Incontinence and headache in preschool children

Abstract

Aims:Headaches in preschool children are associated with behavioral andgastrointestinal symptoms. As the co‐occurrence with incontinence is notknown in young children, the aim of the study was to examine associations ofheadache, psychological symptoms and nocturnal enuresis (NE), daytimeurinary incontinence (DUI), and fecal incontinence (FI) in a population‐basedsample of preschool children.Methods:All preschool children of a defined geographical area were examinedat school‐entry. Parents completed a 22‐item questionnaire, including 14headache, 4 incontinence, and 25 items of the Strength and DifficultiesQuestionnaire (SDQ). Five hundred eighty‐five children (50.4% males) with amean age of 5.8 years were included.Results:In total, 27.2% of all children had headaches. 15.7% had secondary and11.3% primary headaches. Five children had migraine and five tension‐typeheadaches, while all others were unclassifiable. 9.4% of children hadincontinence (7.7% NE; 2.4% DUI, 1.2% FI) and 4.0% constipation. The ratesof incontinence did not differ between children with primary and those withoutheadache for NE (12.9% vs 7.5%), DUI (3.1% vs 2.7%) or FI (3.0% vs 1.0%), butfor constipation (12.1% vs 2.6%). Incontinent children had significantly morebehavioral and externalizing symptoms, children with headache more inter-nalizing problems. Primary headache was a significant predictor for internaliz-ing, while constipation and FI were predictors for externalizing symptoms.Conclusions:This population‐based study showed that headache is associatedwith constipation, but not with incontinence in preschool children. Headacheand incontinence are common risk factors for specific psychological symptomsand should be assessed in clinical practice.