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Challenging factors for enuresis treatment: psychological problems and non-adherence

(2015) JOURNAL OF PEDIATRIC UROLOGY. 11(6). p.308-313
Author
Organization
Abstract
The evidence for organic pathogenetic factors in enuresis and the discovery of effective therapies targeting the bladder and/or nocturnal diuresis have overwhelmed every potential role of psychological factors in pathogenesis and treatment. However, psychopathology is still important in enuresis because according to the document of the International Children's Continence Society (ICCS) 20-30% of the children with enuresis have at least one psychological/psychiatric disorder at rates two times higher than non-wetting children. The most common comorbid disorder with enuresis is attention deficit hyperactivity disorder. The aim of this review is to translate the existing evidence on the importance of a psychological screening into daily clinical practice of the medical practitioner. The use of the minimal psychological screening tool should be considered mandatory in each primary setting. If psychological problems are indicated, referral of the patient to a multidisciplinary setting should be considered, not only to allow psychological assessment to screen for a possible psychopathology, but also since therapy resistance might be expected. This review concentrates on two items from psychopathology/psychotherapy that might predict insufficient treatment response: the psychological comorbidities as described according to the DSM-5 criteria and the underestimated importance of therapy adherence. Adherence is a cornerstone of effective therapy in enuresis. It is a problem involving the doctor, the patient, and the parents. Increasing adherence takes effort and is time-consuming. But it is worthwhile knowing that several studies have demonstrated that high adherence is associated with high therapy success of enuresis. Eventually, this is the ultimate goal of treatment.
Keywords
Nocturnal enuresis, Psychology, Screening, Impact, Adherence, Compliance, DEFICIT-HYPERACTIVITY DISORDER, PRIMARY NOCTURNAL ENURESIS, QUALITY-OF-LIFE, ATTENTION-DEFICIT, DESMOPRESSIN RESPONSE, URINARY-INCONTINENCE, CONTROLLED-TRIAL, SELF-CONCEPT, CHILDREN, POPULATION

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Citation

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MLA
Van Herzeele, Charlotte et al. “Challenging Factors for Enuresis Treatment: Psychological Problems and Non-adherence.” JOURNAL OF PEDIATRIC UROLOGY 11.6 (2015): 308–313. Print.
APA
Van Herzeele, C., De Bruyne, P., De Bruyne, E., & Vande Walle, J. (2015). Challenging factors for enuresis treatment: psychological problems and non-adherence. JOURNAL OF PEDIATRIC UROLOGY, 11(6), 308–313.
Chicago author-date
Van Herzeele, Charlotte, Pauline De Bruyne, Elke De Bruyne, and Johan Vande Walle. 2015. “Challenging Factors for Enuresis Treatment: Psychological Problems and Non-adherence.” Journal of Pediatric Urology 11 (6): 308–313.
Chicago author-date (all authors)
Van Herzeele, Charlotte, Pauline De Bruyne, Elke De Bruyne, and Johan Vande Walle. 2015. “Challenging Factors for Enuresis Treatment: Psychological Problems and Non-adherence.” Journal of Pediatric Urology 11 (6): 308–313.
Vancouver
1.
Van Herzeele C, De Bruyne P, De Bruyne E, Vande Walle J. Challenging factors for enuresis treatment: psychological problems and non-adherence. JOURNAL OF PEDIATRIC UROLOGY. 2015;11(6):308–13.
IEEE
[1]
C. Van Herzeele, P. De Bruyne, E. De Bruyne, and J. Vande Walle, “Challenging factors for enuresis treatment: psychological problems and non-adherence,” JOURNAL OF PEDIATRIC UROLOGY, vol. 11, no. 6, pp. 308–313, 2015.
@article{6925157,
  abstract     = {The evidence for organic pathogenetic factors in enuresis and the discovery of effective therapies targeting the bladder and/or nocturnal diuresis have overwhelmed every potential role of psychological factors in pathogenesis and treatment. However, psychopathology is still important in enuresis because according to the document of the International Children's Continence Society (ICCS) 20-30% of the children with enuresis have at least one psychological/psychiatric disorder at rates two times higher than non-wetting children. The most common comorbid disorder with enuresis is attention deficit hyperactivity disorder. The aim of this review is to translate the existing evidence on the importance of a psychological screening into daily clinical practice of the medical practitioner. The use of the minimal psychological screening tool should be considered mandatory in each primary setting. If psychological problems are indicated, referral of the patient to a multidisciplinary setting should be considered, not only to allow psychological assessment to screen for a possible psychopathology, but also since therapy resistance might be expected. This review concentrates on two items from psychopathology/psychotherapy that might predict insufficient treatment response: the psychological comorbidities as described according to the DSM-5 criteria and the underestimated importance of therapy adherence. Adherence is a cornerstone of effective therapy in enuresis. It is a problem involving the doctor, the patient, and the parents. Increasing adherence takes effort and is time-consuming. But it is worthwhile knowing that several studies have demonstrated that high adherence is associated with high therapy success of enuresis. Eventually, this is the ultimate goal of treatment.},
  author       = {Van Herzeele, Charlotte and De Bruyne, Pauline and De Bruyne, Elke and Vande Walle, Johan},
  issn         = {1477-5131},
  journal      = {JOURNAL OF PEDIATRIC UROLOGY},
  keywords     = {Nocturnal enuresis,Psychology,Screening,Impact,Adherence,Compliance,DEFICIT-HYPERACTIVITY DISORDER,PRIMARY NOCTURNAL ENURESIS,QUALITY-OF-LIFE,ATTENTION-DEFICIT,DESMOPRESSIN RESPONSE,URINARY-INCONTINENCE,CONTROLLED-TRIAL,SELF-CONCEPT,CHILDREN,POPULATION},
  language     = {eng},
  number       = {6},
  pages        = {308--313},
  title        = {Challenging factors for enuresis treatment: psychological problems and non-adherence},
  url          = {http://dx.doi.org/10.1016/j.jpurol.2015.04.035},
  volume       = {11},
  year         = {2015},
}

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