NOCTURNAL ENURESIS - A REVIEW OF GENETIC, PATHOPHYSIOLOGIC, AND PSYCHIATRIC ASSOCIATIONS

Nocturnal enuresis is characterized by a highly complex interaction of somatic and psychiatric factors. A primary monosymptomatic, a symptom atic (with diurnal micturition problems) and a secondary form (followi ng a dry interval) can be differentiated. Despite deep sleep with diff icult arousal, the sleep architecture itself is normal and enuretic ep isodes occur in every sleep stage without urodynamic changes. Changes in the circadian AVP-rhythm with nocturnal polyuria have been demonstr ated repeatedly. Formal genetically, many families are compatible with an autosomal dominant mode of inheritance. Linkage studies have shown a linkage of nocturnal enuresis with regions on chromosomes Nr. 8, 12 and 13. There is a significantly increased rate of psychiatric proble ms. The associations are complex, with psychiatric factors occurring b oth reactively following the enuresis, as well as being causally invol ved in secondary, but not in primary monosymptomatic nocturnal enuresi s.