Psychiatric assessment of nocturnal enuresis in children

In ICD-10, nocturnal enuresis is defined as the repeated involuntary voiding of urine in bed after the age of 5 (or mental age of 4). The following subgroups of enuresis have been described: nocturnal, daily, and their combination. There are two types of enuresis: primary and secondary. Enuresis is defined as primary if the child has never had a 6-month period in which he or she was dry at night or secondary if the child begins wetting after a 6-month period of dryness. Recent studies indicate that nocturnal enuresis is best regarded as a group of conditions with different etiologies. The heterogeneity of primary nocturnal enuresis highlights the need for a differentiated approach to treatment, tailored to the suspected etiology in the individual child. This article reviews the psychiatric aspects of nocturnal enuresis: psychiatric classification, psychosocial factors, psychiatric comorbidity and psychiatric treatment.

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