Abstract General Information

Title

EMOTIONAL AND BEHAVIORAL SYMPTOMS AMONG CHILDREN AT SCHOOL ENTRANCE AND THEIR ASSOCIATION TO URINARY AND/OR FECAL INCONTINENCE – A DANISH SURVEY STUDY.

Introduction and objective

Urinary and fecal incontinence are common disorders among children at school entry. Studies have reported a higher prevalence of attention deficit hyperactivity disorder and other neurodevelopmental disorders among children with incontinence. The objective of the present study was to assess emotional and behavioral symptoms among children at school entrance and explore into a possible relation to urinary and/or fecal incontinence using Childhood Bladder and Bowel Dysfunction Questionnaire (CBBD-Q) and Strength and Difficulties Questionnaire (SDQ).

Method

Parents of children in two municipalities of Denmark received an electronic survey, and a reminder of filling in the survey was given by the school nurse at the scheduled visit during first school year. The survey included the validated questionnaires; CBBD-Q and SDQ. CBBD-Q enabled distinction of children with and without incontinence, and SDQ was used to assess emotional and behavioral symptoms. Data was collected from September 2022 to July 2023.

Results

Data was collected on 1,063 children (mean age 6.41, 95%CI: 6.39-6.44), equal to a response rate of 39.9%. Boys accounted for 51.2% of the population. Urinary and/or fecal incontinence was reported by 34.9%. Children with incontinence had significantly higher scores on emotional symptoms (p-value: 0.00), conduct problems (p-value: 0.00), and hyperactivity/inattention problems (p-value:0.00) as compared to children without incontinence. Moreover, children with incontinence had less prosocial behavior (p-value: 0.00). Children with incontinence did not have significantly more peer relationship problems compared to children without incontinence (p-value: 0.06). Children with combined daytime urinary incontinence and fecal incontinence had a higher total difficulty score than children with solely urinary or fecal incontinence (p-value 0.00).

Conclusion

Children with combined urinary and fecal incontinence have more emotional and behavioral symptoms compared to children without incontinence and children with solely urinary or fecal incontinence. However, incontinence does not seem to influence the peer relationship at this age.