Enuresis and Punishment: The Adverse Effects on Child Development and on Treatment

OBJECTIVE: To investigate the role of punishment in enuretic children and how the punishments can influence therapy response. METHODS: We enrolled 218 enuretic children. The children and their families were asked to participate in the study at the end of the clinical evaluation. RESULTS: The analysis of the questionnaires shows that at least one punishment because of nocturnal enuresis (NE) had been applied to 27 out of 218 (12.4%) children. Punishment methods were reprimanding in 19 out of 27 (70.4%), depriving of sleep in 11 out of 27 (40.7%), mildly beating in 3 out of 27 (11.1%), leaving the child wet in 1 out of 27 (3.7%) and other methods in 2 out of 27 (7.4%). In the group of punished children, a full or partial response in terms of a decreased number of wet nights was achieved in 40.7 vs. 59.2% in children who had not been punished. CONCLUSIONS: Parents should be sensitized on the adverse effects of punishment on child development. It is important in childcare to explain the definitions of the disorder and find the best treatment (behavioural and/or medicinal) depending on the single patient, his/her family and compliance of both. Successful management of NE has benefits to both the child and the family.