Incontinence and parent-reported oppositional defiant disorder symptoms in young children—a population-based study

Abstract

Background: Oppositional defiant disorder (ODD) and incontinence are common disorders of childhood. We have examined associations between ODD symptoms and incontinence in a representative sample of young children. Methods: A questionnaire with seven questions referring to incontinence, eight DSM-IV items of ODD, 15 items of the Home Situations Questionnaire and six items regarding eating, drinking or toileting refusal was administered to the parents of 718 children at school-entry from a defined geographical area at school-entry. Results: Of the 718 6-year-old children included in the analysis, 8.2 % had nocturnal enuresis (NE), 1.5 % had daytime urinary incontinence (DUI) and 1.1 % had faecal incontinence (FI). Significantly more boys than girls had NE (12 vs. 4.3 %). Overall, 6.7 % of children had ODD symptoms. Rates of ODD symptoms were significantly higher in incontinent children (19.5 %) than in continent children (5.2 %), with the highest rate of ODD symptoms in children with DUI (36.4 %). Children with incontinence (mean 6.1 episodes) or ODD symptoms (mean 8.4 episodes) showed non-compliant behaviours in more problem situations than continent children (mean 4.5 episodes) or children without ODD symptoms (mean 4.5 episodes). Conclusions: Incontinence and ODD are common comorbid disorders at school-entry age. Boys are more affected by both disorders. Children with DUI have the highest rate of ODD symptoms. As ODD symptoms affect many daily family situations, ODD needs to be diagnosed and treated in children with incontinence, as it can negatively affect compliance.