Enuresis as an Early Sign of Neuropsychological and Behavioural Disturbances: A Review

Abstract

Enuresis is a common pathological condition in children aged 6–12 years and adolescents, with percentages varying from 10% to 12% and 1%, respectively. It is mainly associated with genetic causes because a family history of enuresis is one of the main risk factors for suffering from the disease. Its pathophysiological mechanisms are still under discussion. However, it is mainly associated with deficiency at the level of hormones, such as antidiuretics, which are altered with circadian cycles, parasympathetic system alterations and sphincter-level problems. To determine the association between the development of enuresis as an early marker in children presenting neurological and behavioural problems. The review found 14 articles that support the strong association between enuresis and various behavioural alterations in children and adolescents, as well as neuropsychological, growth and learning problems. With the advancement of multidisciplinary health teams and a better understanding of conditions that were previously considered part of the expected growth process, it has been recognised that enuresis can be an early clinical sign of mental conditions that, if not addressed, can affect the quality of life and socialisation capacity of children in adulthood. The evidence provided so far shows a strong relationship between enuresis and problems of depression, anxiety, hyperactivity and issues such as obsessive–compulsive syndrome, among others, allowing paediatric urology an early approach to the identification of the issues at the mental health level, even before they are very evident, proposing an alternative for alerting and managing this type of patient.