Cited by 149Autoimmune Neurological Disorders and TreatmentsInfectious Encephalopathies and EncephalitisStreptococcal Infections and Treatments

Clinical management of pediatric acute-onset neuropsychiatric syndrome: Part I-Psychiatric and Behavioral Interventions

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Thienemann, Margo, Murphy, Tanya, Leckman, James, Shaw, Richard, Williams, Kyle, Kapphahn, Cynthia, Frankovich, Jennifer, Geller, Daniel +4 more·2017·Journal of Child and Adolescent Psychopharmacology

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.

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  1. [25]25. March JS, Mulle K: OCD in Children & Adolescents: A Cognitive- Behavioral Treatment Manual. New York, Guilford Press, 1998.

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Authors
Thienemann, M., Murphy, T., Leckman, J., Shaw, R., Williams, K., Kapphahn, C., Frankovich, J., Geller, D., Bernstein, G., Chang, K., Elia, J., & Swedo, S.
Affiliations
  • Stanford University (US)
  • University of South Florida St. Petersburg (US)
  • Yale University (US)
  • Massachusetts General Hospital (US)
  • Harvard University (US)
  • University of Minnesota (US)
  • Alfred I. duPont Hospital for Children (US)
  • National Institute of Mental Health (US)
Corresponding author
Thienemann, Margo
Venue
Journal of Child and Adolescent Psychopharmacology
Published
2017-09
Volume
27
Issue
7
Pages
566-573
ISSN
  • 1044-5463 (ISSN-L)
  • 1557-8992
OpenAlex
W2738337914
Cited by
149
References
48
Citations by year
2026: 13 · 2025: 11 · 2024: 24 · 2023: 19 · 2022: 17 · 2021: 17 · 2020: 10 · 2019: 23 · 2018: 12 · 2017: 3
FWCI
1.74
Type
journal article
Language
en
Open access
Locations
  • Journal of Child and Adolescent Psychopharmacology (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
National Institute of Mental Health (R25MH077823)
Topics
  • Health Sciences › Medicine › Neurology › Autoimmune Neurological Disorders and Treatments
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
Keywords
pediatric acute-onset neuropsychiatric syndrome, PANS, PANDAS, streptococcal infection, psychiatric treatment, behavioral interventions, psychotherapy, psychopharmacology, psychotropic drugs, medication adherence, treatment guidelines
MeSH terms
Acute Disease, Autoimmune Diseases, Behavior Therapy, Child, Child Behavior Disorders, Child, Preschool, Humans, Streptococcal Infections, Syndrome, Disease Management, Immunomodulation, Neurodevelopmental Disorders

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