Nocturnal enuresis and behavioral problems in adolescence: a 15-year longitudinal study

Abstract

Objective: This study examines the relationships between nocturnal enuresis in childhood and measures of behavioral adjustment in adolescence using data collected during the course of a 15-year longitudinal study of a birth cohort of New Zealand children.

Method: Data was collected on patterns of nocturnal bladder control at annual intervals to the age of 13 years. At ages 11, 13, and 15 years measures of conduct problems, attention deficit behaviors, and anxiety/withdrawal were gathered.

Results: The analysis showed that children who were bed-wetting after the age of 10 years as a result of either primary or secondary enuresis had increased rates of behavioral problems up to the age of 15 years with these children having mean behavior scores that were between .30 to .65 standard deviations higher than children who ceased bed-wetting before the age of 5 years. Regression analysis indicated that these associations were largely spurious and arose because the age of cessation of bedwetting was correlated with a series of factors (gender, social maturity, childhood IQ, family social background, family stress, and parental conflict) that were also associated with increased rates of adolescent behavior problems. However, even after adjusting for these factors, children who were bed-wetting after the age of 10 years showed slight increases in rates of conduct problems and attention deficit behaviors up to the age of 13 years and increases rates of anxiety/withdrawal up to the age of 15 years.

Conclusions: It is concluded that bed-wetting after the age of 10 years is associated with small but detectable increases in risks of conduct problems, attention deficit behaviors, and anxiety/withdrawal in early adolescence. These results show that although it is not the case that children showing nocturnal enuresis are at markedly increased risks of serious psychiatric problems, it may be prudent to determine the extent to which children who are bed-wetting after the age of 10 years show increases in anxious or problem behaviors.