355Elimination
 Disorders
Elimination disorders  all involve the inappropriate elimination of urine or feces
and are usually first diagnosed in childhood or adolescence. This group of disorders in-
cludes enuresis,  the repeated voiding of urine into inappropriate places, and encopresis, the
repeated passage of feces into inappropriate places. Subtypes are provided to differentiate
nocturnal from diurnal (i.e., during waking hours) voiding for enuresis and the presence or
absence of constipation and ove rflow incontinence for encopresis. Although there are min-
imum age requirements for diagnosis of both disorders, these are based on developmental
age and not solely on chronological age. Both  disorders may be volun tary or involuntary.
Although these disorder s typically occur separa tely, co-occurrence may also be observed. 
Enuresis
Diagnostic Criteria 307.6 (F98.0)
A. Repeated voiding of urine into bed or clothes, whether involuntary or intentional.
B. The behavior is clinically significant as manifested by either a frequency of at least 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.
C. Chronological age is at least 5 years (or equivalent developmental level).
D. The behavior is not attributable to the physiological effects of a substance (e.g., a di-
uretic, an antipsychotic medication) or another medical condition (e.g., diabetes, spina
bifida, a seizure disorder).
Specify whether:
Nocturnal only: Passage of urine only during nighttime sleep.
Diurnal only: Passage of urine during waking hours.
Nocturnal and diurnal:  A combination of the two subtypes above.
Subtypes