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[Follow-up of encopresis in children]
A Steinmüller1, H C Steinhausen
1Abteilung für Psychiatrie und Neurologie, Freien Universität Berlin.
Insights
Most children with encopresis (fecal incontinence) experience symptom remission, often spontaneously. Favorable outcomes are linked to factors like male gender, low symptom frequency, and normal psychosocial conditions.
Area of Science:
- Pediatrics
- Child and Adolescent Psychiatry
- Gastroenterology
Context:
- Encopresis is a common condition in pediatric clinics.
- Long-term outcomes for encopresis require further investigation.
Purpose:
- To examine the long-term course and remission rates of encopresis in children.
- To identify prognostic factors associated with symptom remission and overall development.
Summary:
- A follow-up study of 41 children with encopresis revealed significant symptom reduction, with 76% symptom-free at an average of 3.5 years post-initial visit.
- Most remissions (81%) occurred within two years, often spontaneously. Improved overall development was noted in 81%, though new problems arose in one-third.
- Favorable prognostic factors included low symptom frequency, male gender, no prior intervention, normal psychosocial status, higher intelligence, absence of constipation, concurrent enuresis, and fewer behavioral issues.
Impact:
- Findings suggest a generally positive long-term outlook for childhood encopresis, particularly with specific favorable factors.
- Highlights the need for considering psychosocial and developmental factors in encopresis management.
- Demonstrates a reduction in emotional disturbances and hyperactivity but not conduct disorders over time.
Abstract:
The course of encopresis in 41 children who had been presented at a child and adolescent university clinic was examined by means of a follow-up interview which took place on an average of 3;6 years after the initial visit. The symptoms in this sample diminished considerably: 76% of the children were free of symptoms at the time of the follow-up interview, whereby most of these children had experienced a spontaneous remission. Eighty-one percent of the children were evaluated as having improved in regards to their whole development while in about one third of all the children new problems arose. Remission occurred within the first two years of the initial consultation in 81% of the sample. An examination of the prognostic factors yielded the following relationships: the total remission of symptoms was considerably greater if the frequency of encopresis had been low, if the subjects were male, and if there had not been any therapeutic intervention. However, treatment was usually reserved for relatively serious cases. Favorable outcome tended to be marked by the following factors: normal psychosocial conditions, higher intelligence, the absence of constipation, a concurrently presenting enuresis, and a low degree of behavioral disorders as evaluated by a parental questionnaire. A comparison of the behavioral disorders at the time of the initial consultation and at follow-up revealed a significant reduction of emotional disturbances and hyperactivity. This favorable development was not evident for conduct disorders.