Enuresis:
08/11/97

Enuresis is discussed under Elimination Disorders (which includes Enuresis and Encopresis) in the Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence section of DSM-IV. It involves the repeated voiding of urine involuntarily in clothes or bed at least twice per week for 3 months (or cause significant distress or impairment for a shorter period). The child must be at least 5 years old (chronological or mental age) and not have a medical condition or take medication that is known to cause wetting. Bedwetting tends to run in families. Most children will begin to stay dry at night around three years of age. There are three subtypes, depending on when the enuresis occurs. Nocturnal only (the most common subtype) is distinguished by voiding urine only during sleep. Nocturnal Enuresis (bedwetting) is very common, and is not considered significant in a child younger than 5 years. Diurnal Enuresis occurs during waking hours and is more common in females than males. A combination of Nocturnal and Diurnal is the third subtype.

Since 1980, the definitive resource for classification of all mental illness in the U.S. has been the Diagnostic and Statistical Manual of Mental Disorders (known as DSM-IV). The DSM-IV criteria for Enuresis is available online.

Treatment (more) for enuresis includes exercises, medication (DDAVP nasal spray), alarm systems and hypnosis. The causes of enuresis are not known, but has been suggested to be related to small bladder size, abnormally deep sleep and can be associated with psychological stress. There are medical conditions which can are have the symptom of enuresis, and although they are rare, it is always best to consult a medical practitioner.

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