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. 2021 Jan:104:152208.
doi: 10.1016/j.comppsych.2020.152208. Epub 2020 Sep 30.

Behavioral problems in children with primary monosymptomatic nocturnal enuresis

Sherifa Ahmed Hamed  1 , Mohamed Fawzy  2 , Enas Ahmed Hamed  3
Affiliations
Free article

Behavioral problems in children with primary monosymptomatic nocturnal enuresis

Sherifa Ahmed Hamed et al. Compr Psychiatry. 2021 Jan.
Free article

Abstract

Background and objectives: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: Behavior; Children; Primary monosymptomatic nocturnal enuresis (PMNE); Strength and Difficulties Questionnaire (SDQ).

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Conflict of interest statement

Declaration of Competing Interest All authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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