Study of the profile of behavioral problems and quality of life indexes in a pediatric cohort of monosymptomatic enuresis

J Pediatr (Rio J). 2019 Mar-Apr;95(2):188-193. doi: 10.1016/j.jped.2017.12.006. Epub 2018 Feb 8.

Abstract

Objective: To evaluate and correlate, before and after the therapeutic intervention, the behavioral problem scores evaluated by the CBCL/6-18 questionnaire and the quality of life indexes evaluated by the PedsQL™ 4.0 in patients with monosymptomatic nocturnal enuresis.

Method: After the initial evaluation and completion of the CBCL/6-18 questionnaire, a multidisciplinary evaluation and completion of the PedsQL™ 4.0 questionnaire was performed. Of the initially evaluated 140 children and adolescents aged 6-16 years, 58 were excluded due to non-monosymptomatic enuresis or associated comorbidities. Of the initially included 82 patients, who were randomized to three treatment groups, 59 completed the CBCL/6-18 and PedsQL™ 4.0 questionnaires at the end of the treatment and were included in this study. The α error was set at 5% for ruling out the null hypothesis.

Results: Of the total of 59 participants, 45.8% responded with total success, 23.7% were partially successful, 23.7% did not reach the improvement criteria, and 6.8% gave up the treatment. There was a significant increase in quality of life indexes and a reduction of post-intervention behavioral problem scores, in the three proposed modalities, in patients who had a total or partial response to treatment. There was no correlation between higher scores of pre-treatment behavior problems and therapeutic failure.

Conclusions: Only the participants who successfully responded to interventions showed improvement in quality of life and behavioral problems, which indicates that enuresis is a primary problem that has a negative impact on these parameters. The authors suggest that it is possible to achieve success in the treatment of monosymptomatic enuresis, even in patients with high pre-intervention behavioral problem scores.

Keywords: Behavioral problems; Desmopressin; Desmopressina; Enurese noturna monossintomática; Monosymptomatic nocturnal enuresis; Problemas de comportamento; Qualidade de vida; Quality of life; Tratamento com alarme; Treatment with alarm.

MeSH terms

  • Adolescent
  • Antidiuretic Agents / administration & dosage*
  • Child
  • Clinical Alarms*
  • Cohort Studies
  • Combined Modality Therapy
  • Deamino Arginine Vasopressin / administration & dosage*
  • Female
  • Humans
  • Male
  • Nocturnal Enuresis / psychology
  • Nocturnal Enuresis / therapy*
  • Patient Care Team
  • Problem Behavior / psychology*
  • Quality of Life / psychology*

Substances

  • Antidiuretic Agents
  • Deamino Arginine Vasopressin