[Analysis of influencing factors for the emotional and behavioral problems in school-age children with lower urinary...

Objective: To analyze the clinical characteristics of lower urinary tract dysfunction (LUTD) in school-age children, examine their correlation with emotional-behavioral problems, and explore the potential influencing factors for such problems in this population. Methods: This case-control study enrolled 130 LUTD patients aged 6-12 years who were admitted to Shanxi Children's Hospital from June 2024 to October 2025, comprising the LUTD group. A control group of 125 age- and gender-matched children undergoing routine health check-ups at the hospital's outpatient department during the same period was also established. All participants were assessed by using a general information questionnaire, the dysfunctional voiding and incontinence scoring system (DVISS) and the Achenbach Child Behavior Checklist (CBCL) to evaluate lower urinary tract symptoms and emotional-behavioral problems. Independent sample t test, Mann Whitney U or χ² test were used for comparison between groups. Multiple linear regression was applied to analyze the risk factors for emotional and behavioral problems in the LUTD group. Spearman rank correlation analysis was used to examine the correlation between emotional and behavioral problems and DVISS scores in the LUTD group. Results: The LUTD group consisted of 72 males and 58 females, with age of (8.5±1.7) years, while the control group included 66 males and 59 females, with age of (8.9±1.7) years. The scores of the total CBCL score, depression, hyperactivity, aggression, boy social problems and schizoid traits were all higher in the LUTD group than in the control group (t=4.78, Z=2.71, 4.76, 3.60, 2.17, 2.10, all P<0.05). Multiple linear regression analysis revealed that low educational level of caregivers, poor academic performance, family conflict and abnormal DVISS score were associated with emotional and behavioral problems in children with LUTD (β=4.99, 5.85, 2.87, 5.75, all P<0.05). In the LUTD group, DVISS scores were all positively correlated with the scores of social withdrawal, hyperactivity, aggression, social problems, obsessive-compulsive symptoms and the total CBCL score (r=0.24, 0.22, 0.21, 0.27, 0.29, 0.51, all P<0.05). Conclusions: School-aged children with LUTD are more likely to develop emotional-behavioral problems than healthy children. These problems are associated with the educational level of caregivers, severity of lower urinary tract symptoms, academic performance, and family relationships.