• Users Online: 160
  • Home
  • Print this page
  • Email this page
Home Current issue Archives Ahead of print Search Subscribe Instructions Submit article About us Editorial board Contacts Login 

 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 39  |  Issue : 3  |  Page : 115-118

Assessment of anxiety and depression risks among mothers having children with nocturnal enuresis disorder


Department of Neuropsychiatry, Seuz Canal University, Seuz Canal, Egypt

Date of Submission10-Dec-2017
Date of Acceptance28-Dec-2017
Date of Web Publication11-Oct-2018

Correspondence Address:
Mona ELsayed
Department of Neuropsychiatry, Seuz Canal University, Seuz Canal
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejpsy.ejpsy_47_17

Rights and Permissions
  Abstract 


Background Enuresis is an important health problem among children between the ages of 5–16 years, and it affects the children and their parents psychosocially.
Objective This study aimed to detect the prevalence of anxiety and depression among the mothers having children with nocturnal enuresis disorder attending the psychiatric outpatients clinics of Seuz canal University Hospital and to detect the risk factors of these disorders in such group of patients.
Patients and methods A case–control study included 38 mothers having children with nocturnal enuresis disorder and 38 matched control group comparable regarding sociodemographic data. Both groups were subjected to clinical interview to collect demographic data, Beck depression inventory to assess depression, and Hamilton anxiety rating scale to assess anxiety.
Results There is a statistically significant difference between the study group and the control group regarding the mean Beck depression scale score; the study group has more depressive symptoms compared with the control group. However, there was no statistically significant difference between both groups regarding Hamilton anxiety scale score. Although there was an obvious increase in the mean Hamilton anxiety. Duration of management of more than 3 years was associated with the greatest risk of anxiety.
Conclusion Our finding suggested that mothers who have children with nocturnal enuresis show more depressive symptoms than the control group. Duration of management of more than 3 years was associated with the greatest risk of anxiety.

Keywords: depression anxiety mother nocturnal enuresis child


How to cite this article:
ELsayed M, Hassan H, Ibraheem O. Assessment of anxiety and depression risks among mothers having children with nocturnal enuresis disorder. Egypt J Psychiatr 2018;39:115-8

How to cite this URL:
ELsayed M, Hassan H, Ibraheem O. Assessment of anxiety and depression risks among mothers having children with nocturnal enuresis disorder. Egypt J Psychiatr [serial online] 2018 [cited 2018 Dec 18];39:115-8. Available from: http://new.ejpsy.eg.net/text.asp?2018/39/3/115/243029




  Introduction Top


Primary nocturnal enuresis (PNE) is the involuntary nighttime bed-wetting after the age of 5 years that does not originate from a urinary or neurological disorder. The etiology is not fully understood, and multifactorial indications have been blamed for it, including genetic causes, disrupted antidiuretic hormones secretion, impaired bladder function, sleep problems, delays in the maturation of central nervous system, and psychological and behavioral problems (Doganer et al., 2015).

The prevalence of PNE is reported to be ∼20% among children at the age of 5 years. However, the prevalence is determined to be different over the world. This difference could be owing to sociodemographic and methodological variances in studies (Merhi et al., 2014).

PNE is the cause of shame for the child and stress for the family. Although the condition is easily diagnosed by parents and physicians, its treatment requires a complex approach (Paediatric Society of New Zealand, 2005).

Increased anxiety and depression levels, as well as marital relationship difficulties, have been reported in parents of enuretic children (Tanriverdi et al., 2014).

Psychiatric condition and emotional well-being of parents are important factors in the psychological development of children (Lazarus et al., 2016).

Parental depression and anxiety can contributed to internalizing problems and psychopathology in their children (Rasing et al., 2015).

Studies that demonstrate the psychosocial conditions of the family having a child with enuresis are rather limited (Sahtiyancı et al., 2011).

So this study aims to identify the prevalence of depression and anxiety in mothers who have a child with PNE.


  Patients and methods Top


Study site

The study was conducted at the Psychiatric Outpatient Clinic of Suez Canal University Hospital.

Type of the study

This is a case–control study.

Study population

The study included 38 mothers having children with nocturnal enuresis attending the Psychiatric Outpatient Clinic, Suez Canal University Hospital.

Inclusion criteria

The following were the inclusion criteria:
  1. Mother aged between 20 and 50 years old.
  2. Mothers having one child or more with nocturnal enuresis disorder.
  3. Mothers who accepted to participate in the study.


Exclusion criteria

The following were the exclusion criteria:
  1. Mothers who have chronic medical illness or disabling medical disorder.
  2. Mothers who have mental disorder and are on regular psychotropic drugs.
  3. Mothers who have a child or more with disabling medical or mental disease or chronic medical illness.
  4. Mothers who refuse to participate in the study.


Control group

The control group included 38 mothers who matched with the study group regarding sociodemographic data.

Methods

Step 1

Mothers were interviewed, and sociodemographic data were collected including name, age, educational level, income, residence, marital status, and duration of management of the child.

Step 2

Depression and anxiety symptoms were assessed using Beck Depression Inventory, the Arabic version (Sweeney et al., 2006), and Hamilton Anxiety Rating scale, the Arabic version, which was obtained from Vahdaninia et al. (2010).

Ethical consideration

An informed consent was taken from each patient.


  Results Top


There is no statistically significant difference between the study group and the control group regarding sociodemographic data ([Table 1] and [Table 2]).
Table 1 Sociodemographic characteristics of the both the studied population

Click here to view
Table 2 Comparison between mother having child with nocturnal enuresis and the controls regarding Hamilton anxiety rating scale and Beck depression inventory scores

Click here to view


There is a statistically significant difference between the study group and the control group regarding the mean Beck depression scale score; the study group has more depressive symptoms compared with the control group. However, there was no statistically significant difference between both the groups regarding Hamilton anxiety scale score. Although there was an obvious increase in the mean Hamilton anxiety score ([Table 3]).
Table 3 Multiple regression analysis for the predictors of anxiety symptoms among mothers having affected child

Click here to view


Duration of management of more than 3 years was associated with the greatest risk of anxiety ([Table 4]).
Table 4 Multiple regression analysis for the predictors of depressive symptoms among mothers having affected child

Click here to view


None of the sociodemographic characteristics or duration of management could significantly predict depression in the study group.


  Discussion Top


This study aimed to detect the prevalence of anxiety and depression in 38 mothers having children with nocturnal enuresis disorder, attending the psychiatric outpatient clinics, Suez Canal University, and to detect the risks factors of these disorders in this group of mothers compared with 38 mothers with normal children as controls.

Our main result in this study is that there is a statistically significant difference between study group and the control group regarding mean ‘Beck depression scale’ score. The study group has more depressive symptoms compared with the control group. However, there was no statistically significant difference between both groups regarding Hamilton anxiety scale score. Although, there was an obvious increase in the mean Hamilton anxiety score.

A recent study by Durmaz et al. (2017) aimed to evaluate psychiatric dimensions in mothers having children with nocturnal enuresis. They found significant differences between the study group and control group regarding depression, anxiety, obsessive compulsive behavior, interpersonal sensitivity, somatization, hostility, and phobic anxiety. Our result is consistent with a previous study regarding depression data but different with it regarding anxiety data. This difference could be owing to difference in culture and usage of different tool in their evaluation (Durmaz et al., 2017).

Another study performed by Egemen et al. (2008), compared mothers of 38 healthy children and 28 children with enuresis, and they found mothers of children with enuresis had higher depression score and lower levels of life quality. This result is in consistence with our result (Egemen et al., 2008).

In another study by Sahtiyancı et al. (2011) that also evaluated 40 mothers of children with enuresis before and after treatment, the identified depression score had dropped after treatment when compared with the scores before treatment. However, no statistically significant difference was detected between the groups with respect to anxiety (Sahtiyancı et al., 2011). This is consistent with our study result.

On the contrary, a recent study by Demirci et al. (2016) aimed to evaluate the frequency of nocturnal enuresis in children and risk of depression and anxiety among parents, and the authors found high depression scores among the group with fathers having child with enuresis than the control group. Although mothers are the sole primary caregivers in our culture, this social role cannot be generalized for all cultures. Thus, assessment of mothers only could be considered to be limitation of our study, as the burden of enuresis affect also fathers as revealed by the previous study (Demirci et al., 2016).

Regarding the predictors of depression and anxiety among the study group, duration of management of more than 3 years was associated with the greatest risk of anxiety. None of the sociodemographic characteristics or duration of management could significantly predict depression among the study group. A recent study by Demirci et al. (2016),found educational level and socioeconomic income level of family as predictors for presence or absence of enuresis in children (Demirci et al., 2016); however, we could not find studies on these factor as predictors of depression or anxiety in mothers as caregiver for these children. In our opinion, the limitation of the studies in these points could be overcome through examining this relationship better in other bigger studies on a large number of children with enuresis and their families.


  Conclusion Top


Nocturnal enuresis is the cause of stress for the mother of affected child. There is a statistically significant difference between mothers of affect children and the control group regarding mean Beck depression scale score; the study group has more depressive symptoms compared with the control group. However, there was no statistically significant difference between both groups regarding Hamilton anxiety scale score. Although there was an obvious increase in the mean Hamilton anxiety. Duration of management more than 3 years was associated with the greatest risk of anxiety for these mothers.

Recommendation

We recommend the following:
  1. Psychoeducational programs need to be conducted for mothers having child with enuresis individually or in groups.
  2. Psychiatric help should be introduced to diagnose and manage affected mothers.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Demirci A, Kasım İ, Koc EM, Aksoy H, Kahveei R, Ertem O et al. (2016). Nocturnal enuresis frequency in children and anxiety-depression risks of parents. J Clin Exp Investig 7:150–156.  Back to cited text no. 1
    
2.
Doganer YC, Aydogan U, Ongel K, Sari O, Koc B, Saglam K (2015). Theprevalence and sociodemographic risk factors of enuresis nocturna among elementary school-age children. J Family Med Prim Care 4:39e44.  Back to cited text no. 2
    
3.
Durmaz O, Kemer S, Mutluer T, Bütün E (2017). Psychiatric dimensions in mothers ofchildren with primary nocturnal enuresis: a controlled study. J Pediatr Urol 13:62.e1–62.e6.  Back to cited text no. 3
    
4.
Egemen A, Akil I, Canda E, Ozyurt BC, Eser E (2008). An evaluation of quality of life of mothers of children with enuresis nocturna. Pediatr Nephrol 23:93–98.  Back to cited text no. 4
    
5.
Lazarus RS, Dodd HF, Majdandzic M, de Vente W, Morris T, Byrow Y et al. (2016). The relationship between challenging parenting behaviour and childhood anxiety disorders. J Affect Dis 190:784e91.  Back to cited text no. 5
    
6.
Merhi BA, Hammoud A, Ziade F, Kamel R, Rajab M (2014). Monosymptomatic nocturnal enuresis in lebanese children: prevalence, relation with obesity, and psychological effect. Clin Med Insight Pediatr 8:5e9.  Back to cited text no. 6
    
7.
Paediatric Society of New Zealand. (2005). Best practice evidence based guideline: nocturnal enuresis ‘bedwetting’. Wellington: New Zealand Guidelines Group. 23–24. Available at: http://www.paediatrics.org.nz/files/guidelines/Enuresisguidelinefinalendorsed.pdf  Back to cited text no. 7
    
8.
Rasing SP, Creemers DH, Janssens JM, Scholte RH (2015). The association between perceived maternal and paternal psychopathology and depression and anxiety symptoms in adolescent girls. Front Psychol 6:963.  Back to cited text no. 8
    
9.
Sahtiyancı M, Aydoğan G, Yılmaz A, Yilmaz A (2011). Primer enürezis nokturnalı hastaların ve annelerinin depresyon ölçekleri ile değerlendirilmesi. JOPP 3:122–128.  Back to cited text no. 9
    
10.
Sweeney C, Schmitz KH, Lazovich D, Virnig BA, Wallace RB, Folsom AR. (2006). Functional limitations in elderly female cancer survivors. J Natl Cancer Inst 98:521–529.  Back to cited text no. 10
    
11.
Tanriverdi MH, Palanci Y, Yilmaz A, Penbegul N, Bez Y, Daggulli M (2014). Effects of enuresis nocturna on parents of affected children: case-control study. Pediatr Int 56:254e7.  Back to cited text no. 11
    
12.
Vahdaninia M, Omidvari S, Montazeri A (2010). What do predict anxiety and depression in breast cancer patients? A follow-up study. Soc Psychiatry Psychiatr Epidemiol 45:355–361.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Patients and methods
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed189    
    Printed2    
    Emailed0    
    PDF Downloaded20    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]