Psychiatric dimensions in mothers of children with primary nocturnal enuresis: A controlled study

SummaryIntroductionThe etiology of primary nocturnal enuresis (PNE) is not fully understood, but multifactorial factors have been associated with PNE. Parental factors, including attitudes to PNE, disciplinary behaviors, and psychiatric comorbidities in parents have been related to etiology of PNE, outcomes and the quality of life in children with enuresis.ObjectiveWe examined the psychopathology in mothers of children diagnosed with monosymptomatic PNE(MoPNE) compared with mothers of non-enuretic children (MoNEC) in terms of personality characteristics, early traumatic experiences, and psychiatric symptom evaluation.Study designThe study included 44 mothers of children diagnosed with PNE and 45 mothers of non-enuretic children who were randomly selected from the population applying to the pediatric outpatient clinic. Individuals were assessed through psychometric questionnaires, including the Eysenck Personality Questionnaire Revised Abbreviated (EPQR-A), the Symptom Checklist-90 (SCL-90-R), and the Childhood Trauma Questionnaire (CTQ), in addition to a sociodemographic form including 9 structured “yes/no” questions that evaluated intrafamilial relationships, as well as mothers' perceptions of enuresis and its treatment.ResultsThe median age of enuretic children was 7 (6, 9.5) (25th, 75th) years in the study population. The rates of history of enuresis in childhood were 26.7% in the MoPNE group (n = 12) and 6.7% in the MoNEC group (n = 3; p = 0.011). There were significant differences between the groups for the subscales of somatization, anxiety, obsessive-compulsive behavior, depression, interpersonal sensitivity, psychoticism, hostility, phobic anxiety, additional items, and the general psychopathology index in the SCL-90-R scores (p < 0.05). Meanwhile, there was no significant difference for the subscale of paranoid ideation (p = 0.070). There were statistically significant results for the subscales of sexual abuse, physical neglect, and total score in CTQ scale, while the personality dimensions evaluated using the EPQR-A resulted in significant differences in the E and L subscales (p < 0.05) (Table).ConclusionOur study showed that psychiatric symptomatology and childhood traumatic experiences were considerably higher in mothers of children with PNE. This study highlights the importance of evaluating PNE not only from a biological aspect, but also in terms of psychosocial factors, including assessment of the mother's mental status.Table. Major psychiatric and sociodemographic differences found between mothers of children with primary nocturnal enuresis and mothers of non-enuretic controls.MoPNEMoNECp-valueaAge, median (25th, 75th)35 (27, 39)34 (31, 37)0.502Number of children, median (25th, 75th)3 (2, 4)2 (2, 2.5)<0.001Number of mothers with enuresis history in childhood12 (26,7%)3 (6, 7%)0.011MoPNE median (25th, 75th)MoNEC, median (25th, 75th)Sexual abuse (CTQ)5 (5, 5)5 (5, 7)0.041Physical neglect (CTQ)7 (6, 11.75)6 (5, 8)0.001Extraversion (EPQR-A)4 (2, 5)5 (2.5, 6)0.049Lying (L) (EPQR-A)5 (4, 6)5 (4, 6)0.019General psychopathology index (SCL 90-R)0.9 (0.46, 1.56)0.41 (0.21, 0.67)<0.001MoPNE, mother of children with primary enuresis nocturna; MoNEC, mother of non-enuretic children; CTQ, Childhood Trauma Questionnaire; EPQR-A, Eysenck Personality Questionnaire Revised Abbreviated; SCL-90-R, Symptom Checklist-90.aMann-Whitney U test.