An expert opinion on PANDAS/PANS: highlights and controversies

Francesca Chiarello, Silvia Spitoni, Eric Hollander, Marco Matucci Cerinic, Stefano Pallanti

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: ‘Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections’ (PANDAS) identified a unique subgroup of patients with abrupt onset of obsessive compulsive disorder (OCD) symptoms clinically related to Streptococcus infection and accompanied by neuropsychological and motor symptoms. After almost 20 years, PANDAS has not been accepted as distinct disorder and new criteria for paediatric acute-onset neuropsychiatric syndrome (PANS) have been replaced it, highlighting the fact that several agents rather than only Streptococcus might be involved. Methods: Extensive review of the PANDAS/PANS literature was performed on PubMed. Results: Although antibiotics have been reported to be effective for acute and prophylactic phases in several uncontrolled studies and non-steroidal anti-inflammatory drugs (NSAID) are used during exacerbations, clinical multicenter trials are still missing. Selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT) are still the first line of recommendation for acute onset OCD spectrum. Immunological therapies should be restricted to a few cases. Conclusions: While PANDAS has found no confirmation as a distinct syndrome, and it is not presented in DSM-5, patients with acute onset OCD spectrum, neurocognitive and motor symptoms should be evaluated for inflammatory, infective, immunological and metabolic abnormalities with a comprehensive diagnostic algorithm.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Psychiatry in Clinical Practice
DOIs
StateAccepted/In press - Feb 9 2017

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Expert Testimony
Obsessive-Compulsive Disorder
Pediatrics
Streptococcus
Serotonin Uptake Inhibitors
Cognitive Therapy
PubMed
Multicenter Studies
Anti-Inflammatory Agents
Clinical Trials
Anti-Bacterial Agents
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections
Infection
Pharmaceutical Preparations
Therapeutics

Keywords

  • OCD
  • PANDAS
  • PANS
  • Streptococcal infection

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

An expert opinion on PANDAS/PANS : highlights and controversies. / Chiarello, Francesca; Spitoni, Silvia; Hollander, Eric; Matucci Cerinic, Marco; Pallanti, Stefano.

In: International Journal of Psychiatry in Clinical Practice, 09.02.2017, p. 1-8.

Research output: Contribution to journalArticle

Chiarello, Francesca ; Spitoni, Silvia ; Hollander, Eric ; Matucci Cerinic, Marco ; Pallanti, Stefano. / An expert opinion on PANDAS/PANS : highlights and controversies. In: International Journal of Psychiatry in Clinical Practice. 2017 ; pp. 1-8.
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