Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities

• Published in: Archives of psychiatric nursing 2017-06, Vol.31 (3), p.319-323
• Main Author: Thurber, Steven
• Format: Article
• Language: English
• Subjects: Behavior Therapy - methods; Deamino Arginine Vasopressin - therapeutic use; Desmopressin; Dry bed training; Enuresis; Enuresis - diagnosis; Enuresis - drug therapy; Enuresis - epidemiology; Humans; Nursing; Pavlovian conditioning; Urine alarm
• ISSN: 0883-9417; 1532-8228
• DOI: 10.1016/j.apnu.2016.11.005

Enuresis constitutes a frequently encountered problem area for children that may adversely affect social and emotional adjustment. This type of incontinence has been of concern to the human family for centuries. A brief history of enuresis is presented followed by current conceptualizations, diagnostic criteria, prevalence rates and psychiatric comorbidities. Historic notions of causation together with ineffective, sometimes barbaric treatments are then discussed, ending with a presentation of evidence-based treatment modalities, with the urine alarm being an essential element of effective treatment. An intervention termed dry bed training combines the urine alarm with a series of procedures designed in part to reduce relapse potential and should be a primary consideration for implementation by treatment professionals. Finally, a brief case study is presented illustrating special etiological and treatment considerations with juvenile psychiatric patients. •Diagnostic criteria for enuresis from international organizations are compared and contrasted.•Information important for the understanding and effective treatment of nocturnal and diurnal enuresis is presented.•There are unique concerns in etiology and treatment of psychiatric patients.•Urine alarm, dry-bed training, and desmopressin are treatments of choice.