Epidemiology And Neuropsychological Characteristics Of Children With Functional Encopresis

Objective Functional encopresis in children was a chronic behavioral problem belonging to defecation dysfunction and resulted in seriously harmful effects on growth and development.This study probed into the epidemiologic feature,risk factors,and neuropsychological characteristics in children with functional encopresis,and provided the theoretical evidence for clinical diagnosis and psycho-behavior therapy of functional encopresis.Methods 4044 children aged 4～5 years(male 2196,female 1848),3828 children aged 6～11 years(male 1818,female 2010) and 4848 children aged 12～16 year old(male 2346, female 2502) were chosen by stratified random cluster sampling in Qingdao and Binzhou city from July 2007 to October 2007.Their family conditions,growth,and development stations were investigated by questionnaires including self-made general condition and factors influencing encopresis questionnaire,Achenbach Child Behavior Checklist(CBCL),NYLS 3～7 year old children temperament questionnaire,Family environment Scale-Chinese Version(FES-CV),and hyperactivity behavior checklist for children.Epidemiology,related factors and neuropsychological characteristics of children with functional encopresis were analyzed.Parents were asked to fill questionnaires.Results(1) The prevalence figure for functional encopresis of children aged 4～5 years was 2.23%,of the total 1.46%males,3.14%females,the prevalence of female much more than that of male.According to the age,the incidence rate was 2.35%for 4 years, and 2.11%for 5 years,1.25%of children aged 6～11 years,1.49 of children aged 12～16 years.Those who soil occasionally was found in 82.22%(74/90) of the 4～5 year old with encopresis.Only 8.89%(8/90) of the 4～5 year old who had encopresis had ever been taken to see a doctor for this problem.(2) Much more children with functional encopresis happened enuresis,constipation,difficult or pain defecation than normal children.(3) Incidence rate of behavior problems in the case group(21.11%,19/90) was higher than that in the control group(12.63%,490/3880).The scores of somatic complaint,immaturity, aggressiveness(0.50±0.50,5.18±3.43,7.62±5.58) were higher than those of normal children(0.29±1.51,3.50±2.60,5.44±4.45) in male for functional encopresis children.The scores of schizoid state,social withdrawal,offensive behavior,aggressiveness,restless behavior and total behavioral problem(4.48±2.93,2.93±2.16,1.65±1.35,6.51±5.35, 3.31±2.58,25.13±17.45)were higher than those of control group in female children (3.55±2.97,2.09±2.31,0.95±1.47,4.89±4.46,2.48±2.59,19.88±16.20).(4) There was a statistically significant difference in the temperament dimensions between the case group and the control.The scores of rhythmicity,approach,attention span and persistence, distractibility,threshold of responsiveness were significantly different from those of the control group.(5) Children with functional encopresis lived in worse family environment. The cohesion and organization scores were lower than those of control group.(6) The problem of attention deficit hyperactivity disorder was far more common among children with encopresis than among normal children.(7) Factors of family income,floor space, pregnancy history,father functional enuresis and encopresis affected the occurence of functional encopresis.Conclusions The epidemiologic survey demonstrated the actual morbidity rate was more than its visiting rate and many children didn't visit doctor.Incidence rate of behavior problems in children with functional encopresis was much higher,and the disease interfered neuropsychological behavior development.Clinician and parents should pay more attention in prevention and treatment of functional encopresis,and provide satisfactory environment for children with functional encopresis.