Monthly Archives:
January 2023

Case Study: An Adolescent with Incapacitating Tics

Nath K, Panja S. An Adolescent with Incapacitating Tics. Ind J Priv Psychiatry 2023;17(1):47–48. Article link.

Case description: This case is about a male of age 15 years with a history of fever 3 years back, after which symptoms such as abnormal sounds and body movements gradually started, which were involuntary. After many trials with different antipsychotics, the patient started responding
but symptoms persist along with anxiety and irritability at times.

Conclusion: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections occur in about 1 in 1,000 children, which is a rare disorder and is difficult to diagnose. The treatment is challenging as a suitable antipsychotic has to be picked in terms of efficacy and dosing.

Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives

Antonella Gagliano, Alessandra Carta, Marcello G Tanca & Stefano
Sotgiu (2023) Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives,
Neuropsychiatric Disease and Treatment, 1221-1250, DOI: 10.2147/NDT.S362202

“The current approach to PANS treatment emphasizes immunomodulation/anti-inflammatory treatments in association with both psychotropic and cognitive-behavioral therapies, while antibiotics are suggested when an active bacterial infection is established. A dimensional view, taking into account the multifactorial origin of psychiatric disorders, should suggest neuro-inflammation as a possible shared substrate of different psychiatric phenotypes. Hence, PANS and PANS-related disorders should be considered as a conceptual framework describing the etiological and phenotypical complexity of many psychiatric disorders.”

Treatment-resistant OCD: Pharmacotherapies in adults

Peter J. van Roessel, Giacomo Grassi, Elias N. Aboujaoude, José M. Menchón, Michael Van Ameringen, Carolyn I. Rodríguez. Treatment-resistant OCD: Pharmacotherapies in adults,
Comprehensive Psychiatry, Volume 120, 2023,152352, ISSN 0010-440X, https://doi.org/10.1016/j.comppsych.2022.152352.

  • Many individuals with OCD do not sufficiently benefit from first-line treatment with serotonin reuptake inhibitors.
  • A broad range of pharmacotherapies have been explored as adjunctive or alternative interventions for treatment-resistant OCD.
  • Glutamatergic and anti-inflammatory interventions, among others, may offer favorable benefit to risk profiles.
  • Dopamine antagonist treatments remain the best evidenced augmentation strategy for treatment-resistant OCD.
Prevalence of post-COVID symptoms of obsessive-compulsive disorder in Saudi Arabia
Alblowi MA, Alkhammash WM, Alzahrani TM, Hakeem MH, Alsarar SA, Alqahtani AA, Almutairi AM, Al Binhar TH. Prevalence of post-COVID symptoms of obsessive-compulsive disorder in Saudi Arabia. Neurosciences (Riyadh). 2023 Jan;28(1):27-35. doi: 10.17712/nsj.2023.1.20220068. PMID: 36617460; PMCID: PMC9987626.
A total of 356 patients were included in the analysis. Approximately 9.0% and 1.7% of the patients had a history of psychiatric disease and OCD diagnosis (respectively). The total symptom score was 32.8%. The most frequently reported domains were rumination of ideas (55.5%), re-checking compulsions (37.0%), and slowness (34.0%), while the least frequently reported domains included obsessive impulses (26.3%), obsessive images (26.5%), and religious compulsions (26.8%). Unlike other domains, the purity and cleanliness compulsions scores were significantly higher than the scale reference population. A higher total symptom score was observed in psychiatric patients (p=0.004) and, to a lesser extent, in OCD patients (p=0.250). 
Diagnosis and monitoring of the functioning of the human nervous system

Liliia Yukhymenko & Sergii Khomenko & Lidiia Iliukha, 2023. “Diagnosis and monitoring of the functioning of the human nervous system,” Chapters of Monographs, in: Modern methods of diagnosing disaeses, chapter 3, pages 69–94, PC TECHNOLOGY CENTER. Handle: RePEc:baq:pcchap:978-617-7319-65-7-ch3.  DOI: 10.15587/978-617-7319-65-7.ch3 

“Substantiation of the role of the infectious factor in the pathogenesis of the disease in
Genetic deficiency of folate cycle (GDFC) creates the prerequisites for testing antimicrobial treatment strategies based on a personalized assessment of the patient’s microbial profile. According to this Lisa A. Snider et al. performed a double-blind, placebo-controlled, randomized clinical trial of long-term prophylactic therapy with penicillin VK 250 mg twice daily and azithromycin 250 mg twice daily once a week for 1 year in PANDAS. A 96 % reduction in the frequency of exacerbations of streptococcal infection and a 61 % reduction in the number of relapses of PANDAS in patients treated with both penicillin and azithromycin compared with placebo was demonstrated [98]. It is clear that children with neuro-psychiatric manifestations require antiviral, antifungal and antiprotozoal treatment, in addition to antibiotic therapy, if relevant infectious agents are identified, which should be studied in controlledclinical trials.”