[Functional enuresis. Which is the border between the organic and the pathological?]

The importance of the psychological aspects in treating the enuretic patient is often underestimated. The author reports 13 patients with functional enuresis, whose emotional implications of the symptom are very clear. In 7 patients a psychodiagnostic evaluation, with colloquia, tests, play and drawing, was carried out: the personality and family features of the children resulted similar to those described in literature (a too close mother-child relationship preventing child's separation, with both aggressiveness against mother and regression; depression; a difficult sexual identification). In 3 patients a psychotherapy lasting more than 6 months was undertaken. Psychologic care and short psychotherapy were always useful to relieve the neurotic symptoms connected with enuresis and to better child's personality; in some patients, they were not completely successful on the symptom, because this persisted although the number of episodes was reduced. The clinical approach depends on the type of enuresis. A psychologic care of the patients with secondary enuresis and of children with neurotic personality is necessary; in the other cases it is advisable to set up a therapeutic alliance with the child against his symptom, and to deal with the depressive traits related to it. We have to think of enuresis not as a border between organic and psychological, but as a problem in which the two aspects are closely linked together without excluding each other. The author believes that psychotherapy with enuretic patients is frequently lasting.