Skip to main content
Top
Published in: European Journal of Pediatrics 2/2017

01-02-2017 | Original Article

Incontinence in persons with Angelman syndrome

Authors: C Wagner, J Niemczyk, M Equit, L Curfs, A von Gontard

Published in: European Journal of Pediatrics | Issue 2/2017

Login to get access

Abstract

Angelman syndrome (AS) is a congenital syndrome with a prevalence of 1:15,000. Individuals with AS often have severe intellectual disability, typical dysmorphic signs, and behavioral problems. The aim of the study was to investigate the rate of incontinence and associated psychological problems in children and adults with AS. Ninety children (4–18 years) and 54 adults (18–31 years) with AS were recruited through a parent support group (55.6% male, mean age 15.1 years). The Parental Questionnaire: Enuresis/Urinary Incontinence, the Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS), as well as the Developmental Behaviour Checklist for parents (DBC-P) or for adults (DBC-A) were filled out by parents or caregivers. 85.6% of individuals with AS were affected by at least one subtype of incontinence (82.7% nocturnal enuresis (NE), 64.7% daytime urinary incontinence (DUI), and 57.1% fecal incontinence (FI)). 52.5% of the children and 32.6% of adults reached a clinically relevant DBC score. Incontinence was not associated with behavioral problems. NE and DUI were associated with genotype and epilepsy.
Conclusion: Children with AS have high rates of incontinence. Many adults are still affected by NE, DUI, or even FI. Screening, assessment, and treatment of incontinence in individuals with AS are recommended.
What is Known:
Incontinence in persons with Angelman syndrome (AS) is associated with younger age, lower level of adaptive functioning, and epilepsy.
What is New:
Children and teens with AS are at special risk for incontinence, but older persons are also affected.
Comorbid epilepsy is significantly associated not only with nocturnal enuresis (NE) but also with daytime urinary incontinence (DUI). Underlying genotype is significantly associated with incontinence.
Literature
1.
go back to reference American Psychiatric Association (APA) (2013) Diagnostic and statistical manual of mental disorders—fifth edition (DSM 5). APA, Washington, D.C. American Psychiatric Association (APA) (2013) Diagnostic and statistical manual of mental disorders—fifth edition (DSM 5). APA, Washington, D.C.
2.
go back to reference Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Walle JV, von Gontard A, Wright A, Yang SS, Nevéus T (2015) The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society. Neurourol Urodyn. doi:10.1002/nau.22751 PubMed Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Walle JV, von Gontard A, Wright A, Yang SS, Nevéus T (2015) The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society. Neurourol Urodyn. doi:10.​1002/​nau.​22751 PubMed
4.
go back to reference Braam W, Didden R, Smits MG (2008) Melatonin for chronic insomnia in Angelman syndrome: a randomized placebo-controlled trial. J Child Neurol 23:649CrossRefPubMed Braam W, Didden R, Smits MG (2008) Melatonin for chronic insomnia in Angelman syndrome: a randomized placebo-controlled trial. J Child Neurol 23:649CrossRefPubMed
5.
go back to reference Buntinx IM, Hennekam RC, Brouwer OF (1995) Clinical profile of Angelman syndrome at different ages. Am J Med Genet 56:176CrossRefPubMed Buntinx IM, Hennekam RC, Brouwer OF (1995) Clinical profile of Angelman syndrome at different ages. Am J Med Genet 56:176CrossRefPubMed
6.
go back to reference De Gennaro M, Niero M, Capitanucci ML, Von Gontard A, Woodward M, Tubaro A, Abrams P (2010) Validity of the international consultation on incontinence questionnaire-pediatric lower urinary tract symptoms: a screening questionnaire for children. J Urol 184:1662–1667CrossRefPubMed De Gennaro M, Niero M, Capitanucci ML, Von Gontard A, Woodward M, Tubaro A, Abrams P (2010) Validity of the international consultation on incontinence questionnaire-pediatric lower urinary tract symptoms: a screening questionnaire for children. J Urol 184:1662–1667CrossRefPubMed
7.
go back to reference Einfeld S, Tonge B (1995) Manual for the Developmental Behaviour Checklist—Primary Carer Version (DBC-P) & Teacher Version (DBC-T). Monash University Centre for Developmental Psychiatry and Psychology, Clayton, Melbourne Einfeld S, Tonge B (1995) Manual for the Developmental Behaviour Checklist—Primary Carer Version (DBC-P) & Teacher Version (DBC-T). Monash University Centre for Developmental Psychiatry and Psychology, Clayton, Melbourne
8.
9.
go back to reference Merks BT, Burger H, Willemsen J (2012) Melatonin treatment in children with therapy-resistant monosymptomatic nocturnal enuresis. J Pediatr Urol 8:416CrossRefPubMed Merks BT, Burger H, Willemsen J (2012) Melatonin treatment in children with therapy-resistant monosymptomatic nocturnal enuresis. J Pediatr Urol 8:416CrossRefPubMed
10.
go back to reference Peters SU, Kaufmann WE, Bacino CA (2011) Alterations in white matter pathways in Angelman syndrome. Dev Med Child Neurol 53:361CrossRefPubMed Peters SU, Kaufmann WE, Bacino CA (2011) Alterations in white matter pathways in Angelman syndrome. Dev Med Child Neurol 53:361CrossRefPubMed
11.
go back to reference Radstaake M, Didden R, Giesbers S, Korzilius H, Peters-Scheffer N, Lang R, von Gontard A, Curfs LMG (2013) Incontinence in individuals with Angelman syndrome: a comparative study. Res Dev Disabil 34:4184–4193CrossRefPubMed Radstaake M, Didden R, Giesbers S, Korzilius H, Peters-Scheffer N, Lang R, von Gontard A, Curfs LMG (2013) Incontinence in individuals with Angelman syndrome: a comparative study. Res Dev Disabil 34:4184–4193CrossRefPubMed
12.
go back to reference Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS (2006) Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 130:1527–1537CrossRefPubMed Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS (2006) Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 130:1527–1537CrossRefPubMed
14.
go back to reference Takaesu Y, Komada Y, Inoue Y (2012) Melatonin profile and its relation to circadian rhythm sleep disorders in Angelman syndrome patients. Sleep Med 13:1164CrossRefPubMed Takaesu Y, Komada Y, Inoue Y (2012) Melatonin profile and its relation to circadian rhythm sleep disorders in Angelman syndrome patients. Sleep Med 13:1164CrossRefPubMed
15.
go back to reference Thibert RL, Larson AM, Hsieh DT (2013) Neurologic manifestations of Angelman syndrome. Pediatr Neurol 48:271CrossRefPubMed Thibert RL, Larson AM, Hsieh DT (2013) Neurologic manifestations of Angelman syndrome. Pediatr Neurol 48:271CrossRefPubMed
16.
go back to reference Von Gontard A (2012) Encopresis. In: Rey JM (ed) IACAPAP e-textbook of child and adolescent mental health. International Association for Child and Adolescent Psychiatry and Allied Professions, Geneva Von Gontard A (2012) Encopresis. In: Rey JM (ed) IACAPAP e-textbook of child and adolescent mental health. International Association for Child and Adolescent Psychiatry and Allied Professions, Geneva
17.
go back to reference Von Von Gontard A (2012) Enuresis. In: Rey JM (ed) IACAPAP e-textbook of child and adolescent mental health. International Association for Child and Adolescent Psychiatry and Allied Professions, Geneva Von Von Gontard A (2012) Enuresis. In: Rey JM (ed) IACAPAP e-textbook of child and adolescent mental health. International Association for Child and Adolescent Psychiatry and Allied Professions, Geneva
18.
go back to reference Von Gontard A, Niemczyk J, Borggrefe-Moussavian S (2015) Incontinence in children, adolescents and adults with Williams Syndrome. Neurourol Urodyn, in press Von Gontard A, Niemczyk J, Borggrefe-Moussavian S (2015) Incontinence in children, adolescents and adults with Williams Syndrome. Neurourol Urodyn, in press
19.
go back to reference Von Wendt L, Simila S, Niskanen P, Jarvelin M (1990) Development of bowel and bladder control in the mentally retarded. Dev Med Child Neurol 32:515–518CrossRefPubMed Von Wendt L, Simila S, Niskanen P, Jarvelin M (1990) Development of bowel and bladder control in the mentally retarded. Dev Med Child Neurol 32:515–518CrossRefPubMed
Metadata
Title
Incontinence in persons with Angelman syndrome
Authors
C Wagner
J Niemczyk
M Equit
L Curfs
A von Gontard
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics / Issue 2/2017
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-016-2828-1

Other articles of this Issue 2/2017

European Journal of Pediatrics 2/2017 Go to the issue