Bowel and Bladder Dysfunction Is Associated with Psychiatric Comorbidities and Functional Impairment in Pediatric...

Area of Science:

• Pediatric Gastroenterology
• Child Psychiatry
• Urology

Background:

• Neuropsychiatric disorders, particularly obsessive-compulsive disorder (OCD), frequently co-occur with bowel and bladder dysfunction (BBD) in children.
• BBD encompasses symptoms such as urinary frequency, urgency, holding, incontinence, and constipation.
• Understanding the prevalence and impact of BBD in pediatric OCD populations is essential for comprehensive care.

Purpose of the Study:

• To evaluate the severity of BBD symptoms in children and adolescents attending a tertiary care OCD clinic.
• To identify potential correlations between BBD symptoms, OCD severity, and psychiatric comorbidities.
• To determine the prevalence of BBD screening positive in a pediatric OCD cohort.

Main Methods:

• A registry study included consecutive patients undergoing initial OCD assessments (2016-2020).
• OCD diagnosis and comorbidities were confirmed via structured clinical interview.
• OCD severity (CY-BOCS), impact (COIS-R), and BBD symptoms (Vancouver Symptom Score - VSS) were assessed using validated self-report measures.

Main Results:

• Of 112 participants, 30.4% screened positive for BBD (VSS score ≥ 11), with higher prevalence in females.
• Daytime urinary incontinence was significantly associated with OCD forbidden thoughts, major depressive disorder (MDD), and somatization disorder.
• A regression model indicated that COIS-R, tic disorder, and MDD were significant predictors of VSS scores, explaining 52.2% of the variance.

Conclusions:

• BBD symptoms are prevalent in pediatric OCD patients and are linked to significant OCD-related impairment and psychiatric comorbidities.
• Standardized BBD assessment in this population can facilitate early identification and intervention.
• Addressing BBD is critical for mitigating long-term physical and mental health consequences in children with OCD.