[Encopresis--predictive factors and outcome].
OBJECTIVE
comparison of diagnostic, clinical and therapeutic features and their predictive value for the outcome of encopresis in children and adolescents.


METHODS
85 children and adolescents (aged 9.6 +/- 3.2 years) with severe encopresis (ICD 10: F98.1) were investigated during inpatient treatment and 35 of them again 5.5 +/- 1.8 years later. Mentally retarded patients were excluded. Inpatient therapy consisted of treating constipation and/or stool regulation by means of laxatives, behavioural approaches, and the specific therapy of comorbid psychiatric disorders.


RESULTS
During inpatient treatment 22% of the patients experienced total remission, 8% an unchanged persistence of symptoms. Of the 35 patients studied at follow-up 5.5 years later, 40% were symptom-free. As main result, prognostic outcome depended significantly on sufficient treatment of obstipation. Another important factor was the specific therapeutic approach to psychiatric comorbidity, especially to ADHD. The outcome for patients with comorbid ICD 10: F43 was significantly better than for the other patients. Those who were symptom-free at discharge had significantly better long-term outcomes.


CONCLUSIONS
Decisive to the success of encopresis treatment were the stool regulation and the specific therapy of associated psychiatric illnesses, in particular of ADHD. Inpatient treatment revealed significantly better long-term outcomes where total remission had been achieved by the time of discharge from hospital.
Mehler-Wex
Claudia
C
Klinik und Poliklinik für Kinder--und Jugendpsychiatrie und Psychotherapie der Universität Würzburg. mehler@nervenklinik.uni-wuerzburg.de
Scheuerpflug
Peter
P
Peschke
Nicole
N
Roth
Michael
M
Reitzle
Karl
K
Warnke
Andreas
A
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy; D002400:Cathartics / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003248:Constipation / Q000628:therapy; D004688:Encopresis / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010343:Patient Admission; D011379:Prognosis; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome
D002400:Cathartics