Emotional problems and urinary incontinence in children from a UK cohort.

BACKGROUND

Emotional problems are more common in children with urinary incontinence (UI). This study examines (i) if UI is related to changes in emotional problems over time and (ii) if changes in emotional problems over time are related to the subsequent risk of UI.

METHODS

The study is based on data from 8188 children aged 6¾-9 years (50.7 % females) from the Avon Longitudinal Study of Parents and Children. Parents reported on their child's UI (bedwetting and daytime wetting) at 7½ and 9½ years and emotional problems (Strengths and Difficulties Questionnaire) at 6¾ and 9½ years. We used a latent difference score model to examine (i) if presence of UI at 7½ years is related to the magnitude of change in emotional problems from 6¾-9½ years and (ii) if a change in emotional problems from 6¾-9½ years is related to the probability of UI at 9½ years.

RESULTS

UI at age 7½ was associated with a change (increase) in emotional problems over time (e.g. daytime wetting: unadjusted β = 0.205 (SE = 0.085), p < 0.001). The change was greater in children with both bedwetting and daytime wetting (unadjusted β = 0.535 (SE = 0.103), p < 0.001). A change in emotional problems from 6¾-9½ years was related to the probability of UI at age 9½ (probit coefficient estimate = 0.145 (SE = 0.03), p < 0.001). Findings were robust to the inclusion of confounders.

CONCLUSIONS

Children with UI experience increased emotional problems over time and changes in emotional problems were associated with subsequent UI. Emotional problems should be evaluated in children treated for incontinence.