title: Enuresis and encopresis in a south Indian population of children.
abstract: BACKGROUND
  Though bladder and bowel control are important developmental milestones in all cultures, the prevalence of enuresis and encopresis has rarely been studied in developing countries despite there being factors in these countries that could affect it. This study reports the prevalence and associations of enuresis and encopresis in children in Kerala, India.
  
  
  METHODS
  The parents of 1403 randomly selected 8-12-year-old children were interviewed. The prevalence of enuresis and encopresis was ascertained using Rutter's A2 scale. Subsamples of children underwent psychiatric, physical and psychometric evaluations.
  
  
  RESULTS
  Of the children, 18.6% had had an episode of enuresis in the past year and 4.3% in the past week. Four per cent had had an episode of encopresis in the past year. Enuresis was associated with parents' education, physical and psychiatric symptoms in the child, poor academic achievement and lax parental attitudes to toilet training. Encopresis was associated with male sex, physical and psychiatric symptoms, poor academic achievement, early separation and not having a toilet.
  
  
  CONCLUSIONS
  The prevalence of enuresis compares with western countries, but encopresis is commoner. The associations of enuresis suggested a multifactorial model in which parental competence was prominent. This study de-emphasized the importance of neurodevelopmental factors in enuresis and encopresis in this age group.
authors.affiliation: School of Psychiatry and Behavioural Sciences, University of Manchester, UK.
authors.forename: R
authors.initials: R
authors.lastname: Hackett
authors.forename: L
authors.initials: L
authors.lastname: Hackett
authors.forename: P
authors.initials: P
authors.lastname: Bhakta
authors.forename: S
authors.initials: S
authors.lastname: Gowers
mesh_terms: D002648:Child; D002668:Child Rearing; D004688:Encopresis / Q000453:epidemiology*; D004775:Enuresis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D015995:Prevalence; D012959:Socioeconomic Factors