Abstract General Information

Title

URINARY INCONTINCE AND SCHOOL PERFORMANCE - THE IMPACT OF MENTAL DISORDERS AND AGE AT TREATMENT ONSET

Introduction and objective

The rate of mental disorders is increased in children with urinary incontinence, and children with ADHD in general have lower school performance.
The aim of this study was to investigate whether UI in children is associated with difference in performance on standardized school tests in a nationwide matched cohort of Danish children, depending on comorbid mental disorder and age at onset of incontinence treatment.

Method

We conducted a population based matched cohort study including children born in Denmark between 1997-2008. We studied the effect of urinary incontinence on National School Test results in grade two to eight, native language and mathematics on a 1-100 point scale.
We estimated school test result differences (△) between children with urinary incontinence and their matched reference group and adjusted for selected confounders. We then subdivided our overall UI population into hierarchical groups regarding various mental disorder codes. Lastly we also investigated the effect of time before and after diagnose/treatment and subsequently divided children into three age groups according to age at matching (5-7, 8-10 and 11+ years).

Results

Overall children with urinary incontinence performed comparably to reference children. In general children with comorbid mental disorders scored far lower than the reference population for all types of mental disorders (△f.adj range [-25.0 ; -3.6]), except from children with autism or emotinal/mood disorders in lanuage.
The oldest age group had overall lower performance than the two other age groups, and the youngest age group performed comparable to the ref. group, e.g. 2 years after treatment △f.adj for 5-7 years olds was -0.6 (95 % CI [-1.0 ; -0.1]) for 8-10 year olds -2.1 (95 % CI [-2.9 ; -1.4]) and for 11+ year olds -5.4 (95 % CI [-7.7 ; -3.1]).

Conclusion

We found a significantly impaired school performance for children for children with mental disorders. Children starting treatment later had lower performance compared to children treated around school start. This strengthens the recommendation to asses for mental disorders but also warrants further research on how delayed treatment affects children with urinary incontince.