PEDIATRICS Vol. 42 No. 4 October 1968, pp. 627-641
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SOCIAL, PSYCHOLOGICAL, AND NEUROLOGICAL FACTORS ASSOCIATED WITH NOCTURNAL ENURESIS

Wallace C. Oppel M.A., M.S.S.W.1, Paul A. Harper M.D., M.P.H.1, and Rowland V. Rider Sc.D.1

1 Johns Hopkins School of Hygiene and Public Health, Johns Hopkins University, Baltimore

Data on 859 children, who have been followed longitudinally from birth through 12 years, display associations of nocturnal enuresis with neurological, social, and psychological factors. To study these associations, various groups were formed, taking into account age of attaining ness and presence or absence of relapse. Most comparisons were of enuretic status at 6 to 8 years versus other measures at 6 to 10 years, as specified. Six-year-old children are at increased risk of having never been dry when they have neurological abnormalities on clinical examination, are middle children in birth order, or when their mothers have an unfavorable evaluation of them, a poor marital adjustment, or a low rating on a social contact scale. Other maternal attitudes are more likely to be associated with the never dry status of girls than of boys. Never dry 7 year olds are more sensitive, more likely to suppress feelings, more with-drawn, less ambitious, and have less fear of failure than the permanently dry group.

Relapsers at 6 to 7frac12 years are more likely to be of low socioeconomic status, have a large number of siblings and display the following personality traits: decreased fear of failure, decreased anxiety and tension, and increased impulsivity when compared to non-relapsers.

Low birth weight carries an increased risk of both prolonged bedwetting (never dry) and relapsing when it is associated with low I.Q. or poor performance on reading tests. Poor performance on Bender-Gestalt tests also is associated with increased risk of relapsing in children who are of low birth weight.

Submitted on December 27, 1967
Accepted on April 23, 1968




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