Abstract
ABSTRACT Highly controlled randomized controlled trials (RCT) have provided considerable evidence for the efficacy of standard urotherapy (SU) consisting of cognitive-behavioral therapy (CBT) in patients with enuresis. However, the effectiveness of CBT under routine care conditions regarding wetting frequency and comorbid mental health problems has not been shown. Changes under routine CBT were analyzed in a sample of n = 220 clinically referred children and adolescents with enuresis (88.2% with at least one comorbid mental disorder) aged 6 to 18 years (M = 9.30; SD = 2.32) treated at a university outpatient clinic (experimental group, EG). At the start and end of treatment, wetting frequency as well as parent- and teacher-rated mental health problems were assessed and compared to a historical control group (CG) receiving a medical placebo. The EG showed a large, statistically significant pre-post reduction in wetting frequency (effect size d = 1.47). When comparing these results to the CG, a net effect size in favor of the EG emerged (d = 1.32). Furthermore, small to large, statistically significant reductions in mental health problems were found in the EG (range: d = 0.26 to d = 1.24). However, a substantial proportion of the EG remained in the clinical range at the end of treatment. The present study indicates that routine CBT for patients with enuresis may be effective, thus supporting the findings of more controlled efficacy trials. Trial registration: DRKS00028094 - Retrospectively registered, May 25, 2022, http://drks.de
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