Effectiveness of an alarm intervention with overlearning for primary nocturnal enuresis.

ABSTRACT

OBJECTIVE: To explore the effectiveness of the enuresis alarm with overlearning for treatment of primary nocturnal enuresis (PNE). A key objective was to explore the effect of overlearning on treatment gains, and its impact on relapse. PATIENTS AND METHODS: The RMIT University Psychology Clinic has been treating PNE in the community for more than 20 years following a standardized treatment protocol. The study analysed archival data of 126 participants, aged ≥ 5 years, presenting with PNE. A mean wetting frequency of 5.13 wet nights per week was observed at baseline. RESULTS: Treatment significantly reduced mean wetting from baseline levels during both treatment and overlearning phases, F(1.41, 176.10) = 588.54, p < 0.001, r(2) = 0.77, 95% CI (0.74-0.81). Wet nights per week reduced from a mean of 5.13 (SD = 1.77) during baseline to 1.88 (SD = 0.85) during treatment, and 0.64 (SD = 0.60) during overlearning. Alarm treatment with overlearning produced a treatment response of 87%, compared with 59% for alarm treatment only. CONCLUSIONS: Evidence of improved treatment response with the addition of overlearning suggests overlearning should be considered as a potentially useful adjunct to alarm treatment for PNE. Overlearning was not unreasonably onerous for participants. Further research is required to explore the impact overlearning has on reducing relapse rates.