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Am J Psychiatry 1943;100:320-325.
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Medical Corps, United States Naval Reserve

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One hundred and fifty cases of enuresis among recruits at the Norfolk Naval Training Station were studied. It was found that enuresis is not a clinical entity in itself but a manifestation of a deep seated personality disturbance. In addition to the enuresis, symptomatology of a neurotic nature was often present, such as somnambulism, nightmares, severe nail-biting and nervousness. The recruit as a rule, attributed his condition to kidney involvement and rarely sought medical attention. The bed-wetter is usually immature, maladjusted, emotionally unstable and insecure.A study of the family background revealed the presence of numerous psychiatric abnormalities among the other siblings and the parents. There was a high incidence of enuresis and home disruption was a common finding. The parents had no insight into their offsprings' manifestations and used crude methods in order to effect a cure.It is felt that the most common etiological factor in the causation of enuresis in the cases studied is the lack of security. This permits the persistence of infantile traits beyond puberty. The insecurity is due to the presence of large families, home disruption, poor economic and social conditions, and neurotic parents.

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