title: Emotional and behavioral functioning in children with bladder exstrophy-epispadias complex: a developmental perspective.
abstract: OBJECTIVE
  To evaluate the emotional and behavioral functioning of children with bladder exstrophy-epispadias complex (BEEC), taking into account developmental and gender considerations. This study also sought to overcome methodological limitations of previous studies evaluating psychological well-being of children with BEEC.
  
  
  METHODS
  Eighty-six children were consecutively evaluated using the parent report version of the Behavior Assessment System for Children during visits to a multidisciplinary urology clinic.
  
  
  RESULTS
  Results indicated normative emotional and behavioral functioning across the sample. However, there was a significant effect of age, such that older children consistently had worse internalizing symptoms and adaptive functioning. Males tended to have more externalizing problems as they aged, and also tended to have lower levels of adaptive functioning but this was independent of age. The level of psychological impairment was unrelated to the specific type of BEEC, and was also unrelated to whether or not the patient had undergone continence surgery.
  
  
  CONCLUSIONS
  Children with BEEC have a greater likelihood of experiencing a wide range of emotional and behavioral problems as they reach adolescence. These findings point to the need to prevent potential psychological distress by intervening with these children before they become clinically impaired.
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: jhankinson@jhmi.edu.
authors: Jessica C
authors: JC
authors: Hankinson
authors: James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Marlo A
authors: MA
authors: Eldridge
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Rick
authors: R
authors: Ostrander
authors: James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Bhavik
authors: B
authors: Shah
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Elizabeth K
authors: EK
authors: Reynolds
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Carisa
authors: C
authors: Perry-Parrish
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Matt W
authors: MW
authors: Specht
authors: James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: John P
authors: JP
authors: Gearhart
mesh_terms: D000293:Adolescent; D001746:Bladder Exstrophy / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D004644:Emotions; D004842:Epispadias / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011606:Psychosexual Development; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control
keywords: Adolescents; Bladder exstrophy; Children; Emotional and behavioral functioning; Urinary bladder