title: Incontinence and parent-reported oppositional defiant disorder symptoms in young children--a population-based study.
abstract: BACKGROUND
  Oppositional defiant disorder (ODD) and incontinence are common disorders of childhood. We have examined associations between ODD symptoms and incontinence in a representative sample of young children.
  
  
  METHODS
  A questionnaire with seven questions referring to incontinence, eight DSM-IV items of ODD, 15 items of the Home Situations Questionnaire and six items regarding eating, drinking or toileting refusal was administered to the parents of 718 children at school-entry from a defined geographical area at school-entry.
  
  
  RESULTS
  Of the 718 6-year-old children included in the analysis, 8.2% had nocturnal enuresis (NE), 1.5% had daytime urinary incontinence (DUI) and 1.1% had faecal incontinence (FI). Significantly more boys than girls had NE (12 vs. 4.3%). Overall, 6.7% of children had ODD symptoms. Rates of ODD symptoms were significantly higher in incontinent children (19.5%) than in continent children (5.2%), with the highest rate of ODD symptoms in children with DUI (36.4%). Children with incontinence (mean 6.1 episodes) or ODD symptoms (mean 8.4 episodes) showed non-compliant behaviours in more problem situations than continent children (mean 4.5 episodes) or children without ODD symptoms (mean 4.5 episodes).
  
  
  CONCLUSIONS
  Incontinence and ODD are common comorbid disorders at school-entry age. Boys are more affected by both disorders. Children with DUI have the highest rate of ODD symptoms. As ODD symptoms affect many daily family situations, ODD needs to be diagnosed and treated in children with incontinence, as it can negatively affect compliance.
authors.affiliation: Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: von Gontard
authors.forename: Justine
authors.initials: J
authors.lastname: Niemczyk
authors.forename: Sigrid
authors.initials: S
authors.lastname: Thomé-Granz
authors.forename: Judith
authors.initials: J
authors.lastname: Nowack
authors.forename: Anne-Michaela
authors.initials: AM
authors.lastname: Moritz
authors.forename: Monika
authors.initials: M
authors.lastname: Equit
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D039721:Diagnostic and Statistical Manual of Mental Disorders; D053207:Diurnal Enuresis / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D004327:Drinking Behavior; D005242:Fecal Incontinence / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D010290:Parents; D011153:Population; D012574:Schools; D012737:Sex Factors; D011795:Surveys and Questionnaires