Child and Adolescent Psychiatry

CHAPTER 18

Enuresis

Though enuresis is sometimes considered a psychiatric disorder, with some
parents imagining that it is due to deep-seated emotional problems, it is
more often a habit or developmental problem than a mental health prob-
lem. Though children and adolescents with enuresis do still get referred to
mental health specialists who are familiar with behavioural approaches, it
is worth remembering that these same behavioural approaches can often
be applied equally effectively by other professionals, for example, specialist
health visitors.
It is important to distinguish betweennocturnal enuresis(bed wetting)
anddiurnal enuresis(daytime wetting). Nocturnal and diurnal enuresis
differ in several respects and examination questions often seem to be
designed to catch out people who confuse the two. Boys are more prone
to nocturnal enuresis, while girls are more prone to diurnal enuresis.
Nocturnal enuresis is commoner than diurnal enuresis (see Box 18.1) and
it is less likely to be associated with urinary tract infections or psychiatric
disorders.

Box 18.1Overlap and relative prevalence of nocturnal and diurnal

enuresis

Diurnal enuresis

60–80% of children with

diurnal enuresis also

wet by night

Nocturnal enuresis

10–30% of children with

nocturnal enuresis also

wet by day

Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.

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