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Published in: European Child & Adolescent Psychiatry 6/2014

01-06-2014 | Original Contribution

Elimination disorders and anxious-depressed symptoms in preschool children: a population-based study

Authors: Monika Equit, Anna-Maria Klein, Katrin Braun-Bither, Stefan Gräber, Alexander von Gontard

Published in: European Child & Adolescent Psychiatry | Issue 6/2014

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Abstract

The prevalence rates of elimination disorders and anxious/depressed symptoms of a representative sample of young children and their associations were assessed. 2,079 children in a defined geographical area were examined at school-entry. A parental questionnaire with 4 questions referring to symptoms of incontinence and 14 items of the anxious/depressed scale of the Child Behavior Checklist (CBCL) was administered. 9.5 % of 6-year-old children wet at night, 2.7 % wet during day and 1.2 % had faecal incontinence. Significantly more boys wet at night (11.7 %) than girls (7.2 %; OR 0.58, 95 % CI 0.43–0.78). 12.7 % had clinically relevant anxious/depressed symptoms. Children with at least one elimination disorder had significantly higher T values of the ‘anxious/depressed’ CBCL than continent controls. Children with faecal incontinence had highest T values of the ‘anxious/depressed’ CBCL syndrome scale, significantly higher than those of children with other elimination disorders and controls. Elimination disorders, as well as anxious/depressed symptoms are common at a young age. Boys are more affected by elimination disorders than girls, but not by anxious/depressed symptoms. Children with faecal incontinence have the highest rate of anxious/depressed symptoms.
Footnotes
1
The t distribution is a normal distribution with a mean of X = 50 and a standard deviation of SD = 10, T scores were calculated with the formula T = 50 + 10 * z score.
 
Literature
1.
go back to reference Nevéus T, von Gontard A, Hoebeke P et al (2006) The standardisation of terminology of lower urinary tract function in children and adolescents: report from the Standardization Committee of the International Children’s Continence Society (ICCS). J Urol 176:314–324PubMedCrossRef Nevéus T, von Gontard A, Hoebeke P et al (2006) The standardisation of terminology of lower urinary tract function in children and adolescents: report from the Standardization Committee of the International Children’s Continence Society (ICCS). J Urol 176:314–324PubMedCrossRef
2.
go back to reference Rasquin A, Di Lorenzo C, Forbes D et al (2006) Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 130:1527–1537PubMedCrossRef Rasquin A, Di Lorenzo C, Forbes D et al (2006) Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 130:1527–1537PubMedCrossRef
3.
go back to reference von Gontard A, Moritz AM, Thomé-Granz S (2011) Association of attention deficit and elimination disorders at school entry—a population-based study. J Urol 185(5):2027–2032CrossRef von Gontard A, Moritz AM, Thomé-Granz S (2011) Association of attention deficit and elimination disorders at school entry—a population-based study. J Urol 185(5):2027–2032CrossRef
4.
go back to reference Butler RJ, Golding J, Northstone K et al (2005) Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int 96:404–410PubMedCrossRef Butler RJ, Golding J, Northstone K et al (2005) Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int 96:404–410PubMedCrossRef
5.
go back to reference Sureshkumar P, Jones M, Caldwell PHY et al (2009) Risk factors for nocturnal enuresis in school-age children. J Urol 182:2893–2899PubMedCrossRef Sureshkumar P, Jones M, Caldwell PHY et al (2009) Risk factors for nocturnal enuresis in school-age children. J Urol 182:2893–2899PubMedCrossRef
6.
go back to reference Sureshkumar P, Craig JC, Roy LP, Knight JF (2000) Daytime urinary incontinence in primary school children: a population-based survey. Pediatrics 137(6):814–818CrossRef Sureshkumar P, Craig JC, Roy LP, Knight JF (2000) Daytime urinary incontinence in primary school children: a population-based survey. Pediatrics 137(6):814–818CrossRef
7.
go back to reference Joinson C, Heron J, von Gontard A (2006) Psychological problems in children with daytime wetting. Pediatrics 118:1985–1993PubMedCrossRef Joinson C, Heron J, von Gontard A (2006) Psychological problems in children with daytime wetting. Pediatrics 118:1985–1993PubMedCrossRef
8.
go back to reference Joinson C, Heron J, Butler U et al (2006) Psychological differences between children with and without soiling problems. Pediatrics 117:1575–1584PubMedCrossRef Joinson C, Heron J, Butler U et al (2006) Psychological differences between children with and without soiling problems. Pediatrics 117:1575–1584PubMedCrossRef
9.
go back to reference van der Wal MF, Benninga MA, HiraSing RA (2005) The prevalence of encopresis in a multicultural population. J Pediatr Gastroenterol Nutr 40(3):345–348PubMed van der Wal MF, Benninga MA, HiraSing RA (2005) The prevalence of encopresis in a multicultural population. J Pediatr Gastroenterol Nutr 40(3):345–348PubMed
10.
go back to reference Bellmann M (1966) Studies on encopresis. Acta Paediatr Scand 170 (Suppl.):1–151 Bellmann M (1966) Studies on encopresis. Acta Paediatr Scand 170 (Suppl.):1–151
11.
go back to reference Heron J, Joinson C, Croudace T, von Gontard A (2008) Trajectories of daytime wetting and soiling in a United Kingdom 4 to 9-year-old population birth cohort study. J Urol 179(5):1970–1975PubMedCrossRef Heron J, Joinson C, Croudace T, von Gontard A (2008) Trajectories of daytime wetting and soiling in a United Kingdom 4 to 9-year-old population birth cohort study. J Urol 179(5):1970–1975PubMedCrossRef
12.
go back to reference Swithinbank LV, Heron J, von Gontard A, Abrams A (2010) The natural history of daytime urinary incontinence in children: a large Britsh cohort. Acta Paediatr 99(7):1031–1036PubMedCrossRef Swithinbank LV, Heron J, von Gontard A, Abrams A (2010) The natural history of daytime urinary incontinence in children: a large Britsh cohort. Acta Paediatr 99(7):1031–1036PubMedCrossRef
13.
go back to reference Egger HL, Angold A (2006) Common emotional and behavioral disorders in preschool children. Presentation, nosology and epidemiology. J Child Psychol Psyc 47:313–337CrossRef Egger HL, Angold A (2006) Common emotional and behavioral disorders in preschool children. Presentation, nosology and epidemiology. J Child Psychol Psyc 47:313–337CrossRef
14.
go back to reference Furniss T, Beyer T, Guggenmoos J (2006) Prevalence of behavioral and emotional problems among six-years-old preschool children: baseline results of a prospective longitudinal study. Soc Psychiatry Psychiatr Epidemiol 41:394–399PubMedCrossRef Furniss T, Beyer T, Guggenmoos J (2006) Prevalence of behavioral and emotional problems among six-years-old preschool children: baseline results of a prospective longitudinal study. Soc Psychiatry Psychiatr Epidemiol 41:394–399PubMedCrossRef
15.
go back to reference Kuschel A, Lübke A, Köppe E et al (2004) Häufigkeit psychischer Auffälligkeiten und Begleitsymptome bei drei- bis sechsjährigen Kindern: Ergebnisse der Braunschweiger Kindergartenstudie. Z. Kinder-Jugendpsychiatr 32(2):97–106CrossRef Kuschel A, Lübke A, Köppe E et al (2004) Häufigkeit psychischer Auffälligkeiten und Begleitsymptome bei drei- bis sechsjährigen Kindern: Ergebnisse der Braunschweiger Kindergartenstudie. Z. Kinder-Jugendpsychiatr 32(2):97–106CrossRef
16.
go back to reference Kuschel A, Heinrichs N, Bertram H et al (2008) Psychische Auffälligkeiten bei Kindergartenkindern aus der Sicht der Eltern und Erzieherinnen in Abhängigkeit von soziodemografischen Merkmalen. Kindheit und Entwicklung 17(3):161–172CrossRef Kuschel A, Heinrichs N, Bertram H et al (2008) Psychische Auffälligkeiten bei Kindergartenkindern aus der Sicht der Eltern und Erzieherinnen in Abhängigkeit von soziodemografischen Merkmalen. Kindheit und Entwicklung 17(3):161–172CrossRef
17.
go back to reference Tröster H, Reinike D (2007) Prävalenz von Verhaltens- und Entwicklungsauffälligkeiten im Kindergartenalter. Kindheit und Entwicklung 16(3):171–179CrossRef Tröster H, Reinike D (2007) Prävalenz von Verhaltens- und Entwicklungsauffälligkeiten im Kindergartenalter. Kindheit und Entwicklung 16(3):171–179CrossRef
18.
go back to reference von Gontard A, Baeyens D, van Hoecke E et al (2011) Psychological and psychiatric issues in urinary and fecal incontinence. J Urol 185:1432–1437CrossRef von Gontard A, Baeyens D, van Hoecke E et al (2011) Psychological and psychiatric issues in urinary and fecal incontinence. J Urol 185:1432–1437CrossRef
19.
go back to reference Feehan M, McGee R, Stanton W et al (1990) A 6 year follow-up of childhood enuresis: prevalence in adolescence and consequences for mental health. J Paediatr Child Health 26:75–79PubMedCrossRef Feehan M, McGee R, Stanton W et al (1990) A 6 year follow-up of childhood enuresis: prevalence in adolescence and consequences for mental health. J Paediatr Child Health 26:75–79PubMedCrossRef
20.
go back to reference Baeyens D, Roeyers H, Vande Walle J et al (2005) Behavioural problems and attention-deficit hyperactivity disorder in children with enuresis: a literature review. Eur J Pediatr 164:665–672PubMedCrossRef Baeyens D, Roeyers H, Vande Walle J et al (2005) Behavioural problems and attention-deficit hyperactivity disorder in children with enuresis: a literature review. Eur J Pediatr 164:665–672PubMedCrossRef
21.
go back to reference Joinson C, Heron J, Emond A et al (2007) Psychological problems in children with bedwetting and combined (day and night) wetting: A UK population-based study. J Pediatr Psychol 32:605–616PubMedCrossRef Joinson C, Heron J, Emond A et al (2007) Psychological problems in children with bedwetting and combined (day and night) wetting: A UK population-based study. J Pediatr Psychol 32:605–616PubMedCrossRef
22.
go back to reference Cox DJ, Morris JB Jr, Borowitz SM et al (2002) Psychological differences between children with and without chronic encopresis. J Pediatr Psychol 27:585–591PubMedCrossRef Cox DJ, Morris JB Jr, Borowitz SM et al (2002) Psychological differences between children with and without chronic encopresis. J Pediatr Psychol 27:585–591PubMedCrossRef
23.
go back to reference Van Hoecke E, Hoebeke P, Braet C et al (2004) An assessment of internalizing problems in children with enuresis. J Urol 171:2580–2583PubMedCrossRef Van Hoecke E, Hoebeke P, Braet C et al (2004) An assessment of internalizing problems in children with enuresis. J Urol 171:2580–2583PubMedCrossRef
24.
go back to reference Bongers MEJ, van Dijk M, Benninga MA et al (2009) Health related quality of life in children with constipation-associated fecal incontinence. J Pediatrics 154(5):749–753CrossRef Bongers MEJ, van Dijk M, Benninga MA et al (2009) Health related quality of life in children with constipation-associated fecal incontinence. J Pediatrics 154(5):749–753CrossRef
25.
go back to reference Joinson C, Heron J, von Gontard A et al (2008) Early childhood risk factors associated with daytime wetting and soiling in school-age children. J Pediatr Psychol 33(7):739–750PubMedCrossRef Joinson C, Heron J, von Gontard A et al (2008) Early childhood risk factors associated with daytime wetting and soiling in school-age children. J Pediatr Psychol 33(7):739–750PubMedCrossRef
26.
go back to reference Joinson C, Heron J, Butler R, Croudace T (2009) Development of nighttime bladder control from 4–9 years: association with dimensions of parent rated child maturational level, child temperament and maternal psychopathology. Longitud Life Course Stud 1(1):73–94 Joinson C, Heron J, Butler R, Croudace T (2009) Development of nighttime bladder control from 4–9 years: association with dimensions of parent rated child maturational level, child temperament and maternal psychopathology. Longitud Life Course Stud 1(1):73–94
27.
go back to reference Bosquet M, Egeland B (2006) The development and maintenance of anxiety symptoms from infancy through adolescence in a longitudinal sample. Dev Psychopathol 18(2):517–550PubMedCrossRef Bosquet M, Egeland B (2006) The development and maintenance of anxiety symptoms from infancy through adolescence in a longitudinal sample. Dev Psychopathol 18(2):517–550PubMedCrossRef
28.
go back to reference Oldehinkel AJ, Hartman CA, De Winter AF et al (2004) Temperament profiles associated with internalizing and externalizing problems in preadolescence. Dev Psychopathol 16(2):421–440PubMedCrossRef Oldehinkel AJ, Hartman CA, De Winter AF et al (2004) Temperament profiles associated with internalizing and externalizing problems in preadolescence. Dev Psychopathol 16(2):421–440PubMedCrossRef
29.
go back to reference Muris P, Ollendick TH (2005) The role of temperament in the etiology of child psychopathology. Clin Child Fam Psychol Rev 8(4):271–289PubMedCrossRef Muris P, Ollendick TH (2005) The role of temperament in the etiology of child psychopathology. Clin Child Fam Psychol Rev 8(4):271–289PubMedCrossRef
30.
go back to reference Mäntymaa M, Puura K, Luoma I et al (2012) Predicting internalizing and externalizing problems at five years by child and parental factors in infancy and toddlerhood. Child Psych Hum Dev 43(2):153–170CrossRef Mäntymaa M, Puura K, Luoma I et al (2012) Predicting internalizing and externalizing problems at five years by child and parental factors in infancy and toddlerhood. Child Psych Hum Dev 43(2):153–170CrossRef
31.
go back to reference Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. University of Vermont, Department of Psychiatry, Burlington Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. University of Vermont, Department of Psychiatry, Burlington
32.
go back to reference Arbeitsgruppe Deutsche Child Behavior Checklist (1998) Elternfragebogen über das Verhalten von Kindern und Jugendlichen. Deutsche Bearbeitung der Child Behavior Checklist (CBCL 4-18). Einführung und Anleitung zur Auswertung. KJFD, Köln Arbeitsgruppe Deutsche Child Behavior Checklist (1998) Elternfragebogen über das Verhalten von Kindern und Jugendlichen. Deutsche Bearbeitung der Child Behavior Checklist (CBCL 4-18). Einführung und Anleitung zur Auswertung. KJFD, Köln
33.
go back to reference Ang RP, Rescorla LA, Achenbach TM et al (2012) Examining the criterion validity of CBCL and TRF problem scales and items in a large Singapore sample. Child Psychiatry Hum Dev 43:70–86PubMedCrossRef Ang RP, Rescorla LA, Achenbach TM et al (2012) Examining the criterion validity of CBCL and TRF problem scales and items in a large Singapore sample. Child Psychiatry Hum Dev 43:70–86PubMedCrossRef
34.
go back to reference Rescorla L, Achenbach T, Ivanova MY et al (2007) Behavioral and emotional problems reported by parents of children ages 6 to 16 in 31 societies. J Emot Behav Disord 15:130–142CrossRef Rescorla L, Achenbach T, Ivanova MY et al (2007) Behavioral and emotional problems reported by parents of children ages 6 to 16 in 31 societies. J Emot Behav Disord 15:130–142CrossRef
35.
go back to reference Pauschardt J, Remschmidt H, Mattejat F (2010) Assessing child and adolescent anxiety in psychiatric samples with the child behavior checklist. J Anxiety Disord 24:461–467PubMedCrossRef Pauschardt J, Remschmidt H, Mattejat F (2010) Assessing child and adolescent anxiety in psychiatric samples with the child behavior checklist. J Anxiety Disord 24:461–467PubMedCrossRef
36.
go back to reference Goodman R (1997) The strength and difficulties questionnaire: a research note. J Child Psychol Psyc 38:581–586CrossRef Goodman R (1997) The strength and difficulties questionnaire: a research note. J Child Psychol Psyc 38:581–586CrossRef
37.
go back to reference Döpfner M, Berner W, Fleischmann T et al (1993) Verhaltensbeurteilungsbogen für Vorschulkinder (VBV 3-6). Beltz, Weinheim Döpfner M, Berner W, Fleischmann T et al (1993) Verhaltensbeurteilungsbogen für Vorschulkinder (VBV 3-6). Beltz, Weinheim
38.
go back to reference Hölling H, Erhart M, Ravens-Sieberer U et al (2007) Verhaltensauffälligkeiten bei Kindern und Jugendlichen. erste Ergebnisse aus dem Kinder- und Jugendgesundheitssurvey (KIGGS). Bundesgesundheitsbl - Gesundheitsforsch – Gesundheitsschutz 50:784–793 Hölling H, Erhart M, Ravens-Sieberer U et al (2007) Verhaltensauffälligkeiten bei Kindern und Jugendlichen. erste Ergebnisse aus dem Kinder- und Jugendgesundheitssurvey (KIGGS). Bundesgesundheitsbl - Gesundheitsforsch – Gesundheitsschutz 50:784–793
39.
go back to reference Costello EJ, Erkanli A, Angold A (2006) Is there an epidemic of child and adolescent depression? J Child Psychol Psyc 47:1263–1271 Costello EJ, Erkanli A, Angold A (2006) Is there an epidemic of child and adolescent depression? J Child Psychol Psyc 47:1263–1271
40.
go back to reference Fuhrmann P, Equit M, Schmidt K et al (2012) Preschool depression is associated with developmental disorders–a population-based study (Manuscript submitted for publication) Fuhrmann P, Equit M, Schmidt K et al (2012) Preschool depression is associated with developmental disorders–a population-based study (Manuscript submitted for publication)
41.
go back to reference Crijnen AAM, Achenbach TM, Verhulst FC (1999) Problems reported by parents of children in multiple cultures: the child behavior checklist syndrome constructs. Am J Psychiatry 156:569–574PubMed Crijnen AAM, Achenbach TM, Verhulst FC (1999) Problems reported by parents of children in multiple cultures: the child behavior checklist syndrome constructs. Am J Psychiatry 156:569–574PubMed
42.
go back to reference Kendall PC, Puliafico AC, Barmish AJ et al (2007) Assessing anxiety with the child behavior checklist and the teacher report form. J Anxiety Disord 21:1004–1015PubMedCrossRef Kendall PC, Puliafico AC, Barmish AJ et al (2007) Assessing anxiety with the child behavior checklist and the teacher report form. J Anxiety Disord 21:1004–1015PubMedCrossRef
43.
go back to reference Goodman R, Ford T, Richards H et al (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psyc 41:645–655CrossRef Goodman R, Ford T, Richards H et al (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psyc 41:645–655CrossRef
Metadata
Title
Elimination disorders and anxious-depressed symptoms in preschool children: a population-based study
Authors
Monika Equit
Anna-Maria Klein
Katrin Braun-Bither
Stefan Gräber
Alexander von Gontard
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 6/2014
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-013-0468-9

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