Anxiety disorders, depression and incontinence in preschool children—A population‐based study

Hussong, Justine; Greiner, Marion; Schiedermaier, Ulrike; Mattheus, Hannah; Gontard, Alexander von

doi:10.1002/nau.25025

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…Continence problems in children are associated with higher levels of parent-reported anxiety disorders (including GAD), but no studies have specifically focused on adolescence. 18 We also found associations between incontinence/LUTS and DE behaviours. Inconsistent findings have been reported by studies of small clinical samples that examined if the prevalence of incontinence is greater in adolescents diagnosed with anorexia compared with the general population.…”

Section: Discussionsupporting

confidence: 52%

Continence problems and mental health in adolescents from a UK cohort

Gordon

Warne

Heron

et al. 2022

Preprint

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Background: Adolescents with continence problems experience a unique range of threats to their psychological wellbeing including perceived stigma, social isolation, and poor self-image. Despite this, the long-term mental health sequelae of adolescent continence problems are unknown. Methods: We used data from the Avon Longitudinal Study of Parents and Children (n=7,332: 3,639 males, 3,693 females) to examine prospective relationships between self-reported incontinence/lower urinary tract symptoms (LUTS) at 14 years (daytime wetting, bedwetting, soiling, urgency, frequent urination, low voided volume, voiding postponement, and nocturia) and common mental health problems at 18 years (any common mental disorder, depression, anxiety, self-harm, and disordered eating). We estimated multivariable regression models adjusted for sex, socioeconomic position, developmental level, IQ, stressful life events, maternal psychopathology, body mass index, and earlier emotional/behavioural problems. Findings: Daytime wetting and voiding postponement showed the greatest number of associations with mental health problems. All incontinence subtypes/LUTS were associated with increased odds of generalised anxiety disorder symptoms [e.g., odds ratio for daytime wetting= 3.01, 95% confidence interval (1.78, 5.09), p<0.001] and/or higher anxiety scores. There was also evidence of associations with common mental disorder [e.g., voiding postponement: 1.88 (1.46, 2.41), p<0.001], depression [e.g., urgency: 1.94 (1.19, 3.14), p=0.008], depressive symptoms [e.g., daytime wetting: 1.70 (1.13, 2.56), p=0.011], self-harm thoughts [e.g., voiding postponement: 1.52 (1.16, 1.99), p=0.003], and disordered eating [e.g., nocturia 1.72 (1.27, 2.34), p=0.001]. Interpretation: Incontinence/LUTS at age 14 are associated with increased vulnerability to mental health problems in late adolescence. Treatment of incontinence/LUTS should be integrated with psychological support to mitigate long-term sequelae.

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Section: Discussionsupporting

confidence: 52%

Continence problems and mental health in adolescents from a UK cohort

Gordon

Warne

Heron

et al. 2022

Preprint

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“…When all confounders are taken into consideration, separation anxiety symptoms remained the only mental health symptoms at age 7 that were associated with new-onset UI at age 9. This underlines the importance of anxiety disorders in the aetiology of wetting, which have been neglected in previous research [ 25 ]. In the study of Hussong et al (2022), separation anxiety was the most common anxiety disorder amongst children with incontinence [ 25 ].…”

Section: Discussionmentioning

confidence: 98%

“…This underlines the importance of anxiety disorders in the aetiology of wetting, which have been neglected in previous research [25]. In the study of Hussong et al (2022), separation anxiety was the most common anxiety disorder amongst children with incontinence [25]. Separation anxiety carries a genetic disposition and can be induced by stressful life events [26].…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Mental health problems, stressful life events and new-onset urinary incontinence in primary school-age children: a prospective cohort study

Warne

Heron

Gontard

et al. 2023

Eur Child Adolesc Psychiatry

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Emotional/behaviour problems and exposure to stressful life events are thought to contribute to new onset of urinary incontinence (UI) amongst children who have attained bladder control. However, very few prospective studies have examined these associations. We assessed whether mental health problems and stressful life events were associated with subsequent new onset in UI using multivariable logistic regression in a prospective UK cohort (n = 6408). Mothers provided information on their child’s symptoms of common mental disorders (Development and Wellbeing Assessment, 7 years), stressful life events (7–8 years) and wetting (day and night, 9 years). There was strong evidence that separation anxiety symptoms were associated with new-onset UI in the fully adjusted model (OR (95% CI) = 2.08 (1.39, 3.13), p < 0.001). Social anxiety, attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms were associated with new-onset UI, but these associations attenuated following adjustment for child developmental level and earlier emotional/behaviour problems. There was weak evidence for a sex interaction with stressful life events (p = 0.065), such that females experiencing more stressful life events were at higher risk of new-onset UI (fully adjusted model OR (95% CI) = 1.66 (1.05, 2.61), p = 0.029), but there was no association in males (fully adjusted model OR (95% CI) = 0.87 (0.52, 1.47), p = 0.608). These results suggest that separation anxiety and stressful life events in girls may lead to an increase in UI.

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