Arousal and Nonarousal Enuretic Events
EDWARD R. RITVO M.D.1,
EDWARD M. ORNITZ M.D.1,
FRED GOTTLIEB M.D.1,
ALVIN F. POUSSAINT M.D.2,
BARRY J. MARON M.D.3,
KEITH S. DITMAN M.D.4, , and
KENNETH A. BLINN M.D.5
1 Assistant professor (in residence) of psychiatry, department of psychiatry, University of California School of Medicine, Los Angeles, Calif.
2 Assistant professor of psychiatry, Tufts University School of Medicine, Boston, Mass.
3 Pediatric resident, Stanford University School of Medicine, Palo Alto, Calif.
4 Research psychiatrist and lecturer, department of psychiatry, University of California School of Medicine, Los Angeles, Calif.
5 Director, electroencephalogram departments, Mt. Sinai Hospital, Los Angeles, and Santa Monica Hospital, Santa Monica, Calif.
Seven boys with primary enuresis were measured by 62 all-night EEGs, during which time 48 wets occurred. Imipramine was administered in a placebo, drug cross-over manner. Subjects with predominantly arousal enuresis showed increased evidence of neuroticism, a history of sporadic wetting, and no family history of enuresis. Subjects with predominantly nonarousal enuresis had minimal evidence of maladjustment, a history of regular wetting, family history of enuresis, and a better response to imipramine. The authors formulate a somatopsychic model for the etiology of enuresis, hypothesizing a pathophysiological substrate to explain the phenomenon.
