Clinical usefulness of the attention-deficit hyperactivity disorder rating scale-IV in the treatment of enuretic children undiagnosed with developmental disorders

Abstract

To determine the association between attention-deficit hyperactivity disorder (ADHD) and nocturnal enuresis (NE) and its relation to the effectiveness of NE treatment in children undiagnosed with developmental disorders. A total of 154 children with NE (112 males and 42 females) were included in this study, aged ≥ 5–<15 years, presenting at the Department of Pediatrics, Showa University Fujigaoka Hospital, between January 2016 and June 2017. None of the participants was diagnosed with developmental disorders. We retrospectively evaluated Attention-Deficit Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) scores, Dysfunctional Voiding Symptom Score (DVSS), NE clinical characteristics, and efficacy of NE treatment. The mean age was 8.0±2.0 years (standard deviation). Sixty-seven (40.3%) patients presented with daytime incontinence (DI). The mean total ADHD-RS and DVSS scores were 7.7± 8.0 and 6.6±4.3, respectively, and they were significantly correlated (p=0.049). ADHDRS scores were significantly higher in patients with DI than in those without DI (p=0.0006). ADHD-RS scores and large-volume DI (a DVSS subscale item) were significantly correlated. Six months after treatment initiation, patients with <50% improvement (nonresponder) in NE had significantly higher total ADHD-RS scores than those with ≥ 50% improvement (responder) (p=0.007). Even in patients not diagnosed with developmental disorders, ADHD characteristics may influence the clinical course of NE. Evaluation of ADHD characteristics using a screening tool such as the ADHD-RS is important in the NE treatment.