Attaining Nocturnal Urinary Control, Nocturnal Enuresis, and Behavioral Problems in Chinese Children Aged 6 Through 16 Years

Objective: To estimate the prevalence of nocturnal enuresis and to examine associations between nocturnal urinary control or enuresis and behavioral problems in Chinese children.

Method: A community sample of 3,600 children aged 6 through 16 years was drawn from Shandong Province of China in 1997; 3,344 (93%) returned completed questionnaires. The Child Behavior Checklist and Teacher's Report Form were used to measure children's behavioral problems.

Results: The proportion of children attaining nocturnal urinary control before age 2 was 7.7%; by age 3, this had increased to 53.1%, and by age 5 to 93%. The overall prevalence of nocturnal enuresis was 4.3%, with a significantly higher prevalence in boys than girls. There was no significant decrease in the prevalence of enuresis between 6 and 16 years of age. Multiple logistic regression analyses showed that attaining nocturnal urinary control after age 4 and current enuresis were significantly associated with an increased risk of behavioral, emotional, and academic problems.

Conclusions: Chinese children attain nocturnal urinary control earlier than Western children. The prevalence of nocturnal enuresis is low but fairly stable in children between 6 and 16 years. The findings support the link between nocturnal enuresis and psychopathology in children and adolescents.