The association of daily urinary and bowel incontinence with emotional functioning in young adults with spina bifida: an ecological momentary assessment study.

Only 23 people were studied, and they were mostly White, female, well educated, employed, and living and moving around fairly independently, so the findings may not hold for people with spina bifida who need more day-to-day help or who have more significant mobility or cognitive limitations. Everyone in the study had had incontinence in the four weeks before it started, so the results say nothing about people whose symptoms are less frequent or less predictable. The study ran for 30 days, which may be too short to capture longer-term or recurring patterns of bladder and bowel problems. Some of the daily questions were adapted from questionnaires designed to be answered about the past rather than about today, and the paper says those adaptations still need proper testing. No one under 18 took part, so this tells you nothing about how continence management and the feelings around it develop during adolescence. There was no treatment and no comparison group, and the authors describe the analysis as descriptive and exploratory, so these are associations rather than proof that one thing causes another.

The authors declare no conflicts of interest. The data came from a larger study supported by grant R21DK121355.

Do not read this as evidence that reducing accidents will fix mood or quality of life. Nobody was treated and there was no comparison group, so these are 23 people's own daily reports moving together; the data cannot show whether the accidents came first or the low mood did.