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Comorbidity of ADHD and incontinence in children

Alexander von Gontard1, Monika Equit

  • 1Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.

European Child & Adolescent Psychiatry
|July 2, 2014
PubMed

Insights

Attention-deficit/hyperactivity disorder (ADHD) and childhood incontinence, including nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI), frequently co-occur. Non-genetic factors likely explain this comorbidity, impacting treatment outcomes.

Area of Science:

  • Pediatric medicine
  • Child psychology
  • Neurodevelopmental disorders

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) and various forms of childhood incontinence (nocturnal enuresis, daytime urinary incontinence, fecal incontinence) are prevalent and often coexist.
  • The co-occurrence exceeds chance, suggesting shared underlying factors or influences.

Purpose of the Study:

  • To review the comorbidity of ADHD with nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in children.
  • To examine the prevalence of ADHD in children diagnosed with NE, DUI, and FI.

Main Methods:

  • Literature review synthesizing findings from clinical and population-based studies.
  • Examination of genetic, neurophysiological, imaging, and pharmacological research.

Main Results:

  • ADHD and NE are commonly studied together, but DUI presents a higher risk for ADHD.
  • Children with FI show high rates of psychological disorders, though not exclusively ADHD.
  • Genetic studies suggest ADHD and incontinence types do not share a genetic basis; non-genetic factors are implicated.
  • Neurophysiological, imaging, and pharmacological studies offer potential links between ADHD and incontinence.

Conclusions:

  • The comorbidity of ADHD and incontinence is influenced by non-genetic factors.
  • Children with both ADHD and incontinence present greater treatment challenges, including lower compliance and poorer outcomes.
  • Integrated assessment and specific treatment approaches are necessary for children with co-occurring ADHD and incontinence.

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