Attention-deficit/hyperactivity disorder (ADHD) as a risk factor for persistent nocturnal enuresis in children: a two-year follow-up study.

Aims: A previous prevalence study indicated that the prevalence of ADHD is highly increased in enuretic children. In the current 2-y follow-up study we investigate the relationship between both disorders further. Our goal is to determine whether the ADHD diagnoses can be reconfirmed and whether children with ADHD are more at risk for difficult-to-cure enuresis. Moreover, we explore the effect of medical enuresis parameters on the course of the voiding problem.

Methods: Eighty-six children with enuresis were screened twice on the presence of ADHD with a 2-y interval. A multi-method, multi-informant assessment of ADHD was used, the child's medical file was consulted, and a parent questionnaire on the child's current voiding problems was completed.

Results: Although 73% of all children with a 2-y-old diagnosis of ADHD still meet the disorder's criteria, only 66% of all subtype diagnoses can be reconfirmed. The odds that a child with ADHD still has voiding problems after 2 y are 3.17 times higher than for a child without ADHD. Although a slightly increased number of prescribed therapies in the ADHD group was noticed, no other significant differences in enuresis treatment methods were found between the groups. The medical parameters were not associated with treatment outcome.

Conclusion: Since 73% of ADHD diagnoses can be reconfirmed, the data suggest that the prevalence of the ADHD syndrome rather than reactive ADHD symptomatology is increased in enuretic children. Children with ADHD are at risk for persistent enuresis. Two-year-old medical enuresis parameters seem to have little effect on the current presence/absence of enuresis.