title: Controlled study of encopresis and enuresis in children with a prepubertal and early adolescent bipolar-I disorder phenotype.
abstract: OBJECTIVE
  To examine the prevalence of encopresis/enuresis, relationship between maternal hostility and encopresis, parent-child concordance of reporting encopresis/enuresis, and familial aggregation of enuresis in subjects with a prepubertal and early adolescent bipolar-I disorder phenotype (PEA-BP), attention-deficit/hyperactivity disorder (ADHD), and healthy controls (HC).
  
  
  METHODS
  There were 268 consecutively ascertained subjects (93 PEA-BP, 81 ADHD, and 94 HC). PEA-BP was defined as DSM-IV BP-I (manic or mixed phase) with elation and/or grandiosity. The WASH-U-KSADS and Psychosocial Schedule for School-Age Children-Revised were administered to parents about their children and separately to children about themselves.
  
  
  RESULTS
  Encopresis was more prevalent in PEA-BP versus HC subjects (15.1% versus 3.2%, chi2 = 6.4, p = .012). Enuresis was more common in PEA-BP versus HC (21.5% versus 6.4%, chi2 = 7.8, p = .005) and ADHD versus HC (22.2% versus 6.4%, chi2 = 6.1, p = .014) subjects. All enuresis onset in subjects not receiving lithium. Most encopresis (81.8%) and enuresis (75.0%) onset before mania. Familial aggregation of enuresis was more frequent in enuretics than nonenuretics (47.7% versus 5.4%, chi2 = 41.2, p < .0001). Maternal hostility was more prevalent in encopretic versus nonencopretic subjects (91.7% versus 55.6%, chi2 = 8.3, p = .004). Parent-child concordance on reporting encopresis and enuresis was poor to fair.
  
  
  CONCLUSIONS
  Children with PEA-BP need to be evaluated for encopresis, enuresis, and mother-child relationships.
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63110, USA.
authors.forename: Tricia
authors.initials: T
authors.lastname: Klages
authors.forename: Barbara
authors.initials: B
authors.lastname: Geller
authors.forename: Rebecca
authors.initials: R
authors.lastname: Tillman
authors.forename: Kristine
authors.initials: K
authors.lastname: Bolhofner
authors.forename: Betsy
authors.initials: B
authors.lastname: Zimerman
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004688:Encopresis / Q000453:epidemiology*; D004775:Enuresis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype