Pediatric Nephrology

, Volume 30, Issue 7, pp 1147–1155 | Cite as

Incontinence and parent-reported oppositional defiant disorder symptoms in young children—a population-based study

  • Alexander von Gontard
  • Justine Niemczyk
  • Sigrid Thomé-Granz
  • Judith Nowack
  • Anne-Michaela Moritz
  • Monika EquitEmail author
Original Article



Oppositional defiant disorder (ODD) and incontinence are common disorders of childhood. We have examined associations between ODD symptoms and incontinence in a representative sample of young children.


A questionnaire with seven questions referring to incontinence, eight DSM-IV items of ODD, 15 items of the Home Situations Questionnaire and six items regarding eating, drinking or toileting refusal was administered to the parents of 718 children at school-entry from a defined geographical area at school-entry.


Of the 718 6-year-old children included in the analysis, 8.2 % had nocturnal enuresis (NE), 1.5 % had daytime urinary incontinence (DUI) and 1.1 % had faecal incontinence (FI). Significantly more boys than girls had NE (12 vs. 4.3 %). Overall, 6.7 % of children had ODD symptoms. Rates of ODD symptoms were significantly higher in incontinent children (19.5 %) than in continent children (5.2 %), with the highest rate of ODD symptoms in children with DUI (36.4 %). Children with incontinence (mean 6.1 episodes) or ODD symptoms (mean 8.4 episodes) showed non-compliant behaviours in more problem situations than continent children (mean 4.5 episodes) or children without ODD symptoms (mean 4.5 episodes).


Incontinence and ODD are common comorbid disorders at school-entry age. Boys are more affected by both disorders. Children with DUI have the highest rate of ODD symptoms. As ODD symptoms affect many daily family situations, ODD needs to be diagnosed and treated in children with incontinence, as it can negatively affect compliance.


Nocturnal enuresis Daytime urinary incontinence Faecal incontinence Oppositional defiant disorder Comorbidity 



Avon Longitudinal Study of Parents and Children


Child Behavior Checklist


Diagnostik-System für psychische Störungen nach ICD-10 und DSM-IV für Kinder und Jugendliche–II


Diagnostic and statistical manual of mental disorders – 4th edn (text revision)


Diagnostic and statistical manual of mental disorders–5th edn


Home Situations Questionnaire (German version)


International Children’s Continence Society


International Classification of Diseases


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Copyright information

© IPNA 2015

Authors and Affiliations

  • Alexander von Gontard
    • 1
  • Justine Niemczyk
    • 1
  • Sigrid Thomé-Granz
    • 2
  • Judith Nowack
    • 2
  • Anne-Michaela Moritz
    • 2
  • Monika Equit
    • 1
    Email author
  1. 1.Department of Child and Adolescent PsychiatrySaarland University HospitalHomburgGermany
  2. 2.Institute for Community HealthHomburgGermany

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