More anxious or more shy? Examining the social anxiety levels of adolescents with primary enuresis nocturna: a controlled study.

INTRODUCTION: Enuresis nocturna (EN) is very common worldwide, and psychiatric disorders are 1.3-4.5 times higher in children with EN. When the authors focus on symptoms of individuals with EN, they figured out that the individuals were impaired in social and emotional skills because of the dramatic consequences of EN. The authors presume that, despite a lack of psychiatric comorbidity, primary enuresis nocturna (PEN) itself and its consequences may increase adolescents' social anxiety (SA), leading to adulthood mental diseases. OBJECTIVE: In this study, the authors aimed to investigate the presence of SA of adolescents with monosymptomatic PEN without any psychiatric comorbidity by comparing them with their healthy peers. METHODS: The study was composed of 56 children who applied to pediatric nephrology outpatient clinic and were diagnosed with monosymptomatic PEN and 42 healthy controls. The psychiatric diagnoses were made by a child psychiatrist, with the help of a semistructured interview (Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, K-SADS-PL), and patients were required to fill out the Screen for Child Anxiety and Related Disorders, Social Anxiety Scale for Adolescents (SAS-A), and Children's Depression Inventory (CDI) scales with the help of a clinical psychologist. The physical examination made by a pediatric nephrologist and dysfunctional voiding and incontinence scoring system questionnaire were used to evaluate the voiding dysfunction in children. RESULTS: There was no significant difference in the total depression and anxiety scores between the groups (p > 0.05). There was a significant difference between the two groups in the subscale of SA (t = 2.67 p = 0.009) (Table). Social Anxiety Scale for Adolescents (p < 0.001) and subscales of SAS-A (Fear of Negative Evaluation [p < 0.001], General Social Avoidance and Distress [p = 0.003], Social Avoidance and Distress in New Situations [p < 0.001]) scores were significantly higher in the patient group. DISCUSSION: The authors want to emphasize the comorbid SA of adolescents diagnosed with PEN. This anxiety may disturb adolescents' health in two ways: first, with the help of direct consequences of the SA and second, being late for seeking help for the EN and possible delay in EN treatments. The main limitation of this study is the assessments of the prior mental status of subjects were made by K-SADS-PL, thus remaining a recall bias. A follow-up study may be more objective. CONCLUSION: So all adolescents diagnosed with PEN should require a detailed mental examination to prevent further negative consequences and provide more comprehensive treatment. Also, the study needed to be repeated in larger samples, and prospective studies should be designed to enhance authors' understanding.

No effect of the IGF-1 gene rs35767 and rs17032362 polymorphisms in the etiology of idiopathic short stature.

Idiopathic short stature (ISS) refers to pathophysiologically wide and heterogeneous range of disorders, which are considered to involve defects in growth hormone (GH) insulin like growth factor-1 (IGF-1) axis. This study was designed to evaluate GH- IGF-1 axis and investigate IGF-1 gene polymorphisms in ISS.108 patients with a mean age of 11.7±3.6 years constituted the study group, while 108 age and gender matched children with normal stature constituted the control group. Serum IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels and two polymorphisms in IGF-1 gene (rs35767, rs17032362) were investigated.While mean IGF-1 SDS value was lower in study group (p=0.002), no difference was detected between mean IGFBP-3 SDS values. The IGF-1 gene rs35767 polymorphism genotype distribution did not exhibit a statistical difference between study (7.1% wild type, 29.6% heterozygous, 63.3% homozygous) and control groups (3.8% wild type, 39.6% heterozygous, 56.6% homozygous). IGF-1 gene rs17032362 polymorphism genotype distribution was not significantly different either between study (94.8% wild type, 5.2% heterozygous, 0% homozygous) and control groups (97.2% wild type, 2.8% heterozygous, 0% homozygous). Comparing the cases with wild type, homozygous and heterozygous carriers for both polymorphisms with respect to height, weight, BMI, IGF-1 and IGFBP-3 SDS values, no significant difference was detected.IGF-1 SDS levels of patients with ISS were significantly lower compared to control group. There was no difference between IGFBP-3 SDS levels. No effect of IGF-1 gene rs35767 and rs17032362 polymorphisms on stature, IGF-1 and IGFBP-3 levels could be demonstrated.