Cargando…

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

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,...

Descripción completa

Detalles Bibliográficos
Autores principales: Thienemann, Margo, Murphy, Tanya, Leckman, James, Shaw, Richard, Williams, Kyle, Kapphahn, Cynthia, Frankovich, Jennifer, Geller, Daniel, Bernstein, Gail, Chang, Kiki, Elia, Josephine, Swedo, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610394/
https://www.ncbi.nlm.nih.gov/pubmed/28722481
http://dx.doi.org/10.1089/cap.2016.0145
_version_ 1783265771493785600
author Thienemann, Margo
Murphy, Tanya
Leckman, James
Shaw, Richard
Williams, Kyle
Kapphahn, Cynthia
Frankovich, Jennifer
Geller, Daniel
Bernstein, Gail
Chang, Kiki
Elia, Josephine
Swedo, Susan
author_facet Thienemann, Margo
Murphy, Tanya
Leckman, James
Shaw, Richard
Williams, Kyle
Kapphahn, Cynthia
Frankovich, Jennifer
Geller, Daniel
Bernstein, Gail
Chang, Kiki
Elia, Josephine
Swedo, Susan
author_sort Thienemann, Margo
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5610394
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Mary Ann Liebert, Inc.
record_format MEDLINE/PubMed
spelling pubmed-56103942017-09-25 Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions Thienemann, Margo Murphy, Tanya Leckman, James Shaw, Richard Williams, Kyle Kapphahn, Cynthia Frankovich, Jennifer Geller, Daniel Bernstein, Gail Chang, Kiki Elia, Josephine Swedo, Susan J Child Adolesc Psychopharmacol Guidelines 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. Mary Ann Liebert, Inc. 2017-09-01 2017-09-01 /pmc/articles/PMC5610394/ /pubmed/28722481 http://dx.doi.org/10.1089/cap.2016.0145 Text en © Margo Thienemann et al. 2017; Published by Mary Ann Liebert, Inc. This article is available under the Creative Commons License CC-BY-NC (http://creativecommons.org/licenses/by-nc/4.0). This license permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited. Permission only needs to be obtained for commercial use and can be done via RightsLink.
spellingShingle Guidelines
Thienemann, Margo
Murphy, Tanya
Leckman, James
Shaw, Richard
Williams, Kyle
Kapphahn, Cynthia
Frankovich, Jennifer
Geller, Daniel
Bernstein, Gail
Chang, Kiki
Elia, Josephine
Swedo, Susan
Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title_full Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title_fullStr Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title_full_unstemmed Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title_short Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions
title_sort clinical management of pediatric acute-onset neuropsychiatric syndrome: part i—psychiatric and behavioral interventions
topic Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610394/
https://www.ncbi.nlm.nih.gov/pubmed/28722481
http://dx.doi.org/10.1089/cap.2016.0145
work_keys_str_mv AT thienemannmargo clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT murphytanya clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT leckmanjames clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT shawrichard clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT williamskyle clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT kapphahncynthia clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT frankovichjennifer clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT gellerdaniel clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT bernsteingail clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT changkiki clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT eliajosephine clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions
AT swedosusan clinicalmanagementofpediatricacuteonsetneuropsychiatricsyndromepartipsychiatricandbehavioralinterventions