Associations Between Psychiatric Disorders and Enuresis in Taiwanese Children: A National Population-Based Study
Received 10 September 2019
Accepted for publication 7 December 2019
Published 18 February 2020 Volume 2020:12 Pages 163—171
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Irene Petersen
Hsin-Lin Tsai,1,2 Jei-Wen Chang,2,3 Mu-Hong Chen,4,5 Mei-Jy Jeng,3,6 Ling-Yu Yang,2,7 Keh-Gong Wu2,3
1Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; 2Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; 4Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; 5Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 6Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan; 7Department of Education, Taipei Veterans General Hospital, Taipei, Taiwan
Correspondence: Jei-Wen Chang
Department of Pediatrics, Taipei Veterans General Hospital, No. 201, Sec.2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, Republic of China
Background: Psychiatric disorders such as attention-deficit/hyperactivity disorder may negatively impact drug compliance and the prognosis of enuresis. However, existing studies regarding associations between lifetime psychiatric disorders and childhood enuresis are primarily from Western countries, and studies from Taiwan are lacking.
Methods: We conducted a population-based retrospective cohort analysis using the Taiwan Longitudinal Health Insurance Database 2010. A total of 1,146 children with enuresis (ICD-9-CM code: 307.6) and 4,584 randomly selected sex- and age-matched controls were identified between January 1, 1997 and December 31, 2011. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the development of psychiatric disorders in the children with enuresis.
Results: Enuresis was more common in the younger children, and the rate was significantly higher in boys (58.7%) than in girls (41.3%). A total of 171 patients (14.9%) in the enuresis group had at least one psychiatric diagnosis vs 259 (5.7%) in the control group (p< 0.001). Multivariate analysis showed that the presence of enuresis increased the odds of developing major depressive/dysthymic disorder (OR=2.841, 95% CI: 1.619, 4.987), attention-deficit/hyperactivity disorder (OR=3.156, 95% CI: 2.446, 4.073), autism spectrum disorder (OR=2.468, 95% CI: 1.264, 4.822), anxiety disorders (OR=3.113, 95% CI: 2.063, 4.699), intelligence disability (OR=3.989, 95% CI: 2.476, 6.426), disruptive behavior disorders (OR=3.749, 95% CI: 1.756, 8.004), and tic disorder (OR=2.660, 95% CI: 1.642, 4.308).
Conclusion: Children with enuresis are likely to have psychiatric disorders, and physicians should consider this during their evaluation.
Keywords: psychiatric disorder, enuresis, attention-deficit/hyperactivity disorder, children
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