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Eur Child Adolesc Psychiatry (2014) 23:417423 DOI 10.1007/s00787-013-0468-9
ORIGINAL CONTRIBUTION
Elimination disorders and anxious-depressed symptoms in preschool children: a population-based study
Monika Equit Anna-Maria Klein
Katrin Braun-Bither Stefan Graber
Alexander von Gontard
Received: 3 September 2012 / Accepted: 18 August 2013 / Published online: 3 September 2013 Springer-Verlag Berlin Heidelberg 2013
Abstract The prevalence rates of elimination disorders and anxious/depressed symptoms of a representative sample of young children and their associations were assessed. 2,079 children in a dened geographical area were examined at school-entry. A parental questionnaire with 4 questions referring to symptoms of incontinence and 14 items of the anxious/depressed scale of the Child Behavior Checklist (CBCL) was administered. 9.5 % of 6-year-old children wet at night, 2.7 % wet during day and 1.2 % had faecal incontinence. Signicantly more boys wet at night(11.7 %) than girls (7.2 %; OR 0.58, 95 % CI 0.430.78).12.7 % had clinically relevant anxious/depressed symptoms. Children with at least one elimination disorder had signicantly higher T values of the anxious/depressed CBCL than continent controls. Children with faecal incontinence had highest T values of the anxious/depressed CBCL syndrome scale, signicantly higher than those of children with other elimination disorders and controls. Elimination disorders, as well as anxious/depressed symptoms are common at a young age. Boys are more affected by elimination disorders than girls, but not by anxious/depressed symptoms. Children with faecal
incontinence have the highest rate of anxious/depressed symptoms.
Keywords Nocturnal enuresis Urinary
incontinence Faecal incontinence Anxious/
depressed symptoms CBCL Young children
Introduction
Elimination disorders including nocturnal enuresis (NE), daytime urinary incontinence (DI) and faecal incontinence (FI) are common disorders of childhood. According to the International Childrens Continence Society (ICCS) [1], NE is dened as incontinence of discrete amounts of urine during sleep in a child aged 5 years or older after organic causes have been ruled out. Four subforms are described: primary (never been dry before) or secondary (relapse after a dry period of at least 6 months), monosymptomatic (without lower urinary tract symptoms) and non-mono-symptomatic (with lower urinary tract symptoms). DI is dened as incontinence of discrete amounts or urine during the day. Functional DI comprises heterogeneous conditions such as overactive bladder, voiding postponement, dys-functional voiding, etc. The Rome III classication differentiates between functional constipation (with or...