Abstract General Information

Title

ANALYSIS OF PREDICTORS FOR LONG-TERM EMOTIONAL AND BEHAVIORAL ALTRATIONS IN CHILDREN AND ADOLESCENTS TREATED FOR BBD: A COHORT STUDY

Introduction and objective

It was observed that about half of the children with bladder and bowel dysfunction (BBD) presents emotional and behavioral alterations1. The objective of this study is to evaluate predictive factors for the presence of long-term emotional and behavioral alterations in children and adolescents treated for BBD.

Method

This is a prospective analytical cohort that included children and adolescents between 5 and 17 years of age at the first consultation treated for BBD in a center specialized in urinary disorders in childhood. All patients were contacted by telephone and had more than one year of treatment. Patients with anatomical and neurological alterations of the urinary and gastrointestinal system or cognitive impairment were excluded. Structed questionnaires with questions about urinary and intestinal symptoms and the Strengths and Difficulties Questionnaire (SDQ) were applied.

Results

A total of 29 patients were included, most of whom were male (16-55.2%). Current age of patients ranged from 8 to 22 years, with a median age of 15 years (IQR 13-17). The long-term follow-up of the project happened with a median of 60 (IQR 52-73) months after the first consultation. Eight (27.6%) patients persisted with SDQ alterations in the scale of total difficulties. The rates of persistence of alterations in the scale of emotional, hyperactivity and behavioral problems were 7 (24.1%), 7 (24.1%) and 8 (27.6%), respectively. Seven (24.1%) improved their scale of total of difficulties. The observed predictive factors were being older than 12 years at the first consultation (p=0,03), presenting incontinence without urgency (p=0,046), birth of an unplanned pregnancy (p=0,021), and higher DVSS (p=0,011) and constipation scores (p=0,034).

Conclusion

Being over 12 years of age at the first consultation, presenting incontinence without urgency, being born from an unplanned pregnancy and having more symptomatic BBD are predictive factors for the presence of emotional and behavioral changes in the long term.