Do children with primary nocturnal enuresis have clinically significant behavior problems?
OBJECTIVE
To determine if primary nocturnal enuresis (PNE) is accompanied by significant behavioral comorbidity.


METHODS
A survey design using a standardized behavioral rating scale.


METHODS
Behavioral pediatric clinics in the Midwest.


METHODS
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.


METHODS
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).


CONCLUSIONS
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.
Friman
P C
PC
Father Flanagan's Boys' Home, Boys Town, Neb, USA. frimanp@boystown.org
Handwerk
M L
ML
Swearer
S M
SM
McGinnis
J C
JC
Warzak
W J
WJ
D002648:Child; D002653:Child Behavior Disorders / Q000150:complications*; D002675:Child, Preschool; D004775:Enuresis / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male