Enuresis and Punishment: The Adverse Effects on Child Development and on Treatment

Beşer

et al. 2022

Cureus

Introduction: This study was conducted to evaluate the accompanying psychosocial problems in enuresis as well as the social anxiety-depression levels in children diagnosed with enuresis.Methods: This descriptive study investigating depression and social anxiety levels of children diagnosed with enuresis was carried out with 167 children who were followed up for at least six months following their enuresis diagnosis. All participating children had no other physical or mental illnesses and were aged five years or older. Data were collected using three measurement tools and evaluated using descriptive, correlational analyzes.Results: In this study, 69.4% of the children diagnosed with enuresis were aged 7-12 years. 38.3% of their parents used "reward", while 37.1% preferred "punishment" as a method for toilet training their children. The children's depression and social anxiety mean scores were 21.48±7.29 and 54.58±8.84, respectively. A strong positive correlation was found between the children's mean depression and social anxiety scores (r=0.677, p<0.001). The median depression scores of children were found to be statistically significantly different according to the children's type of family, night sleep characteristics, type of enuresis, school success, and family life (p<0.05). Those with fragmented families (p=0.049), who did not sleep deeply at night (p=0.031), who slept for about 5-7 hours a day (p<0.01), and those whose school success was negatively affected by enuresis (p=0.021) and those who were exposed to negative family life (p=0.034) all obtained statistically significantly higher median depression scores. Conclusion:Children with enuresis had low depression and moderate social anxiety and their depression increased as their social anxiety increased. The children experienced psychosocial difficulties due to enuresis. When treating children with enuresis, it is necessary to consider both the affected child and their families through the adoption of a holistic approach, and also to evaluate the children both physically and psychosocially.

Section: Discussionsupporting

confidence: 82%

Evaluating the Social Anxiety Depression Levels and Accompanying Psychosocial Problems in Children Diagnosed with Enuresis

Beşer

et al. 2022

Cureus

“…For this reason it is important to explain the definitions of the disorder and find the best treatment (behavioural and/or pharmacological) depending on the single patient, his/ her family and compliance of both. Family quality of life is compromised; for this reason family involvement and management of the condition by parents have to be considered too [8]. Moreover sleep disordered or poor quality of sleep in children is linked to numerous negative psychosocial consequences, including lower health related quality of life, increased behavioural problems impaired neuropsychological functioning and lower school performance [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology of enuresis: a large number of children at risk of low regard

et al. 2020

Self Cite

Aim To describe the epidemiological aspects of nocturnal enuresis (NE). In this study we identify the prevalence and the familial conditions in a large, representative sample of children with monosymptomatic NE (MNE) and nonmonosyptomatic NE (NMNE). Material and methods In this descriptive-analytic study the Italian Society of Pediatrics (SIP) promoted a prevalence study of NE using a questionnaire involved 320 primary care Pediatricians from Northern, Central and Southern Italy, from January 2019 to July 2019, with a total of 130,000 children analyzed by questionnaire related to epidemiology and type of NE, familiarity, quality of sleep, eating and drinking habits, pharmacological and psychological/behavioural interventions and family involvement. Results 270/320 (84.4%) Paediatrician replied to our questionnaire. We enrolled a total of 9307/130,000 (7.2%) children with NE, aged between 5 and 14 years: 2141 diagnosed with MNE and 7176 qualified as NMNE. Poor quality of sleep were reported in 7064 patients; 90% of children did not consider a dietary and drinking recommendation. Pediatrician reported a total of 54.1% of parents who declared to have a negative reaction to their children because of the bedwetting. A percentage of 71.4% of parents declared to use or to have used alternative therapies and not to prefer, at first, a pharmacological intervention. Conclusion The choice of treatment should include psychological/behavioural interventions in all cases to improve the therapeutic outcome. All primary care Pediatricians should be aware of the all aspects of NE to choose the best way to treat every patient.

“…Another critical point is that the doctor should emphasize to the parents that enuresis is not the child's fault, and the child should not be punished for it (39). The importance of this issue becomes clear when polls show that 25% to 33% of parents punish their children for enuresis, which is sometimes a physical punishment (47,48).…”

Section: Treatmentmentioning

confidence: 99%

Comprehensive Review of Nocturnal Enuresis in Children

Sarabi

Nikpasand²,

Mahmoudabadi³

et al. 2022

JPR

Background: Enuresis is a common problem that affects up to 15% of 5‐year‐old children and may have significant psychological, emotional, and social consequences for both the child and their family. Enuresis is the inability of toilet‐trained children to hold urine during the night. It can be classified as primary and secondary. Secondary enuresis occurs in children who have had a dry duration of more than six months; otherwise, it is called primary enuresis. Objectives: This narrative review aims to summarize the available data on the epidemiology, etiology, pathophysiology, evaluation, and treatment of children with enuresis. Methods: This study was conducted through a literature search with the keywords based on Medical Subject Headings (MESH) and were combined with other keywords, including enuresis, pediatric, incontinence, and treatment using PubMed, Embase, Web of Sciences, Scopus, and Cochrane databases. Results: The initial evaluation of enuresis needs a detailed medical history and a careful physical examination with no need for radiology and invasive procedures. The treatment’s mainstay is non‐pharmacological treatments, such as behavioral intervention followed by pharmacotherapy. The appropriate treatment chosen depends on the children's age, midnight voiding patterns, and family and child preferences. Conclusions: Enuresis is a common disorder that affects both the child and the family in many ways. Enuresis's etiology is complex, and it is still not well understood. The child and family must be included in the treatment process, and potential pathophysiological causes must be taken into account.