Paediatr Child Health. 2005 Dec; 10(10): 609–610.
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Primary nocturnal enuresis (PNE) is a relatively common condition of childhood (). According to The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research (2), a child is diagnosed with PNE if there is at least one wetting event per month for children seven years of age and older, and the bedwetting is not due to neurological disorders, abnormalities of the urinary tract or epileptic attacks.
The present study compares the effectiveness of alarm therapy and hypnotherapy in achieving dryness, as suggested by Milling and Costantino (). We also examined the effects of PNE on children’s self-esteem and behaviour problems.
SUBJECTS AND METHODS
Children aged seven to 12 years who presented to the Enuresis Clinic at the Children’s Hospital of Western Ontario (London, Ontario) between September 2000 and December 2002, and who fulfilled PNE criteria, were eligible to participate in the study (n=96). Exclusion criteria were attention-deficit hyperactivity disorder, conditions associated with large urine volumes, abnormal neurological control, abnormalities of bladder and outflow tracts, daytime wetting and previous use of prescription medications for enuresis. Approval was obtained from The University of Western Ontario Research Ethics Board for Health Sciences Research Involving Human Subjects.
At the first clinic, participants were asked to bring in charts of their dry and wet nights over the previous two weeks. Following a clinical history, a physical examination was performed by a paediatrician (FG). The children completed a measure of self-esteem (the Culture-Free Self-Esteem Inventory, Second Edition [CFSEI-2]) (4), while parents completed the Parenting Stress Index, Third Edition (PSI-III) (), and the Child Behavior Checklist (CBCL) (6). The latter two measures assess parenting stress levels and parents’ perception of their child’s behaviour problems, respectively.
Subjects were then randomly assigned to hypnotherapy or alarm therapy. Randomly assigned blocks of 10 subjects minimized any temporal effects. The anatomy and physiology of bladder control was explained to subjects using Figure 8.1 from Olness and Kohen’s Hypnosis and Hypnotherapy with Children, 3rd edition (7). The hypnotherapy protocol in the present study was modelled after the protocol described by Olness and Kohen (7). Hypnotherapy subjects were provided an audiotape, which they were to listen to nightly until they achieved dryness. Alarm therapy patients received instruction about use of the alarm.
Participants were asked to document dryness and wetness each night in a diary for the duration of treatment and to bring the diaries to each clinic visit. Two of the authors (SF and FG) were involved in the care of the children. The psychologist (SF) followed the hypnotherapy subjects.
Outcomes were defined as success (14 consecutive dry nights within three months), failure (not meeting success criteria) or relapse (more than two wet nights in two consecutive weeks) ().
Statistical analysis
Data were entered into the Statistical Package for the Social Sciences, version 11.0 (SPSS Inc, USA). Student’s t tests were used for continuous variables. For the CBCL, total behavioural problem T-scores, internalizing T-scores and externalizing T-scores were compared between the groups. Total stress and life stress scores were compared for the PSI-III. Total self-esteem scores were compared for the CFSEI-2. χ2 tests or the Fisher’s exact test were used for categorical variables, where appropriate. A statistically significant difference was noted at P≤0.05.
RESULTS
Thirty-eight subjects from the alarm therapy group and 36 subjects from the hypnotherapy group, along with their parents, completed the study. Fifteen participants did not finish the trial (six subjects from the alarm therapy group and nine subjects from the hypnotherapy group, 60% male, mean age ± SD 9.1±1.4 years), four subjects refused participation and three subjects were excluded due to concurrent medical conditions that interfered with treatment.
The mean age of the children in both groups was 8.8 years. Most participants were male (68.4% versus 77.8% in the alarm therapy and hypnotherapy groups, respectively, P=0.37). Alarm therapy subjects were more likely than hypnotherapy subjects to achieve dryness (55.3% versus 19.4%, P=0.001). No significant pretreatment differences occurred in mean CBCL, PSI-III or CFSEI-2 scores. Self-esteem and problem behaviour scores of both groups fell within the average range, suggesting that this sample of children did not suffer from low self-esteem or behaviour problems.
Hypnotherapy was stopped for 16 subjects after their second or third clinic because the treatment was not working, and those subjects were categorized as treatment failures. Seven of those subjects continued to have wet nights after switching to the alarm therapy. Those seven subjects were then started on medication (desmopressin acetate).
Compliance – defined as adherence to the procedures for hypnotherapy or alarm therapy, returning to follow-up clinic visits and completion of diary entries – was not significantly different between the alarm therapy and hypnotherapy groups (92.1% versus 86.1%, respectively, P=0.41). Six subjects in the alarm therapy group experienced a relapse, compared with two subjects in the hypnotherapy group (P=0.26).
DISCUSSION
Alarm therapy was more effective than hypnotherapy in achieving dryness in children with PNE. Possible explanations for the poor success of hypnotherapy were ineffectiveness of the audiotape, commencement of treatment before establishing therapeutic rapport and individual differences in hypnotic susceptibility.
There were no pretreatment differences in self-esteem or behaviour problems between the two groups or in comparison with normative groups. This result is contrary to some previous research (,–). Low self-esteem and/or behaviour problems are not an inevitable finding in children with PNE.
ACKNOWLEDGEMENTS
Kids Hypnosis Bedwetting
The authors thank Betty Freedman for all of her work with data entry, and for assisting the parents and children in completing the questionnaires. They also thank Rene Silberman for her editorial assistance.
Footnotes
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FUNDING: This research was supported by a 2000/2001 internal research grant fund from the Children’s Health Research Institute in London, Ontario.
REFERENCES
1. Butler R, Stenberg A. Treatment of childhood nocturnal enuresis: An examination of clinically relevant principles. BJU Int. 2001;88:563–71. [PubMed] [Google Scholar]
2. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research . Geneva: World Health Organization; 1993. [Google Scholar]
3. Milling LS, Costantino CA. Clinical hypnosis with children: First steps toward empirical support. Int J Clin Exp Hypn. 2000;48:113–37. [PubMed] [Google Scholar]
Free Hypnosis Script
4. Battle J. Culture-free Self-esteem Inventories. 2nd edn . Austin: Pro-Ed ; 1992. [Google Scholar]
5. Loyd BH, Abidin RR. Revision of the parenting stress index. J Pediatr Psychol. 1985;10:169–77. [PubMed] [Google Scholar]
6. Achenbach TM. The child behaviour profile: An empirically based system for assessing children’s behavioral problems and competencies. Int J Ment Health. 1979;7:24–42.[Google Scholar]
7. Olness K, Kohen DP. Hypnosis and Hypnotherapy with Children. 3rd edn . New York: The Guilford Press; 1996. [Google Scholar]
8. Butler RJ. Establishment of working definitions in nocturnal enuresis. Arch Dis Child. 1991;66:267–71.[PMC free article] [PubMed] [Google Scholar]
9. Moffatt ME, Kato C, Pless IB. Improvements in self-concept after treatment of nocturnal enuresis: Randomized controlled trial. J Pediatr. 1987;110:647–52. [PubMed] [Google Scholar]
10. Banerjee S, Srivastav A, Palan BM. Hypnosis and self-hypnosis in the management of nocturnal enuresis: A comparative study with imipramine therapy. Am J Clin Hypn. 1993;36:113–9. [PubMed] [Google Scholar]
11. Butler RJ, Redfern EJ, Holland P. Children’s notions about enuresis and the implications for treatment. Scand J Urol Nephrol Suppl. 1994;163:39–47. [PubMed] [Google Scholar]
12. Stromgren A, Thomsen PH. Personality traits in young adults with a history of conditioning-treated childhood enuresis. Acta Psychiatr Scand. 1990;81:538–41. [PubMed] [Google Scholar]
13. Warzak WJ. Psychosocial implications of nocturnal enuresis. Clin Pediatr (Phila) 1993;(Spec No:38–40) [PubMed] [Google Scholar]
14. Fergusson DM, Horwood LJ. Nocturnal enuresis and behavioural problems in adolescence: A 15-year longitudinal study. Pediatrics. 1994;94:662–8. [PubMed] [Google Scholar]
15. Pugner K, Holmes J. Nocturnal enuresis: Economic impacts and self-esteem preliminary research results. Scand J Urol Nephrol Suppl. 1997;183:65–9. [PubMed] [Google Scholar]
16. Hagglof B, Andren O, Bergstrom E, Marklund L, Wendelius M. Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scand J Urol Nephrol Suppl. 1997;183:79–82. [PubMed] [Google Scholar]
17. Hagglof B, Andren O, Bergstrom E, Marklund L, Wendelius M. Self-esteem in children with nocturnal enuresis and urinary incontinence: Improvement of self-esteem after treatment. Eur Urol. 1998;33(Suppl 3):16–9. [PubMed] [Google Scholar]
18. Theunis M, Van Hoecke E, Paesbrugge S, Hoebeke P, Vande Walle J. Self-image and performance in children with nocturnal enuresis. Eur Urol. 2002;41:660–7. [PubMed] [Google Scholar]
19. Collier J, Butler RJ, Redsell SA, Evans JH. An investigation of the impact of nocturnal enuresis on children’s self-concept. Scand J Urol Nephrol. 2002;36:204–8. [PubMed] [Google Scholar]
20. Heap JM. Enuresis in children and young people: A public health nurse approach in New Zealand. J Child Health Care. 2004;8:92–101. [PubMed] [Google Scholar]
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