PANS: New Psychiatric Condition in Kids

Obsessive compulsive disorder symptoms suddenly occur in children without explanation

March 27, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

Rate This Article

3.135295

(dailyRx News) In some cases, symptoms of Obsessive Compulsive Disorder (OCD) can occur suddenly and without explanation. There needs to be a criteria for a new form of OCD, say researchers at the National Institutes of Health.

The disorder is called Pediatric Acute-onset Neuropsychiatric Syndrome, or PANS. There are no known causes for the disorder, but it shows similarities to a disorder known as Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) - which is caused by strep throat.

"More Information about PANS is available from your psychiatrist."

"Parents will describe children with PANS as overcome by a 'ferocious' onset of obsessive thoughts, compulsive rituals and overwhelming fears," says Susan Swedo, M.D., of the National Institute of Mental Health (NIMH). “Clinicians should consider PANS when children or adolescents present with such acute-onset of OCD or eating restrictions in the absence of a clear link to strep.”

Researchers at NIMH evaluated over 400 youth diagnosed with PANDAS in order to gain understanding into the causes of PANS. Symptoms often began to occur before eight years old. Additionally, twice as many boys showed symptoms than girls.

Both PANDAS and PANS cause children and teens to suddenly develop symptoms of OCD or anorexia - often combined with other psychiatric symptoms as well. While PANDAS is known to be caused by strep throat, the causes of PANS are unknown.

"Strep bacteria has evolved a kind of camouflage to evade detection by the immune system," explains Dr. Swedo.

“Eventually, the immune system gets wise to this 'molecular mimicry,' recognizes strep as foreign, and produces antibodies against it; but because of the similarities, the antibodies sometimes react not only with the strep, but also with the mimicked molecules in the human host. Such cross-reactive ‘anti-brain’ antibodies can cause OCD, tics, and the other neuropsychiatric symptoms of PANDAS."

The researchers propose that a patient must meet 3 diagnostic criteria for a diagnosis of PANS:

  • Abrupt, dramatic onset of OCD or anorexia.
  • Presence of at least two additional neuropsychiatric symptoms with similarly severe and acute onset. These include: anxiety; mood swings and depression; aggression, irritability and oppositional behaviors; developmental regression; sudden deterioration in school performance or learning abilities; sensory and motor abnormalities; somatic signs and symptoms.
  • Symptoms are unexplainable by a known neurologic or medical disorder.

In addition to an official categorization of the disorder, the researchers suggest the creation of a registry that will allow scientists to centralize data for better analysis. The registry will help to find the causes of PANS and to develop appropriate treatments.

The researchers proposed the working criteria for PANS in February, 2012, in the open source journal Pediatrics & Therapeutics. 

Reviewed by: 
Review Date: 
March 26, 2012
Last Updated:
March 27, 2012