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Behavioral comorbidity, overweight, and obesity in children with incontinence: An analysis of 1638 cases

Alexander von Gontard1, Hannah Mattheus1, Aikaterini Anagnostakou1

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

Neurourology and Urodynamics
|August 19, 2020
PubMed

Insights

Children with incontinence, including nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI), face higher risks of behavioral issues and obesity. Addressing these comorbidities is crucial for comprehensive care.

Area of Science:

  • Pediatric urology
  • Child psychology
  • Public health

Background:

  • Children with nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are at increased risk for behavioral problems and weight issues.
  • Understanding the specific comorbidities in different types of incontinence is essential for targeted interventions.

Purpose of the Study:

  • To analyze the association between behavioral symptoms, psychiatric disorders, and weight status (overweight/obesity) in children with various subtypes of incontinence.
  • To identify specific risk factors and comorbidities in children presenting with incontinence.

Main Methods:

  • Prospective examination of 1638 children at a tertiary incontinence clinic using International Children's Continence Society (ICCS) criteria.
  • Assessment of behavioral symptoms via the Child Behavior Checklist (CBCL) and psychiatric disorders via ICD-10 criteria.
  • Weight categories determined using World Health Organization (WHO) recommendations.

Main Results:

  • Over one-third of children (39.2%) exhibited clinically relevant behavioral symptoms, and 28.3% had psychiatric diagnoses (primarily ODD and ADHD).
  • 28.6% of children were overweight or obese, with boys showing higher rates of behavioral symptoms, psychiatric disorders, and overweight/obesity.
  • Nocturnal enuresis (NE) was associated with the highest rate of overweight/obesity, and overweight/obesity was significantly linked to behavioral and psychiatric parameters.

Conclusions:

  • Behavioral symptoms, psychiatric disorders, and overweight/obesity are significant risk factors associated with childhood incontinence.
  • Clinical practice should include screening for behavioral symptoms and measuring weight to address overweight/obesity in all incontinent children.
  • The complex interaction between incontinence, behavioral issues, and weight necessitates a holistic approach to management.
Abstract

Keywords:
CBCLbehaviorchildrencomorbiditydaytime urinary incontinenceenuresisfecal incontinenceobesityoverweightpsychiatric diagnoses

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