Published online July 3, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. e308-e316 (doi:10.1542/peds.2006-2891)
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ARTICLE

A United Kingdom Population-Based Study of Intellectual Capacities in Children With and Without Soiling, Daytime Wetting, and Bed-wetting

Carol Joinson, PhDa, Jon Heron, PhDa, Richard Butler, PhD, CPsycholb, Alexander Von Gontard, MDc, Ursula Butler, MRCPCHd, Alan Emond, MDe and Jean Golding, PhDe

a Departments of Social Medicine
e Community Based Medicine, University of Bristol, Bristol, United Kingdom
b Child and Adolescent Mental Health Services, East Leeds Primary Care Trust, Leeds, United Kingdom
c Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
d Sheffield Children's National Health Service Trust, Sheffield, United Kingdom

OBJECTIVE. The objective of this study was to examine differences in intellectual capacities between children with and without soiling, daytime wetting, and bed-wetting.

METHODS. This study was based on a population of >6000 children (age range: 7 years 6 months to 9 years 3 months; median: 7 years 6 months) from the United Kingdom–based Avon Longitudinal Study of Parents and Children. Data on wetting and soiling were obtained from a questionnaire completed by parents. The Wechsler Intelligence Scale for Children–Third Edition was administered at a research clinic.

RESULTS. Bed-wetting was associated with lower Wechsler Intelligence Scale for Children–Third Edition IQ scores compared with control subjects, particularly performance IQ. This difference remained after exclusion of children with an IQ of <70 and adjustment for gender, stressful life events, and sociodemographic background. There were fewer differences in IQ scores between children with and without soiling or daytime wetting. Co-occurring wetting and soiling were associated with lower IQ scores than isolated soiling, daytime wetting, or bed-wetting, but this was mostly attributable to an overrepresentation of children with an IQ of <70 in the co-occurrence group.

CONCLUSIONS. It is hypothesized that the differences in intellectual capacities between children with and without bed-wetting are associated with maturational deficits of the central nervous system. There was less evidence for differences in intellectual capacities between children with and without soiling and daytime wetting. The central nervous system is involved to a lesser extent in soiling and daytime wetting, because peripheral influences from the bladder and gut play a greater role.

Key Words: soiling • bed-wetting • daytime wetting • intellectual capacities • IQ

Abbreviations: CNS—central nervous system • WISC-R—Wechsler Intelligence Scale for Children–Revised • ALSPAC—Avon Longitudinal Study of Parents and Children • WISC-III—Wechsler Intelligence Scale for Children–Third Edition • CI—confidence interval • OR—odds ratio • DSM-IV—Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition

Accepted Jan 25, 2007.


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