Mentalization and emotion regulation abilities in parents of children with nocturnal enuresis and its relationship with perceived caregiver burden.

OBJECTIVE: Various psychological factors play a role in the development of nocturnal enuresis (NE) which causes significant distress both on children and their parents. However, current studies cannot attribute a role to the psychiatric conditions that cause or result from NE. This study aims to reveal some psychiatric parameters related to the parents of patients with NE which may play a role in the etiopathogenesis of NE. METHODS: Seventy-nine parents of primary 53 NE children and 78 parents of 44 healthy children were enrolled to the study. Parents of children with daytime voiding symptoms, additional comorbidity, or secondary enuresis were excluded from the study. Age- and sex-matched parents of healthy children with the absence of voiding symptoms were included as the control group. Parental Reflective Functioning (RF) Questionnaire, Interpersonal Emotion Regulation (ER) Questionnaire, and Zarit Caregiver Burden Scale were recorded to measure psychiatric conditions. RESULTS: Parents of children with NE showed significantly poorer RF and ER abilities compared to the control group. Moreover, the perceived caregiver burden was also significantly higher in parents of NE patients. Correlation analyses also showed that RF and ER are negatively correlated with caregiver burden. CONCLUSION: This study revealed that the parents of primary NE patients may have difficulty mentalizing and ER in interpersonal relationships. These difficulties may be a cause or a consequence of the NE. In addition, our findings showed that parents of NE patients perceive more caregiving burden. Therefore, it may be advisable for parents of NE patients to seek psychological counseling.

Insecure attachment and its relationship with negative self perception in children with nocturnal enuresis.

BACKGROUND: Nocturnal Enuresis (NE) is considered as a multifactorial condition with a specific focus on psychological functioning regarding etiology. Various studies show that children with NE suffer from different types of self-esteem problems and insecure attachment styles. Nevertheless the relationship between these two psychological functions has not been adequately studied. OBJECTIVE: Main objective of the current study is to evaluate self-perception and attachment profiles of enuretic children in relation with various sociodemographic parameters. DESIGN: 41 children with nocturnal enuresis and 40 age and sex matched healthy controls were compared in means of attachment using Kern's Security Scale and self-perception using Self-Perception Profile for Children measures. RESULTS: Our results show that enuretic children suffer significantly more insecure attachment styles and negative self perception issues. Moreover enuretic children varied from healthy controls in means of number of siblings and birth rank. DISCUSSION: Current study suggests that enuretic children should be evaluated for possible psychological difficulties like insecure attachment and self-esteem issues and proper interventions in these areas should be considered. Lower self-esteem as a well-known phenomenon in enuresis research may be addressed in relation with insecure attachment. Nevertheless our study have certain limitation; the possible psychiatric comorbidities from both study groups were excluded only with anamneses. Further the male dominance of the gender of the participants can be seen as a limitation. CONCLUSION: The possible relationship between negative self perception and insecure attachment may serve as an important focus in means of etiology and interventions in NE.