Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part i - Psychiatric and Behavioral Interventions

Margo Thienemann, Tanya Murphy, James Leckman, Richard Shaw, Kyle Williams, Cynthia Kapphahn, Jennifer Frankovich, Daniel Geller, Gail Bernstein, Kiki Chang, Josephine Elia, Susan Swedo

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Objective: This article outlines the consensus guidelines for symptomatic treatment for children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Syndrome Associated with Streptococcal Infection (PANDAS). Methods: Extant literature on behavioral, psychotherapeutic, and psychopharmacologic treatments for PANS and PANDAS was reviewed. Members of the PANS Research Consortium pooled their clinical experiences to find agreement on treatment of PANS and PANDAS symptoms. Results: Current guidelines result from consensus among the Consortium members. Conclusion: While underlying infectious and inflammatory processes in PANS and PANDAS patients are treated, psychiatric and behavioral symptoms need simultaneous treatment to decrease suffering and improve adherence to therapeutic intervention. Psychological, behavioral, and psychopharmacologic interventions tailored to each child's presentation can provide symptom improvement and improve functioning during both the acute and chronic stages of illness. In general, typical evidence-based interventions are appropriate for the varied symptoms of PANS and PANDAS. Individual differences in expected response to psychotropic medication may require marked reduction of initial treatment dose. Antimicrobials and immunomodulatory therapies may be indicated, as discussed in Parts 2 and 3 of this guideline series.

Original languageEnglish (US)
Pages (from-to)566-573
Number of pages8
JournalJournal of child and adolescent psychopharmacology
Volume27
Issue number7
DOIs
StatePublished - Sep 1 2017

Keywords

  • consensus guidelines

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    Thienemann, M., Murphy, T., Leckman, J., Shaw, R., Williams, K., Kapphahn, C., Frankovich, J., Geller, D., Bernstein, G., Chang, K., Elia, J., & Swedo, S. (2017). Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part i - Psychiatric and Behavioral Interventions. Journal of child and adolescent psychopharmacology, 27(7), 566-573. https://doi.org/10.1089/cap.2016.0145