Predicting treatment outcome in nocturnal enuresis
1Enuresis Clinic, Eastern Health Board, Dublin, Ireland.
Insights
This study shows that behavioral interventions like alarm therapy are effective for treating childhood enuresis (bedwetting). A predictive risk score identifies factors such as psychiatric issues and family stress that influence successful outcomes.
Area of Science:
- Pediatrics
- Behavioral Science
Background:
- Childhood enuresis is a common condition requiring effective management strategies.
- Behavioral interventions are a cornerstone of enuresis treatment.
Purpose of the Study:
- To evaluate the effectiveness of baseline behavioral recording and enuresis alarm therapy.
- To identify prognostic factors for successful enuresis treatment.
- To develop a predictive risk score for treatment outcomes.
Main Methods:
- A cohort of 127 children with enuresis was assessed.
- Interventions included baseline behavioral recording and enuresis alarm therapy.
- Logistic regression analysis was used to create a predictive risk score.
Main Results:
- 19% of children achieved dryness with behavioral recording alone.
- 84% of children using the enuresis alarm achieved dryness.
- Absence of adverse environmental factors and psychiatric disorders predicted success.
- Child psychiatric disorder, family stress, and child's concern were key prognostic factors.
Conclusions:
- Baseline recording and enuresis alarms demonstrate high success rates in managing enuresis.
- A novel risk score effectively predicts treatment outcomes for childhood enuresis.
- Conditioning treatments are central to enuresis management.
Abstract:
A presenting sample of 127 consecutive referrals to a community based enuresis clinic were evaluated after treatment with baseline behavioural recording and the enuresis alarm. Almost one in five became dry after baseline recording only while 81 of 96 (84%) enuretics who used the alarm achieved the initial dryness criterion. Successful outcome was associated with the absence of adverse environmental factors and psychiatric disorders in the child. A logistic regression procedure enabled a risk score to be created so that successful outcome could be predicted. Psychiatric disorder in the child, family stress, and the degree of concern shown by the child emerged as the most important prognostic factors in the treatment of enuresis. The favourable success rates with baseline recording and the enuresis alarm confirm the role of conditioning treatment at the forefront of management of enuresis and the risk score allows outcome to be predicted for the first time.
