Psychosocial Difficulties in Children Referred to Pediatric Urology: A Closer Look

• Published in: Urology (Ridgewood, N.J.) N.J.), 2012-10, Vol.80 (4), p.907-913
• Main Authors: Wolfe-Christensen, Cortney, Veenstra, Amy L, Kovacevic, Larisa, Elder, Jack S, Lakshmanan, Yegappan
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Ambulatory Care; Anxiety - complications; Attention Deficit Disorder with Hyperactivity - complications; Biological and medical sciences; Body Mass Index; Child; Child, Preschool; Depression - complications; Female; Genital Diseases, Female - complications; Genital Diseases, Female - diagnosis; Genital Diseases, Male - complications; Genital Diseases, Male - diagnosis; Humans; Kidney Diseases - complications; Kidney Diseases - diagnosis; Male; Medical sciences; Mental Disorders - complications; Multivariate Analysis; Nephrology. Urinary tract diseases; Nocturnal Enuresis - complications; Nocturnal Enuresis - diagnosis; Nocturnal Enuresis - psychology; Odds Ratio; Retrospective Studies; Severity of Illness Index; Surveys and Questionnaires; Urination Disorders - complications; Urination Disorders - diagnosis; Urination Disorders - psychology; Urogenital Abnormalities - complications; Urogenital Abnormalities - diagnosis; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2012.04.077

Objective To assess rates of psychosocial difficulties in children seen in a pediatric urology clinic to determine whether all patients should be screened for psychosocial problems, and to use standardized measures to determine whether the severity of voiding dysfunction and/or enuresis in children is related to their degree of psychosocial difficulties. Methods A retrospective chart review was conducted to collect the Pediatric Symptom Checklist from all children referred to an outpatient urology clinic over a 6-month period. In addition, scores from the child's Dysfunctional Voiding Scoring System were collected for patients referred for voiding dysfunction and/or enuresis. Results Caregivers of 600 children completed the Pediatric Symptom Checklist as part of their child's outpatient clinic paperwork. Overall, 15.2% of the patients met the clinical cut-off for significant psychosocial difficulties. However, children with voiding dysfunction and/or enuresis were at increased risk for these problems, with the severity of their psychosocial difficulties being related to the severity of their urologic condition. Conclusion It is unnecessary to screen all pediatric urology patients, although those referred for voiding dysfunction and/or enuresis should be screened for psychosocial difficulties. Children at greatest risk for psychosocial problems were those who were male, had a high body mass index, had nocturnal enuresis, had an elevated Dysfunctional Voiding Scoring System score, and/or reported frequent episodes of wetting or soaking their underwear when they wet. Importantly, children appear to be most concerned with “wetness.”