title: Incidence of obsessive-compulsive disorder in children with nonmonosymptomatic primary nocturnal enuresis.
abstract: BACKGROUND
  Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive-compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE).
  
  
  METHODS
  In this case-control study, we evaluated 186 children aged 6-17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1-3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale.
  
  
  RESULTS
  The difference in compulsion was significant (P= 0.021), whereas the difference in obsession was significant between the two groups (P= 0.013). The most common symptom in CKD children with compulsion was silent repetition of words.
  
  
  CONCLUSIONS
  Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE.
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Parsa
authors.initials: P
authors.lastname: Yousefichaijan
authors.affiliation: Department of Student Research Committee, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Khosrobeigi
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Psychiatric, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Bahman
authors.initials: B
authors.lastname: Salehi
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Taherahmadi
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Fakhreddin
authors.initials: F
authors.lastname: Shariatmadari
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Ghandi
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Alinejad
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran; Department of Pediatrics, Factuality of Medicine, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Fateme
authors.initials: F
authors.lastname: Farhadiruzbahani
keywords: Children; enuresis; obsessive-compulsive