Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder

Jaspers‐Fayer, Fern; Han, Sang Hun Jerry; Chan, Elisa K.; McKenney, Katherine; Simpson, Annie N.; Boyle, Andrea; Ellwyn, Rhonda; Stewart, S. Evelyn

doi:10.1089/cap.2016.0031

Cited by 44 publications

(32 citation statements)

References 34 publications

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“…To resolve the diagnostic issue, it was hypothesized that PANDAS constitutes a subtype of children's OCD, with the etiology of GAS infection. The legitimacy of PANDAS as a subgroup of OCD was supported by the study performed by Jaspers-Fayer et al in 2017 [34].…”

Section: Pandas and Ocd-where Is The Line?mentioning

confidence: 92%

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Baj

Sitarz

Forma

et al. 2020

IJMS

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The objective of this paper is to review and summarize conclusions from the available literature regarding Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The authors have independently reviewed articles from 1977 onwards, primarily focusing on the etiopathology, symptoms, differentiation between similar psychiatric conditions, immunological reactions, alterations in the nervous system and gut microbiota, genetics, and the available treatment for PANDAS. Recent research indicates that PANDAS patients show noticeable alterations within the structures of the central nervous system, including caudate, putamen, globus pallidus, and striatum, as well as bilateral and lentiform nuclei. Likewise, the presence of autoantibodies that interact with basal ganglia was observed in PANDAS patients. Several studies also suggest a relationship between the presence of obsessive-compulsive disorders like PANDAS and alterations to the gut microbiota. Further, genetic predispositions—including variations in the MBL gene and TNF-α—seem to be relevant regarding PANDAS syndrome. Even though the literature is still scarce, the authors have attempted to provide a thorough insight into the PANDAS syndrome, bearing in mind the diagnostic difficulties of this condition.

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Section: Pandas and Ocd-where Is The Line?mentioning

confidence: 92%

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Baj

Sitarz

Forma

et al. 2020

IJMS

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“…focused on children (18,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and only one article had the required information for metaanalysis (18). Hence, we could not perform a child-specific meta-analysis.…”

Section: Of the 94 Articles That Investigated An Association Between mentioning

confidence: 99%

“…articles discussing this association (19,22,25,27,30,32,35,(37)(38)(39)(40)(41), of which 6 focused on children (22,25,27,30,32,35). Only one of these 12 articles was suitable for meta-analysis although there did appear to be an association between OCD and LUTS based on the content.…”

Section: Association Of Luts and Ocdmentioning

confidence: 99%

Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Mahjani

Koskela

Batuure

et al. 2020

Preprint

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Background: Clinically, lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, are associated with anxiety disorders. However, the existing evidence for the overlap of these conditions has not been systematically evaluated. The aim of this study was to examine this relationship. Methods: We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms "clinical anxiety") and subtypes of LUTS. We performed random-effect meta-analyses, and inspected funnel plots and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID=CRD42019118607). Results: We identified 814 articles, of which 94 fulfilled inclusion criteria and 23 had sufficient data for meta-analysis. The odds ratio for clinical anxiety among individuals with LUTS was 2.87 (95% CI: 2.38,3.46, P < 0.001). Very few studies looked at LUTS among individuals ascertained for clinical anxiety, but there appear to be significantly elevated odds ratio here as well. A large I2 value suggests high heterogeneity between studies. Conclusions: The results demonstrate a clinically significant association between clinical anxiety and LUTS. There were limited data on youth, which should motivate further study in this area. Understanding the co-occurrence of these conditions will lead to better prevention and interventions to ameliorate the progression of the symptoms and to improve quality of life.

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“…It is one of the rare clearly identified etiological factors of OCD. About 5% of pediatric OCD patients meet the criteria for PANDAS (or PANS) [117] and it is important to distinguish this etiology from others in OCD patients. Indeed, the prognosis of PANDAS seems relatively good, as Leon et al found that 88% of children originally suffering from PANDAS with moderate-to-severe OCD presented no OCD symptoms (55%) or only subclinical symptoms (33%) after approximately three years of follow-up [118] (Table 5).…”

Section: Infections and Ocdmentioning

confidence: 99%

“…By contrast, 48% of OCD patients were found to be still symptomatic after 30 years [119]. However, as this study began in 1954, and PANDAS patients, which represent about 5% of OCD patients, were first described in 1998 [105,117], one may hypothesize that PANDAS and non-PANDAS OCD patients were pooled together. Furthermore, treatment of PANDAS (described below) is not identical to OCD treatment.…”

Section: Infections and Ocdmentioning

confidence: 99%

Individualized Immunological Data for Precise Classification of OCD Patients

et al. 2018

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Obsessive–compulsive disorder (OCD) affects about 2% of the general population, for which several etiological factors were identified. Important among these is immunological dysfunction. This review aims to show how immunology can inform specific etiological factors, and how distinguishing between these etiologies is important from a personalized treatment perspective. We found discrepancies concerning cytokines, raising the hypothesis of specific immunological etiological factors. Antibody studies support the existence of a potential autoimmune etiological factor. Infections may also provoke OCD symptoms, and therefore, could be considered as specific etiological factors with specific immunological impairments. Finally, we underline the importance of distinguishing between different etiological factors since some specific treatments already exist in the context of immunological factors for the improvement of classic treatments.

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Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder

Abstract: A small yet significant percentage of pediatric OCD outpatients met criteria for PANDAS and/or PANS, justifying routine screening and attention to related characteristics during assessment and management. Longitudinal studies of these putative subtypes are warranted.

Cited by 44 publications

References 34 publications

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Individualized Immunological Data for Precise Classification of OCD Patients

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