Incontinence and ADHD

[Mercury]

Does anyone know of a link between ADHD (or just ADD) and incontinence?

This is a very difficult subject for me to talk about, but I figured I'd embrace the annominity of the internet and look into it anyways.

I was diagnosed with ADHD as a child in the 80s. Back then I know alot less was known about the disorder. My diagnosis was a little iffy because my doctors didn't think girls got ADHD and because I had bathroom problems. The medical experience went pretty badly for me. The medications didn't do much other than make me high, so I haven't been on them since grade school. There was no physical problem found for me bathroom problems I was basically treated like I didn't care that these things were happening to me and given alot of really insulting treatments.

These days I am a functional adult with ADHD, that strives to keep my incontinence a secret. I would love to not have to deal with these things, but am scared of running into the same frustrating medical situations as when I was a child.

I was just curious if anyone else had dealt with similar problems and had some advise for me.

[madd]

Hi, that is a delicate question. I don't know of any link between the two but then I'm not a doctor. There are some medically knowledgable people that frequent this place so hopefully one of them can help you more. I just wanted to say that, from my experience, its not just what you ask a doctor, its which doctor you ask. Do some research on urologists and urological procedures and search out a helpful doctor that offers some real help. Don't just settle for what the HMO offers or tells you. And be willing to foot the bill. From my experience (prostate) a lot of problems of this sort aren't taken real seriously by the medical establishment. It isn't really a life or death problem so they pooh pah it and call it a quality of life issue. The last doctor that told me that I told him that if you pluck the wings off of a fly, thats a quality of life issue. You won't kill but it'll wish it was dead. But on the other hand we add'ers tend to obsess over just this kinda thing. Don't let it get you. Do the best you can with what available to you and then pat yourself on the back. Good luck.

[meadd823]

This is a very difficult subject for me to talk about, but I figured I'd embrace the annominity of the internet and look into it anyways

Older publications would some times mention the link between ADD and urinary incontinence especially at night and was mostly linked to young boys.

Although the details given are sketchy and understandably so I have done some checking into the condition and maybe while we are waiting for the smart people some of these sites may be of assistance!

American Academy of Family Phy.


More information here also

Hope these help!!

[tired_need_help]

Hi. nocturnal enuresis was a symptom that i suffered from when i was a child too..
this was an article that i came across when i was researching about this and i have attaced this from my file. hope that helps in some way


------------------------------------------
The Journal of Urology

Copyright (C) 2003 by American Urological Association, Inc.

Volume 170(4, Part 1 of 2), October 2003, pp 1347-1350

Management of Urinary Incontinence and Nocturnal Enuresis in Attention-Deficit
Hyperactivity Disorder
[PEDIATRIC UROLOGY]

CRIMMINS, C. R.; RATHBUN, S. R.; HUSMANN, D. A.*
From the Department of Urology, Mayo Clinic, Rochester, Minnesota
Accepted for publication May 30, 2003.
* Corresponding author and requests for reprints: Department of Urology, Mayo
Clinic, Rochester, Minnesota 55905 (telephone: 507-284-2959; FAX: 507-284-4951;
e-mail: dhusmann@mayo.edu).

----------------------------------------------

Outline

ABSTRACT

MATERIALS AND METHODS

RESULTS

DISCUSSION

CONCLUSIONS

REFERENCES

Graphics

Table 1
Table 2
Table 3

ABSTRACT

Purpose: We sought to determine whether attention-deficit hyperactivity disorder
(ADHD) influences the resolution of urinary incontinence (UI, or diurnal and
nocturnal wetness) and monosymptomatic nocturnal enuresis (NE).

: We performed a retrospective review of patients with ADHD, UI and NE.
Individuals with UI were treated with timed voiding, and anticholinergics were
added only after timed voiding failed. Patients with NE were treated with either
an enuretic alarm, desmopressin or imipramine. Statistical comparisons used a
control population matched for age, sex, IQ, and urinary and gastrointestinal
symptoms.

: The presence of ADHD had a negative effect on the resolution of incontinence,
with 68% of the patients with ADHD becoming continent compared to 91% of
controls (p

: Treatment of urinary incontinence in children with ADHD is impaired compared
to those without ADHD, and is directly affected by compliance and IQ.

----------------------------------------------

Attention-deficit hyperactivity disorder (ADHD), a neurobehavioral complaint
manifested by impulsive hyperactive inattentive behavior, affects approximately
5% of school-age children. The coexistence of ADHD and toileting problems is
well known, with current studies documenting that 20% to 25% of children with
ADHD will have coexisting urinary incontinence. 1-4 Further documenting the
concurrent toileting problems found in patients with ADHD is the finding that
20% of the children presenting with the combined complaints of encopresis and
enuresis have ADHD. 5,6

We have been actively treating children with enuresis since 1986. During this
time span we developed the impression that we were significantly less successful
in achieving resolution of enuresis in children with ADHD. Although we attempted
to confirm our intuition by reviewing the existing literature, we found a
paucity of published data on this topic. Therefore, the purpose of this study is
to elucidate the following questions-Do children with ADHD and urinary
incontinence respond to treatment as well as those without ADHD? Does coexisting
encopresis impact the ability to treat successfully urinary incontinence in the
child with ADHD? Does the child with ADHD and a decreased IQ have the same
treatment success as the patient with ADHD and a normal IQ? Does the patient
with monosymptomatic nocturnal enuresis and ADHD respond to the same therapy as
the child with monosymptomatic nocturnal enuresis without ADHD?

MATERIALS AND METHODS

A retrospective review of all patients referred with a diagnosis of attention-deficit
hyperactivity disorder and enuresis from 1986 to 2002 was performed. The
diagnosis of ADHD had been made by either a clinical psychologist, child
psychiatrist or pediatrician. All patients were under pharmacological treatment
for ADHD when their urinary incontinence was evaluated and treated. We excluded
children who had a concomitant history of profound mental retardation,
psychosis, autism, traumatic head injury and seizure disorders. We assessed IQ
in all of our patients with ADHD and urinary incontinence using the Wechsler
Intelligence Scale for Children. Patients with urinary incontinence were then
further subdivided into 2 categories-normal IQ 84 or greater and subnormal
mentation IQ 36 to 83.

Incontinence of urine was defined as the presence of uncontrolled wetting in
children older than 6 years. Cases of incontinence were separated into 2 major
categories-urinary incontinence (diurnal and nocturnal incontinence/mixed
enuresis) and monosymptomatic nocturnal enuresis. To be included in this study a
patient with urinary incontinence had to have one or more episodes of diurnal
incontinence per week combined with 3 or more nocturnal enuretic episodes per
week. Individuals entering the study for monosymptomatic nocturnal enuresis had
3 or more nocturnal enuretic episodes per week. These 2 major categories were
further subdivided into primary (patients who had never been continent of urine)
and secondary incontinence (patients who had development of urinary incontinence
after a 6-month dry interval).

All patients with urinary incontinence were initially treated with timed voiding
at 2-hour intervals throughout the day. Anticholinergic medications were added
if timed voiding failed. Noncompliance with a timed voiding interval was defined
as the failure of the patient to attempt to adhere to a 2-hour voiding interval.
It is noteworthy that in children with a combined history of urinary incontinence
and encopresis anticholinergic medication was not initiated until gastrointestinal
(GI) symptoms were under treatment. Successful resolution of urinary incontinence
was defined as complete resolution of diurnal wetness for 6 months.

This article does not review the results regarding treatment of the nocturnal
component of patients with ADHD and urinary incontinence. Patients with ADHD
treated for monosymptomatic nocturnal enuresis were offered the options of
enuretic alarm, desmopressin (DDAVP) and imipramine. The treatment chosen was
directed by family choice. No crossover between treatment modalities is reported
in this study. Children were removed from the enuretic alarm after nocturnal
urinary continence had been established for a 3-month interval. Regarding the
pharmacological treatment of nocturnal enuresis, we attempted to wean patients
from their medication 1 year after starting therapy. Successful treatment of
monosymptomatic nocturnal enuresis was defined as 0 to 1 enuretic night per
month. Patients included in this study had to have a minimum followup interval
of 1 year after initiating treatment.

All patients were screened for coexisting encopresis. Encopresis was defined as
the presence of fecal soiling occurring at least once per week for greater than
6 months. Invariably, simultaneous constipation was noted along with the
encopresis. Treatment of encopresis/constipation was by colonic disimpaction
with a series of enemas followed by sufficient laxative therapy to produce at
least one soft stool per day. Successful resolution of encopresis was defined as
the resolution of encopresis for a 6-month interval.

For statistical comparisons a control population referred for treatment of
urinary incontinence or monosymptomatic nocturnal enuresis during the same time
interval was identified. The control population was without a medical diagnosis
of ADHD and was matched for age, sex, and urinary and gastrointestinal symptoms
to the study population. Regarding the control population and IQ assessment, the
control population was matched to the study population only for those patients
with an IQ of less than 84. Since we could not always locate an exact match for
the IQ, the controls were within 5 IQ points of the patients with enuresis.
Statistical evaluations used the chi-square test, with p

RESULTS

A total of 192 patients with concurrent ADHD and urinary incontinence/nocturnal
enuresis met our study criteria between 1996 and 2002. There were 38 females
with a median age of 8 years (range 5 to 15) and 154 males with a median age of
7 years (range 5 to 16). No significant difference in the incidence of primary
and secondary urinary incontinence was noted between the children with urinary
incontinence and those with nocturnal enuresis. However, a significant
difference in the presence of encopresis was found between the 2 patient
populations (p

----------------------------------------------



Table 1. Patient cohorts grouped by urinary and GI symptoms



----------------------------------------------

Of the patients with ADHD and urinary incontinence 37% (29 of 79) 68% of the
control population achieved diurnal continence on timed voiding alone compared
to (54 of 79, p

Coexisting encopresis and urinary incontinence were found in 49% of the children
with ADHD (39 of 79). Table 2 shows our success rates in the treatment of these
2 separate entities. It is noteworthy that children with ADHD, urinary
incontinence and GI symptoms are just as likely to be treated successfully for
their wetness as those with ADHD without GI symptoms (74% versus 63%).

----------------------------------------------



Table 2. Results of treatment of urinary incontinence with coexisting
encopresis* p



----------------------------------------------

The IQ of the child with ADHD and urinary incontinence greatly affects the
success of treatment. Of the 19 children with a subnormal IQ (median 70, range
58 to 82) 6 (32%) achieved diurnal continence while undergoing treatment. In
contrast, of the 60 patients with ADHD and an IQ of 84 or greater 48 (80%) had
resolution of their urinary incontinence (p

Significantly fewer children with ADHD and monosymptomatic nocturnal enuresis
treated with an enuretic alarm and behavior modification were continent 6 months
after initiating therapy compared to the controls (43% vs 69%, p

----------------------------------------------



Table 3. Results of treatment in patients with ADHD and nocturnal enuresis
only* p



----------------------------------------------

DISCUSSION

Historically, a distinction has always been made between urinary incontinence
and nocturnal enuresis, and between primary and secondary nocturnal enuresis.
Classically, it was described that urinary incontinence and/or secondary
nocturnal enuresis either developed as a consequence of an inciting psychosocial
event or was the result of psychopathology. 7-9 However, recent investigations
have produced considerable doubt regarding whether these 2 disorders have any
relationship with either social stress factors or psychopathology, with one
notable exception, the consistent association of ADHD with urinary incontinence
and nocturnal enuresis. 2-5,10-12

During the last decade our experience with treating urinary incontinence in
children with ADHD resulted in the clinical impression that we were significantly
less successful in treating this disorder within this specific patient
population. This review confirmed our suspicion. Specifically, when placed on
identical treatment regimens, 68% of the children with ADHD and urinary
incontinence became continent compared to 91% of an age, sex and symptom matched
control population (p

Several important points must be brought out when assessing these data. All of
the patients with ADHD entered in this study were on active pharmacological
treatment for their hyperactivity at the time we treated their urinary
incontinence. In fact, we had prescreened patients with urinary incontinence
before appointments at our clinic. Specifically, if a patient had a history of
ADHD, we would accept this patient for evaluation only if the referring
physician was actively treating the hyperactivity. This fact may have inadvertently
resulted in a selection bias toward recalcitrant enuresis. To help prove this
point, we would note that some authors have reported resolution or improvement
of enuresis after starting stimulant therapy for the ADHD alone. 13,14

Conversely, the fact that all of the children with ADHD and enuresis were on
stimulant medication can also be interpreted as having favorably biased our
results. This latter possibility is based on the concept that hyperactivity
results in a shortened attention span that would preclude the ability to comply
with medical directives. Indeed, in some of the rare reports detailing treatment
of enuresis in children with ADHD the treatment of enuresis was found to be
greatly enhanced by stimulant medication. 2,15 It was the knowledge of these
facts that prompted us to ask all physicians referring a child with ADHD and
enuresis to have the child on active treatment of his/her ADHD before our
evaluation. In any event our findings cannot address the question of whether
stimulant medication aids in the treatment of enuresis.

It is also imperative to mention when assessing our data that we did not
evaluate the effect that the family social structure has on treatment success.
Although certainly not present in all children with ADHD, there is a high
frequency of social pathology, especially hysteria (conversion disorder) and
alcoholism, found in the parents of children with ADHD. 16 The impact of an
aberrant familial social structure or parental disorders on the successful
treatment of enuresis cannot be addressed within this article.

In a large referral clinic where children are presenting for the evaluation of
urinary incontinence and encopresis approximately 20% of those presenting with
both complaints will have ADHD. 5,6 Whether it was due to a selective referral
bias or just the frequent coexistence of ADHD and encopresis, about 50% of the
patients with ADHD referred to us were noted to have concomitant enuresis and
encopresis. Our impression before we performed this review was that the presence
of these duel symptoms would be associated with a higher likelihood of treatment
failure. We were surprised to find that this was not the case. Specifically,
children with ADHD, urinary incontinence and coexisting encopresis were just as
likely to be treated successfully for their urinary incontinence as the patients
without GI symptoms (74% versus 63%). It is noteworthy that all children
involved in this study had the GI and genitourinary symptoms treated simultaneously.

Approximately 25% of the patients referred with ADHD and urinary incontinence
had a subnormal IQ. In our experience this combination greatly interferes with
the ability to treat the enuresis successfully, with only 32% of patients with
ADHD and a subnormal IQ becoming continent compared to 80% of those with ADHD
and a normal IQ and 79% of controls with a diminished IQ. In essence, it appears
that a subnormal IQ in association with ADHD greatly inhibits our ability to
treat the patient successfully (p

Regarding the question of whether children with monosymptomatic nocturnal
enuresis and ADHD respond to the same therapy as the child without ADHD, our
data indicate a significant difference between the 2 populations. Specifically,
patients with ADHD were more noncompliant with the enuretic alarm than patients
without ADHD (38% vs 22%, p

The high incidence of urinary incontinence in children with ADHD transfers to
the finding that children with hyperactivity are approximately 2.5 times more
likely to have nocturnal enuresis than their age matched counterparts and 4.5
times more likely to have urinary incontinence. 2,4,11-13 One of the major
questions regarding the coexistence of these disorders is why does this
relationship exist? Hidden within the previous published literature and the data
of this study is a clue regarding this association. Specifically, previous
publications have noted either resolution or improvement of nocturnal enuresis
after starting stimulant therapy for the ADHD alone, a finding suggestive that
these 2 disorders either share a chemical imbalance or alternatively that the
incontinence may be due to inattentiveness. 2,13-15 We found that patients with
ADHD and monosymptomatic nocturnal enuresis responded efficaciously to DDAVP and
imipramine and not behavioral modification with an enuretic alarm.

The combination of these findings leads us to hypothesize that a central
neurochemical dysfunction maybe shared between nocturnal enuresis and ADHD.
Specifically, nocturnal urinary incontinence is conjectured to be due to an
abnormal circadian secretion of arginine vasopressin (AVP). Although AVP is best
known for its antidiuretic and vasopressor effects, it is also a neural
transmitter in several regions of the brain. Indeed, the positive influence of
AVP on memory and learning is well known and has been extensively studied. 18,19
Germane to this discussion is the fact that one of the main central nervous
system actions of AVP is to enhance dopamine use and release within the brain.
Moreover, the pharmaceutical analogue to AVP, desmopressin, when administered to
laboratory animals via peripheral routes has been found to alter brain dopamine.
20 It is intriguing to note that ADHD is hypothesized to be due to abnormally
low levels of extracellular dopamine within the brain. 1 To support further the
concept that these 2 disorders share a neurotransmitter abnormality is the
knowledge that imipramine, a tricyclic antidepressant successfully used to treat
both disorders, is known to enhance brain response to dopamine. 21 Based on
these facts, we hypothesize that patients with ADHD frequently have coexisting
urinary incontinence and enuresis because they share an abnormality in a
neurotransmitter defect, probably dopaminergic in etiology.

CONCLUSIONS

Our data document that children with ADHD and urinary incontinence are
significantly less likely to respond to treatment than normal children with
mixed enuresis (68% vs 91%, p

Our findings suggest that the current treatment modalities used for the child
with ADHD and urinary incontinence are inadequate. We would suggest that
alterations of current treatment protocols are merited, perhaps by the addition
of a child psychologist to form a therapeutic team to treat the patient with
ADHD and urinary incontinence. The psychologist could add to the therapeutic
endeavors by helping to investigate the parent-child relationship and help in
developing a specific behavioral plan that could possibly improve the clinical
outcome.

REFERENCES

1. Cantwell, D. P.: Attention deficit disorder: a review of the past 10 years. J
Am Acad Child Adolesc Psychiatry, 35: 978, 1996 Ovid Full Text Bibliographic
Links

2. Robson, W. L., Jackson, H. P., Blackhurst, D. and Leung, A. K.: Enuresis in
children with attention-deficit hyperactivity disorder. South Med J, 90: 503,
1997 Bibliographic Links

3. Steinhausen, H. C. and Gobel, D.: Enuresis in child psychiatric clinic
patients. J Am Acad Child Adolesc Psychiatry, 28: 279, 1989

4. Bailey, J. N., Ornitz, E. M., Gehricke, J. G., Gabikian, P., Russell, A. T.
and Smalley, S. L.: Transmission of primary nocturnal enuresis and attention
deficit hyperactivity disorder. Acta Paediatr, 88: 1364, 1999 Bibliographic
Links

5. Mikkelsen, E. J., Brown, G. L., Minichiello, M. D., Millican, F. K. and
Rapoport, J. L.: Neurologic status in hyperactive enuretic, encopretic, and
normal boys. J Am Acad Child Psychiatry, 21: 75, 1982

6. Johnston, B. D. and Wright, J. A.: Attentional dysfunction in children with
encopresis. J Dev Behav Pediatr, 14: 381, 1993 Bibliographic Links

7. Hinman, F. and Baumann, F. W.: Vesical and ureteral damage from voiding
dysfunction in boys without neurologic or obstructive disease. J Urol, 109: 727,
1973

8. Allen, T. D.: The non-neurogenic neurogenic bladder. J Urol, 117: 232, 1977
Bibliographic Links

9. Husmann, D. A.: Enuresis. Urology, 48: 184, 1996 Bibliographic Links

10. Fergusson, D. M., Horwood, L. J. and Shannon, F. T.: Factors related to the
age of attainment of nocturnal bladder control: an 8-year longitudinal study.
Pediatrics, 78: 884, 1986 Bibliographic Links

11. Biederman, J., Santangelo, S. L., Faraone, S. V., Kiely, K., Guite, J.,
Mick, E. et al: Clinical correlates of enuresis in ADHD and non-ADHD children. J
Child Psychol Psychiatry, 36: 865, 1995 Bibliographic Links

12. Fergusson, D. M. and Horwood, L. J.: Nocturnal enuresis and behavioral
problems in adolescence: a 15-year longitudinal study. Pediatrics, 94: 662, 1994
Bibliographic Links

13. Rey, J. M., Bird, K. D. and Hensley, V. R.: Bedwetting and psychopathology
in adolescents. J Paediatr Child Health, 31: 508, 1995 Bibliographic Links

14. Shaffer, D., Gardner, A. and Hedge, B.: Behavioral and bladder disturbance
of enuretic children: a rational classification of a common disorder. Dev Med
Child Neurol, 26: 781, 1984 Bibliographic Links

15. Diamond, J. M. and Stein, J. M.: Enuresis: a new look at stimulant therapy.
Can J Psychiatry, 28: 395, 1983

16. Spencer, T. J.: Attention-deficit/hyperactivity disorder. Arch Neurol, 59:
314, 2002 Bibliographic Links

17. Roijen, L. E., Postema, K., Limbeek, V. J. and Kuppevelt, V. H.: Development
of bladder control in children and adolescents with cerebral palsy. Dev Med
Child Neurol, 43: 103, 2001 Bibliographic Links

18. DeWied, D.: Neurohypophyseal hormone influences on learning and memory
processes. In: Neurobiology of Learning and Memory, 4th ed. Edited by G. Lynch,
J. L. McGaugh and N. M. Weimberger. New York: Guilford Press, pp. 289-312, 1984

19. Metzger, D., Alescio-Lautier, B., Bosler, O., Devigne, C. and Soumireu-Mourat,
B.: Effect of changes in the intrahippocampal vasopressin on memory retrieval
and relearning. Behav Neural Biol, 59: 29, 1993 Bibliographic Links

20. Di Michele, S., Sillen, U., Engel, J. A., Hjalmas, E. K., Rubenson, A. and
Soderpalm, B.: Desmopressin and vasopressin increase locomotor activity in the
rat via a central mechanism: implications for nocturnal enuresis. J Urol, 156:
1164, 1996 Ovid Full Text Bibliographic Links

21. Lammers, C. H., Diaz, J., Schwartz, J. C. and Sokoloff, P.: Selective
increase of dopamine D3 receptor gene expression as a common effect of chronic
antidepressant treatments. Mol Psychiatry, 5: 378, 2000 Bibliographic Links

Key Words: urinary incontinence; enuresis; encopresis; attention deficit
disorder with hyperactivity

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Accession Number: 00005392-200310000-00080

[tired_need_help]

dear moderator, i have posted a text copy of a journal, i am not sure about the copy right issues and things like that, so please advice me if this is ok.
thanks.

[lettie]

I too have heard this mentioned frequently as applies to boys and night incontinence. That, however, was when I was still researching symptoms for my son... trying to talk myself around the overwhelming evidence of his symptoms. not sure about anything else as I am blessed not to have this problem...as of yet.

by tired need help
we hypothesize that patients with ADHD frequently have coexisting
urinary incontinence and enuresis because they share an abnormality in a
neurotransmitter defect, probably dopaminergic in etiology.

okay...I just saw that, and I will be quiet now. When all else fails read the instructions, or wait for the smart people to come up with the answer...and hope to ride in on their coat tails

Oh... and it really makes me tired and tense everytime I look at tired need help's avatar. A splendid choice of name, or of avatar, or a combo of both

[Scattered]

Interesting article Tired! I know my daughter's pediatrician asked me about eneurisis problems with my daughter who is ADHD. She said they're very common with ADHD kids. My daughter was late to toilet train and at eight still has occasional accidents -- three this week.

Scattered

[tired_need_help]

Originally Posted by lettie

Oh... and it really makes me tired and tense everytime I look at tired need help's avatar. A splendid choice of name, or of avatar, or a combo of both

I hope it is not bothersome! (i wasnt sure if u meant u liked it or that it was disturbing!) i could change it if thts so!! no problem at all..

Originally Posted by scattered

I know my daughter's pediatrician asked me about eneurisis problems with my daughter who is ADHD.

Hi i wonder how old your daughter is.
I had the trouble right till i was almost 7 and seeing my distress my parents did something that really helped me out. It might seem a bit wierd, but it worked for me. My dad came across an article that said how yoga/meditation was used to control various disorders and decided to give it a short. so with the help of a book he taught me how to work on some basic yoga exercises and included a form of reinforcement therapy (by asking me to tell myself that i could control it). While i still wonder how that worked for me, now i think it must have been those exercises coupled with a little development of will power that helped.

(reasoning it chemically, i think the reinforcing and the concentration exercises resulted in increasing the dopamine levels that gave considerable control over involuntary actions; i was not under any form of medication( other than calcium supplements) at that time, as i wouldnt talk about it to a doctor)

[meadd823]

dear moderator, i have posted a text copy of a journal, i am not sure about the copy right issues and things like that, so please advice me if this is ok.

I often do the same thing...to a smaller scale as long article quote comes complete with original writer, source ect.... giving proper credit where rightfully due.

I saw a list of sources.....if original writer information / source needs to be added private message me the information (along with specific instructions as to where in post ) I will be happy to place it in post for you.

Sorry I didn't read all the information provided. Meds wearing off and attention span wearing off along with it. ADD moderators for an ADD forum... go figure huh!

Thanks for asking.

[QueensU_girl]

There are several kinds of Incontinence: eg Stress (while sneezing; while jumping up and down), Functional, etc.

Incontinence (while awake) is not the same as Enuresis (bed-wetting).

Have you given birth? This is the #1 cause of Incontinence (urinary) in women. (eg damage or weakness to the Pelvic Floor).

[Trooper Keith]

As has been covered, there's an apparent link between ADHD and nocturnal enuresis.

Shreeram, S., He, J., Kalaydjian, A., Brothers, S., & Merikangas, K. R. (2009). Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: Results from a nationally representative study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(1), 35-41. Retrieved from PsycINFO database on September 17, 2009.

Originally Posted by Shreeram et al

Objective: There are no published nationally representative prevalence estimates of enuresis among children in the United States using standardized diagnostic criteria. This study sets out to describe the prevalence, demographic correlates, comorbidities, and service patterns for enuresis in a representative sample of U.S. children. Method: The diagnosis of enuresis was derived from parent-reported data for "enuresis, nocturnal" collected using the computerized version of the Diagnostic Interview Schedule for Children (C-DISC 4.0) from a nationally representative sample of 8- to 11-year-old children (n = 1,136) who participated in the 2001-2004 National Health and Nutrition Examination Surveys. Results: The overall 12-month prevalence of enuresis was 4.45%. The prevalence in boys (6.21%) was significantly greater than that in girls (2.51%). Enuresis was more common at younger ages and among black youth. Attention-deficit/hyperactivity disorder (ADHD) was strongly associated with enuresis (odds ratio 2.88; 95% confidence interval 1.26-6.57). Only 36% of the enuretic children had received health services for enuresis. Conclusions: Enuresis is a common condition among children in the United States. Few families seek treatment for enuresis despite the potential for adverse effects on emotional health. Child health care professionals should routinely screen for enuresis and its effects on the emotional health of the child and the family. Assessment of ADHD should routinely include evaluation for enuresis and vice versa. Research on the explanations for the association between enuresis and ADHD is indicated. (PsycINFO Database Record © 2009 APA, all rights reserved)

But I searched PsycINFO and another database and found nothing linking ADHD and incontinence.

Invest in Imodium.

[roseisrose360]

I have recently been told by our young man's psychiatrist that ADHD and Incontinence are not separate, but the latter is a symptom of the former.

The have asked us to look into how we feel about DDAVP. I've read the professional page about it on Drugs.com and frankly, I'd rather find another way to treat/deal with his incontinence. Granted that is based on reading one link . . . I will be following up and checking others, but it scares me when a doctor wants you to look it up and decide. Not that I don't question what they prescribe, I've got a strong pharmacologic background. It makes me think that they don't really want to do it, unless we "make" them . . .

FWIW, I'd welcome the input of others with more experience on this.

[munky_do]

Just as a little update on the topic, since it's something that (very embarrassingly!) has affected me since forever, it looks like bladder control has indeed been linked to ADHD. My problem has always been that the moment I get in the door, although I felt fine before, suddenly I have to go RIGHT AWAY. Or when I suddenly feel like I have to go, it's an urge I can't usually ignore, though it has gotten better strangely with age (and also possibly with medication?) I'm 27 now, never had kids. When I was little, this was a big problem for me. I had no problems being toilet trained but I remember a couple occasions getting a really bad case of the giggles and ending up in a really embarrassing situation.

Here's the article from http://www.reuters.com/article/2011/...70J5U320110120

Turkish researchers found that among 62 children with ADHD and 124 without the disorder, kids with ADHD scored considerably higher on a questionnaire on "voiding" symptoms -- problems emptying the bladder.
In particular, they tended to have more problems with bedwetting and habitually feeling an urgent need to go to the bathroom.

[PinkRoxy]

I dont know much about incontinence with ADHD but I do know I have an overactive bladder, but my problem comes and goes it has its bad patches and then there are times where my bladder is fine and functions normal. I dont have incontinence though even though I have become very close to having accidents in some situations.

Anyway I hope you get things sorted honey because I understand that having aproblem like this is not very nice.

(((hug)))

[escott]

Work with a doctor who specializes in this type of problem. Talk about it at a support group. There are others out there like you.







Well then maybe you should not drink many liquids before leaving the house. Or before a long road trip.

No medical evidence to suggest there is a correlation.

maybe because the excitement precipitated by the ADHD is whats creating an uncontrollable behavior.

Go to a doctor and get another diagnosis and if need be medication.

I have never heard of a correlation before. Sorry.

A doctor should be able to answer your question better than I.

You dont know that the ADHD is whats causing it I would be happy to refer you to a doctor close to where you live.