Monthly Archives:
February 2021

Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS

Navin Prasad, Stephanie Y. Johng, Daniel Powell, Matthew Williams, Elizabeth Latimer, Earl H. Harley, Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS, American Journal of Otolaryngology, 2021, 102963, ISSN 0196-0709, DOI: 10.1016/j.amjoto.2021.102963.

“Caregivers reported a decreasing frequency of symptoms over time regardless of treatment and had no difference in satisfaction. T&A was the most preferred treatment and the most impactful on symptoms for surgical patients. Given the challenges of immunologic therapies, T&A in combination with antibiotics should be considered as an early intervention for PANDAS.”

Evaluation of Intravenous Immunoglobulin in Pediatric Acute-Onset Neuropsychiatric Syndrome
Isaac Melamed, Roger H. Kobayashi, Maeve O’Connor, Ai Lan Kobayashi, Andrew Schechterman, Melinda Heffron, Sharon Canterberry, Holly Miranda, and Nazia Rashid.Journal of Child and Adolescent Psychopharmacology. Feb 18, 20210 DOI: 10.1089/cap.2020.0100

Conclusions: In PANS, which may be associated with an underlying immune dysregulation, sequential infusions of IVIG [Octagam 5%] successfully ameliorated psychological symptoms and dysfunction, with sustained benefits for at least 8 weeks, and up to 46 weeks in a subset of subjects. In addition, baseline immune and autoimmune profiles demonstrated significant elevations in a majority of subjects, which requires further evaluation, characterization, and study to clarify the potential immune dysfunction by which PANS manifests and progresses.

Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis

Irina A. Vanzhula, Shruti S. Kinkel-Ram, Cheri A. Levinson. Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis. Journal of Affective Disorders. Volume 283, 2021,p 302-309, DOI: 10.1016/j.jad.2021.01.083.

Highlights

  • Difficulties controlling intrusive thoughts is a common symptom between eating disorders and OCD
  • Perfectionism symptoms bridge eating disorders and OCD
  • Restriction links to checking compulsions and rigidity
  • Binge eating links to hoarding symptoms

Conclusions
The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.

 

Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics

Margo Thienemann, Michelle Park, Avis Chan, Jennifer Frankovich. Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics. Journal of Psychiatric Research, Vol 135, 2021, PP 270-278. DOI: 10.1016/j.jpsychires.2021.01.022.

  • More than half of patients with PANS require psychotropic medication.
  • Side effects requiring a therapy change are common.
  • Drug doses at which side effects occur are usually less than recommended.
  • Clinicians should start with lower doses of psychotropics in PANS patients.

“Antidepressants’ most common side effects were anxiety, agitation, aggression, and akathisia. Antipsychotics’ most common side effects were dystonia, aggression, self-injurious behavior, and movement abnormality. Side effects were common at doses lower than the suggested starting doses for these medications. Patients tolerated antidepressants and antipsychotics when doses were low.”