NEW YORK (Reuters Health) — Elementary school-age children who wet their pants during the daytime are more vulnerable to psychological problems — particularly externalising problems, such as attention and conduct problems and oppositional behaviour — than children who remain dry during the day, according to research from the UK.“The presence of psychological problems ... in children with daytime wetting as young as seven years old highlights the importance of parents seeking early intervention for the condition to help prevent later psychological problems,” Dr. Carol Joinson, from the University of Bristol, and colleagues write in the journal Paediatrics.

“Many parents do not know that daytime wetting is a condition for which they can seek medical help,” the investigators maintain, and that “problems such as low self-esteem and other sub-clinical psychological symptoms have a high likelihood of resolving after successful treatment for daytime wetting.”

However, they also caution that children with more severe emotional symptoms may require psychiatric/psychological treatment, and that behavioural problems are likely to interfere with treatment for daytime wetting. Small studies have suggested a link between daytime wetting and psychological problems. According to recent research, children rate daytime wetting as one of the most stressful life events they could encounter.

Joinson’s team had the mothers of 8,213 children who were about 7.5 years old complete questionnaires regarding their child’s toileting behaviour, as well as any psychological problems. They found that nearly eight percent (291 boys and 352 girls) still wet their pants in the daytime. These children were much more likely than the control subjects to be developmentally delayed. What’s more, they were approximately twice as likely to have externalising problems, including attention deficit/hyperactivity disorder, oppositional behaviour, or conduct problems. Adjustment for developmental delay and propensity to soil their pants were the most significant variables that reduced the likelihood of some of the psychological problems. In contrast, adjustment for gender, stressful life events and sociodemographic background had only moderate effects. Nevertheless, in a fully adjusted model, the risk among daytime wetters was still elevated for separation anxiety and externalising problems.

Joinson’s group points out that it is not clear whether emotional problems are a cause or a consequence of daytime wetting.