Accuracy of the short screening instrument for psychological problems (SSIPPE) in enuresis in the Identification of attention-deficit/ hyperactivity symptoms in the enuretic population

Flávia Cristina de Carvalho Mrad; Gabriel Sesana da Silva; Geyce Kelly de Souza Rodrigues; José Murillo Bastos Netto; Eleonora Moreira Lima; Tânia Antunes Carvalho; Melissa Faria Dutra; José de Bessa Junior; Mônica Maria de Almeida Vasconcelos

doi:10.1016/j.jpurol.2022.02.003

Accuracy of the short screening instrument for psychological problems (SSIPPE) in enuresis in the Identification of attention-deficit/ hyperactivity symptoms in the enuretic population

J Pediatr Urol. 2022 Jun;18(3):350.e1-350.e6. doi: 10.1016/j.jpurol.2022.02.003. Epub 2022 Feb 12.

Authors

Flávia Cristina de Carvalho Mrad¹, Gabriel Sesana da Silva², Geyce Kelly de Souza Rodrigues³, José Murillo Bastos Netto⁴, Eleonora Moreira Lima⁵, Tânia Antunes Carvalho⁶, Melissa Faria Dutra⁷, José de Bessa Junior⁸, Mônica Maria de Almeida Vasconcelos⁹

Affiliations

¹ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: flaviacarvalhomrad@gmail.com.
² Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: gabrielsesana02@hotmail.com.
³ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: geycelgd@gmail.com.
⁴ Universidade Federal de Juiz de Fora, School of Medicine, Urology Department, Brazil; Faculdade de Ciências Médicas de Juiz de Fora e Maternidade Therezinha de Jesus, Urology Department, Brazil. Electronic address: jose.murillo@ufjf.edu.br.
⁵ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: eleonoralima330@gmail.com.
⁶ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: taniaantunessc@gmail.com.
⁷ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: melissafariadutra@gmail.com.
⁸ Universidade Estadual de Feira de Santana, Urology Department, Brazil. Electronic address: josedebessa@gmail.com.
⁹ Universidade Federal de Minas Gerais (UFMG), Pediatrics Department, School of Medicine, Pediatric Nephrology Unit, Hospital Das Clínicas da UFMG, Brazil. Electronic address: monicamavascon@gmail.com.

PMID: 35283019
DOI: 10.1016/j.jpurol.2022.02.003

Abstract

Introduction: Enuresis prevalence is approximately 5-15% in children aged 6-7 years. The presence of attention deficit hyperactivity disorder (ADHD) in enuretic children is associated with 3 times greater risk of persistent enuresis. The Multimodal Treatment Study for ADHD (MTA) Swanson, Nolan, and Pelham version IV (SNAP-IV) is one of the most used instruments to evaluate ADHD symptoms, but it is a time-consuming questionnaire.

Objective: This study aims to compare the accuracy of an easy questionnaire named Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) to MTA-SNAP-IV in identifying ADHD symptoms in children and adolescents with enuresis.

Methods: ADHD symptoms screening was performed by applying SSIPPE and MTA-SNAP-IV in 160 children and adolescents with enuresis, aged 6-14 years, who regularly attended a specialized clinic for pediatric urology.

Results: A total of 153 individuals with enuresis were included in the study (52% males), among them 55 (35.9%) were considered positive for inattention and hyperactivity-impulsivity by the MTA-SNAP-IV. Sensitivity for SSIPPE concerning MTA-SNAP-IV was 85.5%, and specificity was 84.7%, with an overall accuracy of 85% in identifying ADHD symptoms.

Discussion: In the present study, we found high accuracy of SSIPPE in relation to MTA-SNAP-IV in identifying ADHD symptoms in the enuretic population, with substantial agreement between instruments. Its sensitivity and specificity were considered high for a screening method. However, there are some limitations. The population studied is composed of a group of children with enuresis, which can lead to an overestimation of the test's accuracy, as the disorder under investigation is more prevalent in this population. This can be explained by the high specificity of the test (84.7%) associated with the fact that the SSIPPE is an instrument tailored for an enuretic population, unlike the MTA-SNAP IV.

Conclusion: The SSIPPE has proven to be a reliable tool in identifying ADHD symptoms in the enuretic population. In addition to being a quick and easily applicable instrument.

Keywords: Adolescents; Attention deficit disorder with hyperactivity; Children; Enuresis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / epidemiology
Child
Female
Humans
Male
Nocturnal Enuresis* / epidemiology
Surveys and Questionnaires
Urinary Incontinence* / complications