The preferred behavioral treatment is alarm conditioning (12), associated with a success rate of 65% and 42% of relapse (13). Desmopressin acetate, the most effective drug treatment, reduces the production of urine during the night, significantly decreasing wetting (11). There clearly is a genetic basis at the origin of these phenomena (9), and the difficulty in waking up when the bladder is full is a sign of problems in the maturation of the central nervous system (10).īoth pharmacological and behavioral treatments are currently available for nocturnal enuresis. Nevertheless, there is consensus concerning the notion that nocturnal enuresis arises from a combination of lack of vasopressin release during sleep or bladder hyperactivity and the inability to be aroused from sleep by bladder sensations (8). The etiology and underlying physiological mechanisms of nocturnal enuresis are heterogeneous (7). The variation in the criteria employed by different investigators to define enuresis makes it difficult to establish a precise prevalence rate (5). However, if DSM-IV criteria are employed, the prevalence of enuresis is around 2.6% (3). Nocturnal enuresis is one of the most frequent problems of childhood, affecting up to 15% of children from 5 to 7 years of age and 1 to 2% of young adults (3-6). In addition to that, the DSM-IV criteria states that the involuntary voiding must occur at least twice a week for at least three months (2). Children must be at least five years old to be diagnosed with enuresis. Key words: enuresis behavior therapy child adolescent group therapyĪccording to the International Children Continence Society, nocturnal enuresis is defined as discrete incontinence episodes while an individual is asleep (1). Missing a higher number of support sessions, which may reflect low motivation for treatment, increased the risk of failure. The time until success was shorter for participants missing fewer support sessions.ĬONCLUSIONS: Alarm treatment was effective for the present sample, regardless of age or type of support. The result was similar for children and adolescents and for individual or group support. RESULTS: 71% of the participants achieved success, defined as 14 consecutive dry nights. MATERIALS AND METHODS: During 32 weeks, 84 children and adolescents received alarm treatment together with weekly psychological support sessions for individual families or groups of 5 to 10 families. PURPOSES: To investigate the efficacy of alarm treatment in a sample of Brazilian children and adolescents with nocturnal enuresis and relate treatment success to age and type of clinical support. Bragaīehavior Therapy Laboratory, Institute of Psychology, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Behavioral alarm treatment for nocturnal enuresis
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