title: The prevalence of attention deficit-hyperactivity disorder in children with nonmonosymptomatic nocturnal enuresis: a 4-year followup study.
abstract: OBJECTIVE
  The prevalence of attention deficit-hyperactivity disorder was increased in a predominantly nonmonosymptomatic nocturnal enuresis population reported on previously. At 2 years after onset of treatment for enuresis attention deficit-hyperactivity disorder seemed to be a risk factor for continuing enuresis. In the current 4-year followup study we sought to determine whether the original attention deficit-hyperactivity disorder diagnosis could be reconfirmed, thereby reflecting the presence of a psychiatric syndrome rather than a coping behavior to deal with the negative consequences of enuresis. An additional study goal was to investigate the evolution in enuresis status in children with and without attention deficit-hyperactivity disorder.
  
  
  METHODS
  A total of 79 children diagnosed with enuresis in the baseline study took part in a 3rd screening for attention deficit-hyperactivity disorder. A diagnostic interview (Diagnostic Interview Schedule for Children-Parent Edition) was administered to the parents, questionnaires (Child Behavior Checklist/Teacher Report Form, Disruptive Behavior Disorder Rating Scale) were completed by the parents and teachers, and medical files were consulted.
  
  
  RESULTS
  Of the baseline attention deficit-hyperactivity disorder diagnoses 64% could be reconfirmed at 4-year followup, compared to 73% at 2-year followup. The prevalence of enuresis also decreased by 23%, to 42%. The distribution of enuresis at 4-year followup did not significantly differ between children with and without a baseline or final diagnosis of attention deficit-hyperactivity disorder. No significant predictors of bedwetting episodes could be found in sociodemographic, attention deficit-hyperactivity disorder or organic characteristics.
  
  
  CONCLUSIONS
  At 4-year followup a substantial number of children still met the criteria for attention deficit-hyperactivity disorder, even after becoming dry. The prevalence rate of enuresis decreased much faster than that of attention deficit-hyperactivity disorder, suggesting the presence of a psychiatric syndrome rather than a coping behavior. Contrary to intermediate findings, current enuresis status could no longer be predicted by attention deficit-hyperactivity disorder symptoms.
authors.affiliation: Department of Psychology, Developmental Disorders, Ghent University, Ghent, Belgium. Dieter.Baeyens@UGent.be
authors.forename: Dieter
authors.initials: D
authors.lastname: Baeyens
authors.forename: Herbert
authors.initials: H
authors.lastname: Roeyers
authors.forename: Sofie
authors.initials: S
authors.lastname: Van Erdeghem
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.forename: Johan
authors.initials: J
authors.lastname: Vande Walle
mesh_terms: D017677:Age Distribution; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011336:Probability; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors