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Porter JS, Paladino AJ, Russell K, Rupff R, Griffith J, Mai Y, Zhang H, Hankins JS, Wang WC. Nocturnal Enuresis in Sickle Cell: Sociodemographic, Medical, and Quality of Life Factors. J Pediatr Psychol 2021; 47:75-85. [PMID: 34432048 DOI: 10.1093/jpepsy/jsab079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Nocturnal enuresis is more prevalent in youth with sickle cell disease (SCD) compared to the general population. The purpose of this study is to estimate prevalence of nocturnal enuresis using diagnostic criteria and identify associated sociodemographic, medical, and health-related quality of life (HRQOL) factors. METHODS Youth with SCD (N = 248; ages 6.00-17.99 years) and their caregivers completed semi-structured interviews and questionnaires. HRQOL was measured using the Pediatric Quality of Life (PedsQL) Inventory. Medical information was abstracted from medical record. We generated multivariable logistic regression models to examine associations between factors and current nocturnal enuresis and nocturnal enuresis occurring any time in the past (lifetime). RESULTS Among participants (mean age, 11.3 ± 3.6 years; 50.8% male), 21.4% reported current nocturnal enuresis and 46% reported lifetime nocturnal enuresis. Male sex [odds ratio (OR), 2.57; p = .001], difficulty arousing from sleep (OR, 3.57; p < .001), higher school functioning HRQOL (OR, 1.02; p = .014), and higher fetal hemoglobin levels (OR, 1.03; p = .048) were associated with lifetime nocturnal enuresis. Younger age (OR, 1.16; p = .005), higher youth-reported fatigue (OR, 1.01; p = .045), difficulty arousing from sleep (OR, 4.92; p < .001), and higher lactate dehydrogenase levels (OR, 1.00; p = .042) were associated with current nocturnal enuresis. CONCLUSIONS Nocturnal enuresis is prevalent in youth with SCD and is associated with HRQOL, diminished sleep, greater fatigue, and disease severity markers. Routine assessment of sleep behaviors and fatigue are necessary when treating patients with SCD to understand the impact of nocturnal enuresis on HRQOL.
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Affiliation(s)
- Jerlym S Porter
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Andrew J Paladino
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Preventive Medicine, University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA
| | - Kathryn Russell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rebecca Rupff
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.,Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Jamilla Griffith
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yujiao Mai
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Hui Zhang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Winfred C Wang
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
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Murphy JM, Bergmann P, Chiang C, Sturner R, Howard B, Abel MR, Jellinek M. The PSC-17: Subscale Scores, Reliability, and Factor Structure in a New National Sample. Pediatrics 2016; 138:peds.2016-0038. [PMID: 27519444 PMCID: PMC5005018 DOI: 10.1542/peds.2016-0038] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Pediatric Symptom Checklist-17 (PSC-17) is a widely used, briefer version of the PSC-35, a parent-completed measure of children's psychosocial functioning. Despite the extensive use of the PSC-17 over the past 15 years there has not been a large-scale replication of the original derivation study. OBJECTIVE To examine the prevalence of positive screens, reliability, and factor structure of PSC-17 scores in a new national sample and compare them with the derivation sample. METHODS Data were collected on 80 680 pediatric outpatients, ages 4 to 15 years, whose parents filled out the PSC-17 from 2006 to 2015 via the Child Health and Development Interactive System, an electronic system that presents and scores clinical measures. RESULTS The rates of positive screening on the overall PSC-17 (11.6%) and on the internalizing (10.4%) and attention (9.1%) subscales were comparable to rates found in the original sample, although the rate of externalizing problems (10.2%) was lower than in the derivation study. Reliability was high (internal consistency 0.89; test-retest 0.85), and a confirmatory factor analysis provided support for the original 3-factor model. CONCLUSIONS Fifteen years after the PSC-17 was derived in a large nationally representative outpatient pediatric sample, a new and larger national sample found rates of positive screening, reliability, and factor structure that were comparable. Findings from this study support the continued use of the PSC-17 clinically as a screening tool in pediatric settings and in research.
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Affiliation(s)
- J. Michael Murphy
- Massachusetts General Hospital, Boston, Massachusetts;,Harvard Medical School, Boston, Massachusetts
| | - Paul Bergmann
- PrairieCare Institute, Minneapolis, Minnesota;,Foresight Logic, Inc, St Paul, Minnesota
| | - Cindy Chiang
- Massachusetts General Hospital, Boston, Massachusetts
| | - Raymond Sturner
- Johns Hopkins University School of Medicine and Center for Promotion of Child Development Through Primary Care, Baltimore, Maryland
| | - Barbara Howard
- Johns Hopkins University School of Medicine and Total Child Health, Baltimore, Maryland; and
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Lehmann GC, Bell TR, Kirkham FJ, Gavlak JC, Ferguson TF, Strunk RC, Austin P, Rosen CL, Marshall MJ, Wilkey O, Rodeghier MJ, Warner JO, DeBaun MR. Enuresis associated with sleep disordered breathing in children with sickle cell anemia. J Urol 2012; 188:1572-6. [PMID: 22910247 PMCID: PMC3722896 DOI: 10.1016/j.juro.2012.02.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Indexed: 11/17/2022]
Abstract
PURPOSE Enuresis and sleep disordered breathing are common among children with sickle cell anemia. We evaluated whether enuresis is associated with sleep disordered breathing in children with sickle cell anemia. MATERIALS AND METHODS Baseline data were used from a multicenter prospective cohort study of 221 unselected children with sickle cell anemia. A questionnaire was used to evaluate, by parental report during the previous month, the presence of enuresis and its severity. Overnight polysomnography was used to determine the presence of sleep disordered breathing by the number of obstructive apneas and/or hypopneas per hour of sleep. Logistic and ordinal regression models were used to evaluate the association of sleep disordered breathing and enuresis. RESULTS The mean age of participants was 10.1 years (median 10.0, range 4 to 19). Enuresis occurred in 38.9% of participants and was significantly associated with an obstructive apnea-hypopnea index of 2 or more per hour after adjusting for age and gender (OR 2.19; 95% CI 1.09, 4.40; p = 0.03). Enuresis severity was associated with obstructive apneas and hypopneas with 3% or more desaturation 2 or more times per hour with and without habitual snoring (OR 3.23; 95% CI 1.53, 6.81; p = 0.001 and OR 2.07; 95% CI 1.09, 3.92; p = 0.03, respectively). CONCLUSIONS In this unselected group of children with sickle cell anemia, sleep disordered breathing was associated with enuresis. Results of this study support that children with sickle cell anemia who present with enuresis should be evaluated by a pulmonologist for sleep disordered breathing.
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Affiliation(s)
- Gloria C. Lehmann
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Teal R. Bell
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Fenella J. Kirkham
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Johanna C. Gavlak
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Tekeda F. Ferguson
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Robert C. Strunk
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | | | - Carol L. Rosen
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Melanie J. Marshall
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Olu Wilkey
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Mark J. Rodeghier
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - John O. Warner
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
| | - Michael R. DeBaun
- Departments of Pediatrics (GCL, RCS) and Surgery, Division of Urology (PA), Washington University School of Medicine, and Department of Epidemiology, Saint Louis University School of Public Health (TRB, TFF), St. Louis, Missouri; University College London Institute of Child Health (FJK, JCG, MJM), North Middlesex University Hospital (OW), and Biomedical Centre, Imperial College and Imperial College Healthcare NHS Trust (JOW), London, United Kingdom; Department of Pediatrics, Division of Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio (CLR); Chicago, Illinois (MJR); and Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (MRD)
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