A follow-up of enuresis from childhood to adolescence.

Abstract

To determine the prevalence and treatment of enuresis in a national population-based follow-up study of children aged 8-14 years, to evaluate possible factors that enhance or hamper the attainment of continence and to examine the relationships between enuresis and psychiatric disturbance. An initial study was carried out in 1989 as part of the Finnish Child Psychiatric National Epidemiological Study. Three types of questionnaires were used; the Rutter Scale A for completion by parents, including a question about enuresis, the Rutter scale B for completion by teachers and the Children's Depression Inventory (CDI), completed by the children. Parents were also asked about demographic and family issues, teachers about school achievements and children about additional psychosomatic symptoms. In a follow-up in 1995, the target population comprised all previous enuretics and their controls, matched by age, gender, class and school, in the first phase of the study. Replies were received from 315 enuretic boys and 186 girls, with the corresponding values for controls being 310 and 183. The parents were asked about the adolescents' present enuresis and for permission for a treatment trial, if needed. The adolescents completed the CDI, and a questionnaire about enuresis, previous treatments and possible willingness for a treatment trial. They also reported basic somatic data, their life events and living habits. In the initial study, the enuretic children had higher total and subscores as reported by parents, teachers and themselves, except for emotional items reported by the teachers. Additionally, a significantly greater proportion of these children soiled, had sleeping difficulties and difficulties in falling asleep. Enuretic boys had more frequent nightly arousal and early morning waking, while the enuretic girls had more nightmares than non-enuretic girls. At 14 years old, the parents reported that 13 adolescents were enuretic; from the children's replies, nine boys and seven girls were enuretic. The prevalence of enuresis in those previously enuretic was surprisingly low, probably because of the efficient treatment methods, conditioning and medication. There were evident connections between childhood enuresis and mental well-being.