Prevalence of behavior problems and mental health utilization among encopretic children: implications for behavioral pediatrics

The psychiatric literature traditionally has viewed encopretic children as having severe and characteristic behavior problems. Current psychiatric views as expressed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-III), and in the pediatric literature, however, tend to regard the behavior problems of encopretic children as being rather mild or secondary to the consequences of the encopresis itself. Using a behavioral checklist with empirically derived factors (the Child Behavior Checklist), 55 children presenting for medical treatment of their encopresis have been assessed. Numerous behavior problems are reported on parental ratings, but the overall severity of behavior problems in this group of children falls below that found in children with behavior problems who are referred for mental health services. Most children presenting for medical management of encopresis have not been seen or evaluated by mental health services. Encopresis is a disorder in which psychological evaluation and intervention by the pediatrician may be advisable.