Elimination disorders are sometimes considered the ugly step-child in psychiatry. Nocturnal enuresis is the voiding of urine at night and is always involuntary. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) specifically mentions antipsychotic medications as a potential cause. Encopresis is the repeated elimination of feces into inappropriate places, whether voluntary or involuntary. All children with elimination problems should see a pediatrician to rule out medical/physical causes. The prevalence of enuresis has been found to be higher in large or crowded families or in families that practice co-sleeping. A multitiered system of support approach begins with good toilet training and addresses occasional accidents. Simple behavioral treatments can usually resolve the problems. A case example illustrates a typical case.
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