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Maternal Anxiety Associated with Nocturnal Childhood Enuresis
Javier Quiroz-Guerrero1, Alejandra Ortega-Pardo2, Rafael Edgardo Maldonado-Valadez3
1Department of Pediatric Urology, Hospital Regional de Alta Especialidad del Bajío, Leon 37660, Mexico.
Insights
Mothers of children with nocturnal enuresis experience significantly higher levels of both trait and state anxiety compared to mothers of healthy children. These findings highlight the need to address maternal anxiety in enuresis treatment programs.
Area of Science:
- Pediatric Urology
- Child Psychology
- Maternal Mental Health
Background:
- Nocturnal enuresis affects 20% of 5-year-olds, with prevalence decreasing with age.
- Maternal distress, including stress, depression, and anxiety, is linked to childhood urinary incontinence.
- Parental expectations shift towards increased child responsibility with age.
Purpose of the Study:
- To compare trait and state anxiety levels in mothers of children with nocturnal enuresis versus mothers of healthy children.
- To investigate the psychological impact of nocturnal enuresis on mothers.
- To inform clinical practice regarding the management of maternal anxiety in enuresis treatment.
Main Methods:
- Prospective, cross-sectional, comparative study design.
- Inclusion of two groups: 25 mothers of children with nocturnal enuresis and 25 mothers of healthy children.
- Assessment of trait anxiety (STAI-T) and state anxiety (STAI-S) using validated tests, with blind evaluation.
Main Results:
- Mothers of children with nocturnal enuresis showed significantly higher STAI-T scores (53.00 ± 8.39) compared to controls (41.52 ± 9.61, p < 0.001).
- State anxiety was markedly elevated in mothers of enuretic children (STAI-S: 56.48 ± 6.83) versus controls (43.84 ± 10.57, p < 0.001).
- 56% of mothers of enuretic children had moderate-to-severe trait anxiety, and 92% had moderate-to-severe state anxiety.
Conclusions:
- Mothers of children experiencing nocturnal enuresis exhibit significant moderate-to-severe state anxiety.
- Maternal anxiety is a crucial factor that should not be overlooked in pediatric enuresis treatment protocols.
- Integrating psychological support and evaluation of state anxiety is recommended for comprehensive enuresis management programs.
Abstract:
Introduction: Nocturnal enuresis is a common problem affecting 20% of 5-year-old children; its prevalence decreases with age. Nocturnal bedwetting in children younger than 5 is generally accepted by parents and society, but the expectation of parents is that children will achieve a higher degree of responsibility and increased control with age. Some studies have identified maternal distress as a factor associated with childhood urinary incontinence; specifically, maternal stress, maternal depression, and maternal anxiety. The aim of this study was to compare the degree of anxiety (trait and state) among mothers of children with nocturnal enuresis and mothers of healthy children. Methods: This was a prospective, cross-sectional, comparative study including two groups: a control group of 25 mothers of healthy children from open population, and an enuresis group of 25 mothers of children with nocturnal enuresis of the pediatric urology clinic of a third-level Mexican Hospital. STAI-T and STAI-S tests were performed and assessed blindly. Quantitative variables were compared using the Mann−Whitney U test, and qualitative determinations using a chi-square test or Fischer’s exact test. Results: The STAI-S and STAI-T tests results identified 14 (56%) mothers of enuretic children with moderate-to-severe trait anxiety versus 4 (16%) mothers from the control group and moderate-to-severe state anxiety in 23 (92%) of the mothers of enuretic children compared to 7 (28%) control-group mothers. The anxiety scores were significantly higher for the enuresis group for both tests: STAI-T: 53.00 ± 8.39 versus 41.52 ± 9.61 (p < 0.001) and STAI-S: 56.48 ± 6.83 versus 43.84 ± 10.57 (p < 0.001). Conclusion: Mothers of children with nocturnal enuresis present state anxiety ranging from moderate to severe. In clinical practice, our results indicate that the transitory emotion experienced by mothers of enuretic children cannot be neglected in an enuresis treatment program, state anxiety needs to be evaluated, and psychological interventions need to be implemented.
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