Posts by:
Gabriella True

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.”

Anorexia nervosa and autoimmune comorbidities: A bidirectional route?
Sirufo MM, Magnanimi LM, Ginaldi L, De Martinis M. Anorexia nervosa and autoimmune comorbidities: A bidirectional route? CNS Neurosci Ther. 2022 Dec;28(12):1921-1929. doi: 10.1111/cns.13953. Epub 2022 Sep 16. PMID: 36114699; PMCID: PMC9627382.
In this review, in addition to reporting the numerous cases described in which autoimmune disorders are associated with anorexia or vice versa, we summarize the many aspects of this relationship between the immune system (IS) and AN. We describe how the microbiota affects the IS, disrupts gut-brain communication, and possibly triggers eating disorders. We also describe the shared immunological pathways of autoimmune and eating disorders and in particular the occurrence of disrupted T cell tolerance and autoantibodies in AN. The described observations represent the starting point for possible, future research directions.
Neuropsychiatric Symptoms and Tick-Borne Diseases

Book: Microorganisms and Mental Health

Chapter: Neuropsychiatric Symptoms and Tick-Borne Diseases. Shannon L. Delaney, Lilly A. Murray & Brian A. Fallon. First Online:

In North America, Lyme disease (LD) is primarily caused by the spirochetal bacterium Borrelia burgdorferi, transmitted to humans by Ixodes species tick bites, at an estimated rate of 476,000 patients diagnosed per year. Acute LD often manifests with flu-like symptoms and an expanding rash known as erythema migrans (EM) and less often with neurologic, neuropsychiatric, arthritic, or cardiac features. Most acute cases of Lyme disease are effectively treated with antibiotics, but 10–20% of individuals may experience recurrent or persistent symptoms. This chapter focuses on the neuropsychiatric aspects of Lyme disease, as these are less widely recognized by physicians and often overlooked. Broader education about the potential complexity, severity, and diverse manifestations of tick-borne diseases is needed.

Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome

Ellerkamp H, Thienemann M, Tinero J, Shaw R, Dowtin LL, Frankovich J, Borkovi TC. Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Clin Psychol Med Settings. 2022 Dec 8. doi: 10.1007/s10880-022-09926-0. Epub ahead of print. PMID: 36480109.

Parents of children with diagnoses of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) may experience significant psychological distress related to their child’s severe and relapsing illness and challenges with the traumatic nature of its treatment.

  • Assessed the feasibility, satisfaction, and treatment fidelity of a brief 9-session group therapy intervention for parents based on principles of trauma-focused cognitive behavior therapy (CBT). Ten parents participated in the study.
  • The 9-session intervention used a combination of techniques that included cognitive restructuring, coping skills, self-care, and a trauma narrative to address psychological stress, trust, grief, and unwanted emotions.
  • Outcome measures included parental symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), as well as rating of parental satisfaction with the intervention.
  • The treatment was feasible and deliverable with high fidelity. The intervention was rated as useful and satisfactory by parents (overall average usefulness of 4.54 and satisfaction of 4.71 out of 5.0). Elevated symptoms of PTSD and depression decreased with large effect sizes (Cohen’s d = 1.42 and Cohen’s d = 1.38, respectively).
  • Participating parents demonstrated significantly more active coping and acceptance behaviors and stances.
  • A brief 9-session group therapy intervention based on principles of trauma-focused CBT was found to be effective in reducing symptoms of psychological distress in parents of children with PANS.