Daytime and Nighttime Enuresis: a Functional Disorder and Its Ethological Decoding

Abstract

AbstractIn wetting children (functional enuresis nocturna and diurna) days and nights with perfect bladder control alternate with wet days and nights. Changes of behaviourial regulation are responsible for the temporary disfunction of bladder control when awake or asleep. By means of long-term behaviour observations of wetting children in their families and in kindergarten we succeeded in isolating different forms of wetting. Wetting during zealous play, referred to as enuresis diurna type A, occurs when the bladder is filled during an intensive play activity. Wetting due to conflict (enuresis diurna type B) as well as nighttime wetting (enuresis nocturna) occur independently of the filling of the bladder, but directly depending on preceding stressful events. Step by step the information from the behaviour observations are incorporated into the functional diagram of the regulation of micturition until the elements of the faulty regulation in functional enuresis can be demonstrated. In the wetting child the need for loving attention has become the signal for the micturition. This learned association is the pathological part within the behaviour regulation. Functional enuresis is an example for a modification of biologically adaptive behaviourial elements by unfavourable environmental conditions.