The essential feature of Enuresis is repeated voiding of urine during the
day or at night into bed or clothes. Most often this is
involuntary but occasionally may be intentional.
Specific Symptoms of Enuresis
- Repeated voiding of urine into bed or clothes (whether involuntary or
- The behavior is clinically significant as manifested by either a
frequency of twice a week for at least 3 consecutive months or the
presence of clinically significant distress or impairment in social,
academic (occupational), or other important areas of functioning.
- Chronological age is at least 5 years (or equivalent developmental
- The behavior is not due exclusively to the direct physiological
effect of a substance (e.g., a diuretic) or a general medical condition
(e.g., diabetes, spina bifida, a seizure disorder).
The situation in which the Enuresis occurs may be noted by one of the
- Nocturnal Only. This is the most common subtype and is defined as passage
of urine only during nighttime sleep. The enuretic event typically occurs
during the first one-third of the night. Occasionally the voiding takes
place during the rapid eye movement (REM) stage of sleep, and the child
may recall a dream that involved the act of urinating.
- Diurnal Only. This subtype is defined as the passage of urine during
waking hours. Diurnal Enuresis is more common in females than in males
and is uncommon after age 9 years. The enuretic event most commonly
occurs in the early afternoon on school days. Diurnal enuresis is
sometimes due to a reluctance to use the toilet because of social anxiety
or a preoccupation with school or play activity.
- Nocturnal and Diurnal. This subtype is defined as a combination of the
two subtypes above.
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual
of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
« Disorders Index
By John M. Grohol, Psy.D. on
16 Oct 2010
Published on PsychCentral.com. All rights reserved.
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