Association between mental health problems and nocturnal enuresis among children and adolescents in Ethiopia

Abstract

Background: Mental health problem impacts the life of children, adolescents, and their family. Different physiological factors were implicated as etiology of Nocturnal Enuresis (NE). Small body of research examined the impact of mental health problem on NE in children and adolescents. Method: At Wolaita Sodo University Comprehensive Specialized Hospital, a cross-sectional study was carried out between September 22, 2022, and November 22, 2022 to examine association between mental health problems and NE among children and adolescents. A Sample of 423 research participants was recruited using systematic random sampling. A structured, in-person interviewer-administered questionnaire was used to collect the data. A Diagnostic Statistical Manual (DSM-5) were used to assess NE and Strengths and Difficulties questionnaire (SDQ) parent report version were used to screen for child and adolescent mental health problems. Bi-variate and multivariate analysis were used to determine the association between independent and outcome variables. A 95% confidence interval (CI) with a corresponding p-value < 0.05 was used to determine the strength of the association. Result: Out of 423 participants 417 were participated in the study. The mean age of the participants was 8.3 ± 2.3 years. Two hundred forty seven (n 247, 59.2%) of the participants were between 5 and 8 years and (n 271, 65%) were boys. Regarding living status of the participated children and adolescents (n 297, 71.2%) were living with their parents. According to the educational level of children and adolescents (n 270, 64.7%) were primary school and above, while education level for (n 151, 36.2%) parents were high school and above. The magnitude of NE was (n 57, 13.7%). The overall magnitude of behavioral and emotional problem was, (n 154, 36.9%) and specifically (n 139, 33.3%) had emotional problems, (n 73, 17.5%) had hyperactive-inattention, (n 89, 21.3%) had conduct problems, and (n 134, 32.1%) had peer problems. NE occurred among 29.8% (n 17) of children with abnormal total difficulty score, 22.8% (n 13) of children with conduct problem, 10.5% (n 6) of children with emotional problems, 21.1% (n 12) of children with hyperactive-inattention problem, and 10.5% (n 6) of children with peer problems. The total difficulty score (AOR = 0.94; 95% CI: 0.46, 1.93), conduct problems (AOR = 0.72; 95% CI: 0.35, 1.48) and hyperactivity-inattention problems (AOR = 0.49; 95% CI: 0.23, 1.04) were not found to be associated with NE. But Emotional problems (AOR = 3.7; 95% CI: 1.52, 9.04) and peer problems (AOR = 3.4; 95% CI: 1.39, 8.31) found to independently associated with NE. Conclusion and recommendation: In this study emotional and peer-problems - but not the total difficulty score, conduct or hyperactivity problems – were associated with NE. Thus, targeted early intervention focusing on emotional and peer problems should be designed to improve children’s and adolescents NE.