[Enuresis from the viewpoint of the pediatric psychiatrist].

Abstract

The etiological aspects of enuresis are diverse. Biological factors such as infection, developmental delay and genitourinary tract malformation must be excluded before the child psychiatrist ever undertakes to treat enuresis. In enuresis patients treated by a psychiatrist, an important role is played by the patients' social setting. These children came more often than controls from broken families, unhappy and quarreling parents who tends to give less attention to their children and encourage early separation. Enuresis is also more frequently associated with psychosocial changes (e.g., hospitalization, birth of a sibling, moving to a new home, etc.). The paper examines developmental stages of the child from the point of view of toilet training, circadian rhythms, and sleep stages from the point of view of enuresis incidence. What has a child psychiatrist to offer? Treatment of enuresis should involve a detailed analysis of the lifestyle, psychotherapy and drug therapy, rehabilitation and re-educational training. The most effective drugs are reviewed; these include tricyclic antidepressives (with a number of side effects) and Adiuretin as the drug of first choice, therapeutically hard-to-control enuresis, enuresis in adolescence, and the Peter Pan syndrome.