Medication side effects. Enuresis may occur during treatment with antipsychotic med-
ications, diuretics, or other medications that may induce incontinence. In this case, the di-
agnosis should not be made in isolation but may be noted as a medication side effect.
However, a diagnosis of enuresis may be made if urinary incontinence was regularly pres-
ent prior to treatment with the medication.
Comorbidity
Although most children with enuresis do not have a comorbid mental disorder, the prevalence
of comorbid behavioral symptoms is higher in children with enuresis than in children without
enuresis. Developmental delays, including speech, language, learning, and motor skills
delays, are also present in a portion of childr en with enuresis. Encopresis, sleepwalking, and
sleep terror disorder may be present. Urinar y tract infections are more common in children
with enuresis, especially the diurnal subtype, than in those who are continent.
Encopresis
Diagnostic Criteria 307.7 (F98.1)
A. Repeated passage of feces into inappropriate places (e.g., clothing, floor), whether in-
voluntary or intentional.
B. At least one such event occurs each month for at least 3 months.
C. Chronological age is at least 4 years (or equivalent developmental level).
D. The behavior is not attributable to the physiological effects of a substance (e.g., laxa-
tives) or another medical condition except through a mechanism involving constipation.