Monthly Archives:
March 2019

Autoimmune Diseases and Psychotic Disorders

Rose Jeppesen, Michael Eriksen Benros
Frontiers in Psychiatry

The increasing knowledge on the potential involvement of inflammatory processes in mental disorders and the associations found between autoimmunity and psychotic disorders can help the expanding field of immuno-psychiatry and have impact on the outcome of patients. In the last couple of years, researchers have focused on the role of infections, autoantibodies and other immune components that plays a major role in autoimmune diseases. Potentially this might also be the case for mental disorders.

Treating pediatric acute-onset neuropsychiatric syndrome

Elizabeth Heavey; Kathleen Peterson
The Nurse Practitioner-2019

Pediatric acute-onset neuropsychiatric syndrome (PANS) can be caused by infectious and noninfectious triggers. NPs can help children with PANS recover from their symptoms and prevent future recurrences by appropriately screening, recognizing, and diagnosing the clinical presentation of PANS. PANS treatment includes pharmacologic therapies as well as cognitive behavioral therapy.

Paediatric acute-onset neuropsychiatric syndrome in children and adolescents: an observational cohort study

Johnson, Fernell, Preda, Wallin, Fasth, Gillberg, Gillberg.
Lancet Child Adolesc Health-2019

Excerpt: Of 41 patients (37 referred and four visited upon parents’ request), 23 (ten girls and 13 boys) met PANS diagnostic criteria. Mean age at PANS onset was 8·5 years (SD 3·37). 11 (48%) patients had a family history of developmental or neuropsychiatric disorders in a first-degree relative and 11 (48%) had a family history of autoimmune or inflammatory diseases in a first-degree relative. 

Psychotic symptoms in youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) may reflect syndrome severity and heterogeneity

Silverman M, Frankovich J, Nguyen E, Leibold C, Yoon J, Mark Freeman G Jr, Karpel H, Thienemann M.
J Psychiatr Res.-2019

Conclusions: Over 1/3 of children with PANS experienced transient hallucinations. They were more impaired than those without psychotic symptoms, but showed no differences in disease progression. This difference may point toward heterogeneity in PANS. When evaluating children with acute psychotic symptoms, clinicians should screen for abrupt-onset of a symptom cluster including OCD and/or food refusal, with neuropsychiatric symptoms (enuresis, handwriting changes, tics, hyperactivity, sleep disorder) before initiating treatment.