Multi-modal Treatment of Nocturnal Enuresis

Abstract

This study reports a multi-modal treatment of nocturnal enuresis and anxious behavior in a woman with mild mental retardation. Previous prescription of Tofranil had been shown to be an ineffective treatment for nocturnal enuresis and may have exacerbated the subject's anxious behavior. Reduction of this drug to eliminate anxious behavior was only partially successful and behavioral treatment alone proved ineffective as a treatment for nocturnal enuresis. However behavioral treatment and the removal of caffeine from the subject's diet eliminated both nocturnal enuresis and anxious behavior. The need to consider the diagnosis of caffeinism when assessing clients for a wide variety of symptoms is discussed with implications for clinical practice.