| Title |
The impact of DSM-5 and guidelines for assessment and treatment of elimination disorders
|
|---|---|
| Published in |
European Child & Adolescent Psychiatry, December 2012
|
| DOI | 10.1007/s00787-012-0363-9 |
| Pubmed ID | |
| Authors |
Alexander von Gontard |
| Abstract |
Elimination disorders are very common in children: 10 % of 7-year-olds wet at night (nocturnal enuresis), 2-3 % during daytime (diurnal urinary incontinence) and 1-3 % soil (faecal incontinence). In the past decades, many subtypes of elimination disorders have been identified with different symptoms, aetiologies, comorbid disorders and specific treatment options. The aim of the paper is to present a short overview of the proposed DSM-5, the ICCS and the Rome-III classification systems, of assessment and of treatment. The DSM-5 criteria no longer reflect current research data and a revision is needed. Classification systems of the International Children's Incontinence Society (ICCS) for enuresis and urinary incontinence and the ROME-III criteria for functional gastrointestinal disorders offer new and relevant suggestions for both clinical and research purposes. Assessment of most elimination disorders can be performed in paediatric and child psychiatric primary care settings. The standard assessment consists of a thorough history, frequency/volume charts, specific questionnaires, a full physical examination, sonography and urinalysis. If possible, a child psychiatric assessment is performed. In all other settings, screening with a validated behavioural questionnaire and referral if indicated is recommended. All other investigations are indicated only in complicated cases and if an organic cause is to be ruled out. Treatment is symptom oriented and based on the exact diagnosis of the type of elimination disorder. Counselling is recommended in every case. Most elimination disorders can be treated by specific treatment programmes integrating cognitive-behavioural elements. Nocturnal enuresis is best treated with alarms. Medication can be indicated in nocturnal enuresis (desmopressin), urge incontinence (anticholinergics such as oxybutynin, propiverine, etc.) and faecal incontinence with constipation (polyethylene glycol). Comorbid behavioural and emotional disorders require additional treatment. |
Mendeley readers
The data shown below were compiled from readership statistics for 79 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 3% |
| Netherlands | 1 | 1% |
| Canada | 1 | 1% |
| Unknown | 75 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 10 | 13% |
| Student > Ph. D. Student | 8 | 10% |
| Researcher | 7 | 9% |
| Student > Postgraduate | 7 | 9% |
| Other | 7 | 9% |
| Other | 21 | 27% |
| Unknown | 19 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 30% |
| Psychology | 15 | 19% |
| Nursing and Health Professions | 4 | 5% |
| Agricultural and Biological Sciences | 3 | 4% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Other | 6 | 8% |
| Unknown | 25 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 April 2022.
All research outputs
#7,470,952
of 23,482,849 outputs
Outputs from European Child & Adolescent Psychiatry
#801
of 1,689 outputs
Outputs of similar age
#81,547
of 284,146 outputs
Outputs of similar age from European Child & Adolescent Psychiatry
#8
of 16 outputs
Altmetric has tracked 23,482,849 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 1,689 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.1. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,146 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 16 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.