Sixty-three children with functional enuresis or encopresis were clinically evaluated for their symptoms and underlying causes. Five enuretics with convulsive disorder were excluded. Nine of 14 children with diurnal enuresis also had nocturnal enuresis. Most were the first born children. The number of males with enuresis were almost twice more than females. The mean age was 8.87 years, and generally the primary type patients tended to visit the hospital later than secondary type patients. The onset of primary encopresis was earlier than that of enuresis. The mean frequencies of enuresis and encopresis were 4.7 and 2.3 per week respectively, and the patients had additional one or two. urinary functional symptoms as urgency or incontnence. The most patients with primary enuresis had the withdrawn personality, while those with secondary enuresis had the out-going personality. Two of the 30 enuretics showed abnormal EEG findings, 13 borderline findings and 15 normal findings. Secondary tybe patients showed more normal findings. Parents’ marital discord overprotection, seperation, punishment, sibling rivalry and other familial problems were more frequently associated with the secondary type disorder. However, depression, other emotional problems and functional somatic symptoms were more frequently found in the secondary type disorder, suggesting that these symptoms are reactive to enuresis or encopresis. The behavioral problems such as hyperactivity, speech disorders and sleep disorders, and past history of prematurity, convulsion, developmental delay and attention deficit and family history of enuresis were more frequently found in the primary type disorder. These findings suggest that unknown genetic or physiological defects in the central nervous system may be a significant etiological factor, especially in primary type enuresis and encopresis, while the secondary type disorder maybe caused by more of psychodynamic complications.
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연구대상 및 방법
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