Psychological Factors and Family Communication in Children and Adolescents with Elimination Disorders

Background: Elimination disorders, such as urinary (enuresis) and fecal incontinence (encopresis), involve inappropriate voiding beyond the expected age due to developmental, psychological, or physiological factors. These conditions impact children’s emotional well-being, self-esteem, social functioning, and family relationships. However, few studies have compared psychological functioning and family communication in affected children. This study examines general health, behavioral problems, and mother-child relationships in children with elimination disorders versus healthy peers. Methods: Seventy-two children participated: 25 with urinary incontinence, 24 with fecal incontinence, and 23 healthy controls. Participants were recruited from hospitals in Isfahan. Data were collected using standardized questionnaires: the General Health Questionnaire, Dyadic Adjustment Scale, Eyberg Child Behavior Inventory, and Mother–Child Relationship Evaluation. Statistical analyses included descriptive statistics, Shapiro–Wilk and Levene’s tests for assumptions, and group comparisons using univariate and multivariate analysis of variance (ANOVA and MANOVA). Results: No significant differences were found between groups in maternal general health or marital satisfaction. However, children with elimination disorders displayed more severe behavioral problems and faced greater challenges in their mother–child relationships, including lower maternal acceptance and higher levels of overprotection and rejection. Conclusion and Recommendations: Elimination disorders are associated with behavioral difficulties and strained family interactions. Early psychological screening, family counseling, and public education are recommended to improve outcomes for affected children and their families.