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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Do children with primary nocturnal enuresis have clinically significant behavior problems?
P C Friman1, M L Handwerk, S M Swearer
1Father Flanagan's Boys' Home, Boys Town, Neb, USA. frimanp@boystown.org
Insights
Primary nocturnal enuresis (PNE) rarely involves significant behavioral issues. Most cases are common biobehavioral problems, not psychiatric conditions, suggesting PNE can be treated without a psychiatric focus.
Area of Science:
- Pediatric behavioral health
- Child psychology
- Urology
Background:
- Primary nocturnal enuresis (PNE) is common in children.
- The association between PNE and behavioral comorbidity requires further investigation.
Purpose of the Study:
- To investigate the prevalence of behavioral comorbidity in children diagnosed with primary nocturnal enuresis (PNE).
Main Methods:
- A survey design was employed using the Eyberg Child Behavior Inventory (ECBI), a standardized parent-report scale.
- Participants included children with PNE (n=92), a clinical sample without PNE (n=92), and a nonclinical sample (n=92).
Main Results:
- A significant main effect for group was found on both Problem Intensity and Problem Number (P<.001).
- The PNE sample showed higher Problem Intensity than the nonclinical sample, but lower than the clinical sample.
- Problem Number did not differ between PNE and nonclinical samples, but both were lower than the clinical sample.
Conclusions:
- Primary nocturnal enuresis (PNE) is typically not associated with significant behavioral comorbidity.
- PNE is generally a common biobehavioral issue, not a psychiatric disorder.
- Pediatricians can treat PNE as a biobehavioral problem, avoiding unnecessary psychiatric evaluation unless clinically indicated.
Objective:
To determine if primary nocturnal enuresis (PNE) is accompanied by significant behavioral comorbidity.
Design:
A survey design using a standardized behavioral rating scale.
Setting:
Behavioral pediatric clinics in the Midwest.
Participants:
Subjects with PNE (n=92) were selected from 122 consecutive referrals for enuresis. Criteria included age 5 years or older, PNE status, and wetting frequency of at least once per week. The clinical sample without PNE (n=92) was randomly selected from 429 consecutive referrals to the same pediatric clinics, stratified for age and sex. The nonclinical sample (n=92) was randomly selected by strata from the standardization sample (N=614) of the behavioral checklist used in the study.
Main Outcome Measure:
The Eyberg Child Behavior Inventory (ECBI), a standardized parent report scale, was used to measure the degree of behavioral comorbidity. The ECBI yields 2 scores, Problem Intensity and Problem Number.
Results:
Results from 2 separate 3 (group) x 2 (sex) analyses of variance indicated a significant main effect for group on Problem Intensity and Problem Number (P<.001). For Problem Intensity, post hoc comparisons indicated the mean of the PNE sample was significantly higher than the mean of the nonclinical sample (P<.05), but the mean scores of the clinical sample were significantly higher than those of both the PNE and nonclinical samples (P<.05). For Problem Number, post hoc comparisons revealed the means of the PNE and nonclinical samples did not differ from each other (P>.05) but were lower than the mean of the clinical sample (P<.05).
Conclusion:
Primary nocturnal enuresis does not present with significant behavioral comorbidity in most cases. The results suggest that, with the exception of an extraordinary clinical presentation, pediatricians should treat PNE as a common biobehavioral problem without a psychiatric component.
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