Social and emotional impact of faecal incontinence after surgery for anorectal abnormalities.

L Ludman, L Spitz, E M Kiely

Department of Paediatric Surgery, Institute of Child Health, London.

A significant proportion of children with anorectal malformations have long term problems with faecal continence. The psychological consequences of this chronic disability was assessed in 160 children and adolescents. The prevalence of clinically significant emotional problems among the sample overall, as assessed by a diagnostic psychiatric interview (19%), parental assessment (27%), and child self report depressive scale (24%) was higher than expected relative to normative populations. With the exception of the young girls (6-11 years), the incontinent children and adolescents were not judged to be less well adjusted than those with good bowel control. Treatment for anorectal malformations appears to be associated with an increased risk for behavioural and social problems, but this was not related to the level of continence. Parental factors and gender were significantly associated with outcome. These children and families would benefit from psychological evaluation and support especially during early childhood.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ludman, L. (2003). Gut feelings: a psychologist's 20-year journey with paediatric surgeons. JRSM 96: 87-91 [Full Text]  
• Ludman, L, Spitz, L, Tsuji, H, Pierro, A (2002). Hirschsprung's disease: functional and psychological follow up comparing total colonic and rectosigmoid aganglionosis. Arch. Dis. Child. 86: 348-351 [Abstract] [Full Text]  
• Kamm, M. A (1998). Fortnightly review : Faecal incontinence. BMJ 316: 528-532 [Abstract] [Full Text]  
• Diseth, T. H, Bjørnland, K., Nøvik, T. S, Emblem, R. (1997). Bowel function, mental health, and psychosocial function in adolescents with Hirschsprung's disease. Arch. Dis. Child. 76: 100-106 [Abstract] [Full Text]