A survey of voiding dysfunction in children with attention deficit-hyperactivity disorder

Area of Science:

• Pediatric Urology
• Neurodevelopmental Disorders
• Behavioral Pediatrics

Background:

• Physicians observe a higher prevalence of voiding dysfunction and incontinence in children with attention deficit-hyperactivity disorder (ADHD).
• Empirical data to support this clinical observation were previously lacking.

Purpose of the Study:

• To investigate the association between attention deficit-hyperactivity disorder (ADHD) and functional bladder symptoms.
• To compare voiding dysfunction rates in children with and without ADHD using a standardized survey.

Main Methods:

• The Dysfunctional Voiding Symptom Survey (DVSS), a 10-question assessment, was administered to children with rigorously diagnosed ADHD and a control group.
• The DVSS evaluates symptoms including daytime incontinence, nocturnal enuresis, constipation, urgency, voiding frequency, and dysuria, with scores ranging from 0 to 40.
• Statistical analyses were performed separately for boys and girls, comparing aggregate and individual question scores between groups.

Main Results:

• Children with ADHD exhibited significantly higher overall DVSS scores compared to the control group, indicating more severe voiding symptoms.
• Boys with ADHD showed statistically significant differences in several individual voiding symptom categories.
• Due to a limited sample size of girls, significant differences in individual symptom scores were not observed in this subgroup.

Conclusions:

• Children diagnosed with ADHD demonstrate significantly increased rates of incontinence, constipation, urgency, infrequent voiding, nocturnal enuresis, and dysuria.
• Further research is warranted to elucidate the underlying causes of these differences.
• Developing targeted treatment strategies for these associated voiding dysfunctions in children with ADHD is essential.