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Childhood nocturnal enuresis: developing a conceptual framework

Richard J Butler1

  • 1Child and Adolescent Mental Health, East Leeds Primary Care Trust, United Kingdom.

Clinical Psychology Review
|November 10, 2004
PubMed

Insights

Nocturnal enuresis (bedwetting) in children is common and distressing. A new

Area of Science:

  • Pediatrics
  • Child Psychology
  • Urology

Background:

  • Nocturnal enuresis is a prevalent childhood issue causing significant distress.
  • Psychological distress can arise from bedwetting, impacting self-esteem and behavior.
  • The etiology of nocturnal enuresis is recognized as heterogeneous.

Purpose of the Study:

  • To introduce and explain the 'three systems' model for understanding nocturnal enuresis.
  • To provide a framework for identifying appropriate interventions based on the model.
  • To review treatment methods in light of the new model.

Main Methods:

  • Empirical findings support the proposed 'three systems' model.
  • The model integrates excessive nocturnal urine production, bladder overactivity, and arousal difficulties.
  • Clinical understanding is enhanced by this new etiological framework.

Main Results:

  • The 'three systems' model offers a clearer clinical understanding of nocturnal enuresis.
  • It facilitates the identification of specific deficits contributing to bedwetting.
  • This model guides the selection of targeted psychological and pharmacological treatments.

Conclusions:

  • Effective treatment for nocturnal enuresis requires identifying the child's specific needs.
  • The 'three systems' model aids in tailoring interventions.
  • A combination of psychological and pharmacological approaches may be necessary.

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