-14 years, who regularly attended a specialized clinic for pediatric urology.
A total of 153 individuals with enuresis were included in the study (52% males), among them 55 (35.9%) were considered positive for inattention and hyperactivity-impulsivity by the MTA-SNAP-IV. Sensitivity for SSIPPE concerning MTA-SNAP-IV was 85.5%, and specificity was 84.7%, with an overall accuracy of 85% in identifying ADHD symptoms.
In the present study, we found high accuracy of SSIPPE in relation to MTA-SNAP-IV in identifying ADHD symptoms in the enuretic population, with substantial agreement between instruments. Its sensitivity and specificity were considered high for a screening method. However, there are some limitations. The population studied is composed of a group of children with enuresis, which can lead to an overestimation of the test's accuracy, as the disorder under investigation is more prevalent in this population. This can be explained by the high specificity of the test (84.7%) associated with the fact that the SSIPPE is an instrument tailored for an enuretic population, unlike the MTA-SNAP IV.
The SSIPPE has proven to be a reliable tool in identifying ADHD symptoms in the enuretic population. In addition to being a quick and easily applicable instrument.
6 - 7岁儿童的遗尿症患病率约为5% - 15%。遗尿儿童中存在注意力缺陷多动障碍（ADHD）会使持续性遗尿的风险增加两倍。多动症多模式治疗研究（MTA）斯旺森、诺兰和佩勒姆第四版（SNAP - IV）是评估ADHD症状最常用的工具之一，但它是一份耗时的问卷。
本研究旨在比较一份名为遗尿症心理问题简易筛查工具（SSIPPE）的简易问卷与MTA - SNAP - IV在识别遗尿症儿童和青少年ADHD症状方面的准确性。
对160名6 - 14岁、定期到儿科泌尿科专科门诊就诊的遗尿症儿童和青少年应用SSIPPE和MTA - SNAP - IV进行ADHD症状筛查。
本研究共纳入153名遗尿症患者（52%为男性），其中55名（35.9%）被MTA - SNAP - IV判定为注意力不集中和多动 - 冲动阳性。SSIPPE相对于MTA - SNAP - IV的敏感性为85.5%，特异性为84.7%，在识别ADHD症状方面的总体准确率为85%。
在本研究中，我们发现SSIPPE在识别遗尿症人群的ADHD症状方面相对于MTA - SNAP - IV具有较高的准确性，两种工具之间存在高度一致性。作为一种筛查方法，其敏感性和特异性被认为较高。然而，存在一些局限性。所研究的人群由一组遗尿症儿童组成，这可能导致对测试准确性的高估，因为所研究的疾病在该人群中更为普遍。这可以通过测试的高特异性（84.7%）以及SSIPPE是专门为遗尿症人群量身定制的工具这一事实来解释，这与MTA - SNAP - IV不同。
SSIPPE已被证明是识别遗尿症人群ADHD症状的可靠工具。此外，它还是一种快速且易于应用的工具。
