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The impact of DSM-5 and guidelines for assessment and treatment of elimination disorders

Overview of attention for article published in European Child & Adolescent Psychiatry, December 2012
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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 58 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 2%
Canada 1 2%
Unknown 54 93%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 16%
Student > Ph. D. Student 9 16%
Unspecified 7 12%
Student > Postgraduate 6 10%
Student > Doctoral Student 5 9%
Other 22 38%
Readers by discipline Count As %
Medicine and Dentistry 21 36%
Psychology 14 24%
Unspecified 10 17%
Nursing and Health Professions 4 7%
Social Sciences 3 5%
Other 6 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 22 December 2012.
All research outputs
#10,836,653
of 12,224,495 outputs
Outputs from European Child & Adolescent Psychiatry
#852
of 969 outputs
Outputs of similar age
#238,448
of 282,443 outputs
Outputs of similar age from European Child & Adolescent Psychiatry
#22
of 27 outputs
Altmetric has tracked 12,224,495 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 969 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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 282,443 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.