A FOLLOW-UP OF ENURESIS FROM CHILDHOOD TO ADOLESCENCE

Objective To determine the prevalence and treatment of enuresis in a n ational population-based follow-up study of children aged 8-14 years, to evaluate possible factors that enhance or hamper the attainment of continence and to examine the relationships between enuresis and psych iatric disturbance. Subjects and methods An initial study was carried out in 1989 as part of the Finnish Child Psychiatric National Epidemio logical Study. Three types of questionnaires were used; the Rutter Sca le A for completion by parents, including a question about enuresis, t he Rutter scale B for completion by teachers and the Children's Depres sion Inventory (CDI), completed by the children. Parents were also ask ed about demographic and family issues, teachers about school achievem ents and children about additional psychosomatic symptoms. In a follow -up in 1995, the target population comprised all previous enuretics an d their controls, matched by age, gender, class and school, in the fir st phase of the study. Replies were received from 315 enuretic boys an d 186 girls, with the corresponding values for controls being 310 and 183. The parents were asked about the adolescents' present enuresis an d for permission for a treatment trial, if needed, The adolescents com pleted the CDI, and a questionnaire about enuresis, previous treatment s and possible willingness for a treatment trial. They also reported b asic somatic data, their life events and living habits. Results In the initial study, the enuretic children had higher total and subscores a s reported by parents, teachers and themselves, except for emotional i tems reported by the teachers. Additionally, a significantly greater p roportion of these children soiled, had sleeping difficulties and diff iculties in falling asleep. Enuretic boys had more frequent nightly ar ousal and early morning waking, while the enuretic girls had more nigh tmares than non-enuretic girls. At 14 years old, the parents reported that 13 adolescents were enuretic; from the children's replies, nine b oys and seven girls were enuretic. Conclusions The prevalence of enure sis in those previously enuretic was surprisingly low, probably becaus e of the efficient treatment methods, conditioning and medication. The re were evident connections between childhood enuresis and mental well -being.