1. Dr j. Golmirzaei Child & adolescent psychiatrist

2. Enuresis Definition Etiology Epidemiology Differential Diagnosis

3. Treatment Rate of spontaneous remission 15% per year Behavioral conditioning with bell and pad DDAVP Imipramine Anticholinergic Combination

4. Outcome & follow-up 6 months treatment 6 months later treatment Observation 16% Imipramine 16% DDAVP 10% Behavioral 56% First line

5. Encopresis Defination Epidemiology Etiology Differential Diagnosis

6. Subtypes Retentive (most frequent) Non-retentive Volitional(least frequent)

7. First line of treatment for retentive subtype is Education about bowel functioning Physiological treatment (laxative or mineral oil) Behavioral Biofeedback

8. Case report : Imipramine for non-retentive encopresis

9. Psychodynamic assessment for volitional encopresis