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Incontinence and parent-reported oppositional defiant disorder symptoms in young children--a population-based study
Alexander von Gontard1, Justine Niemczyk, Sigrid Thomé-Granz
1Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
Insights
Oppositional defiant disorder (ODD) and incontinence are common in young children, especially boys. Incontinent children show higher rates of ODD symptoms, indicating a need for integrated diagnosis and treatment.
Area of Science:
- Childhood developmental disorders
- Pediatric behavioral health
- Urology and continence care
Background:
- Oppositional defiant disorder (ODD) and incontinence are prevalent childhood conditions.
- These disorders frequently co-occur in young children.
- Understanding their association is crucial for effective intervention.
Purpose of the Study:
- To investigate the relationship between oppositional defiant disorder symptoms and incontinence in a representative sample of school-entry children.
- To identify specific patterns of comorbidity between ODD and different types of incontinence.
Main Methods:
- A cross-sectional study involving 718 children at school entry.
- Parental questionnaires assessed incontinence (nocturnal enuresis, daytime urinary incontinence, fecal incontinence) and DSM-IV criteria for ODD.
- Additional measures included the Home Situations Questionnaire and toileting refusal items.
Main Results:
- Overall, 6.7% of children exhibited ODD symptoms.
- Incontinent children had significantly higher rates of ODD symptoms (19.5%) compared to continent children (5.2%).
- Children with daytime urinary incontinence (DUI) showed the highest ODD symptom prevalence (36.4%). Boys were more affected by both ODD and nocturnal enuresis.
Conclusions:
- Incontinence and ODD are common comorbid conditions at school entry, with boys disproportionately affected.
- Daytime urinary incontinence is strongly associated with ODD symptoms.
- Integrated diagnosis and treatment of ODD in children with incontinence are recommended to improve compliance and daily functioning.
Background:
Oppositional defiant disorder (ODD) and incontinence are common disorders of childhood. We have examined associations between ODD symptoms and incontinence in a representative sample of young children.
Methods:
A questionnaire with seven questions referring to incontinence, eight DSM-IV items of ODD, 15 items of the Home Situations Questionnaire and six items regarding eating, drinking or toileting refusal was administered to the parents of 718 children at school-entry from a defined geographical area at school-entry.
Results:
Of the 718 6-year-old children included in the analysis, 8.2% had nocturnal enuresis (NE), 1.5% had daytime urinary incontinence (DUI) and 1.1% had faecal incontinence (FI). Significantly more boys than girls had NE (12 vs. 4.3%). Overall, 6.7% of children had ODD symptoms. Rates of ODD symptoms were significantly higher in incontinent children (19.5%) than in continent children (5.2%), with the highest rate of ODD symptoms in children with DUI (36.4%). Children with incontinence (mean 6.1 episodes) or ODD symptoms (mean 8.4 episodes) showed non-compliant behaviours in more problem situations than continent children (mean 4.5 episodes) or children without ODD symptoms (mean 4.5 episodes).
Conclusions:
Incontinence and ODD are common comorbid disorders at school-entry age. Boys are more affected by both disorders. Children with DUI have the highest rate of ODD symptoms. As ODD symptoms affect many daily family situations, ODD needs to be diagnosed and treated in children with incontinence, as it can negatively affect compliance.
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