Punishment for bedwetting is associated with child depression and reduced quality of life

Abstract

This study assessed the relationship between parental punishment and depression as well as quality of life in children with primary monosymptomatic nocturnal enuresis (PMNE). A consecutive sample of 65 children (7-13 years) with PMNE and 40 healthy children, selected as controls (Group III), were included in the study. The children with PMNE were further sub-classified into two groups: Group I, which included children who received parental punishment for enuresis and Group II, which comprised children who were not punished for bedwetting. Depression and health-related quality of life (HRQL) were assessed among the three groups. The number of wet nights per week was significantly increased in Group I compared with Group II (P<.001). In addition, the severity of depressive symptoms increased in Group I as compared to the other two groups (P<.001). Similarly, the psychosocial HRQL lower in Group compared to the control group (Group III) (P<.001). Prior parental discipline, including corporal punishment (B=0.55, P=.008), as well as the frequency (B=0.73, P<.001) and duration of punishment (B=0.33, P=.02) were strong predictors of increased depressive symptom severity. It was also found that prior punishment (B=-0.42, P=.01) and the frequency (B=-0.62, P<.001) and duration of punishment (B=-0.34, P=.02) were strong predictors for poor psychosocial HRQL. Overall, parental punishment has a poor outcome in children with PMNE.

Keywords: Depression; Nocturnal enuresis; Parental punishment; Quality of life.