CHICAGO—Children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) have unique patterns of obsessions and compulsions and associated neuropsychiatric symptoms, compared with children who have obsessive-compulsive disorder (OCD) without PANDAS, reported Gail A. Bernstein, MD, and colleagues at the 55th Annual Meeting of the American Academy of Child and Adolescent Psychiatry.
Of 19 participants, ages 6 to 14, 11 met criteria for PANDAS, and eight met criteria for OCD without PANDAS. Subjects were assessed with use of the Anxiety Disorders Interview Schedule for DSM-IV, parent version; the Children’s Yale-Brown OCD Scale (CY-BOCS); and the Yale Global Tic Severity Scale (YGTSS).
The mean YGTSS total severity score at exacerbation was significantly different between the PANDAS and non-PANDAS groups (16.50 vs 2.43, respectively), observed Dr. Bernstein, a Professor in the Division of Child and Adolescent Psychiatry at the University of Minnesota Medical School in Minneapolis, and coauthors. This was largely accounted for by mean total vocal tic subscale scores (8 vs 0, respectively).
Conversely, mean CY-BOCS total score at exacerbation was not significantly different between the PANDAS and non-PANDAS groups (mean scores, 22.00 vs 21.86, respectively). However, different patterns of obsessions and compulsions were seen in children with and without PANDAS. Symptoms such as doubting, hoarding, washing, checking, and ordering were much more frequent in the non-PANDAS group.
Sixteen parents completed the Associated Symptoms Questionnaire to assess symptoms at the initial psychiatric episode of OCD and/or tic disorder. Two children were having an initial episode at the time of their exacerbation assessment. Children with and without PANDAS had their initial symptom onset at similar ages (7.7 and 7.5 years, respectively).
Both groups had significant differences in associated psychiatric symptoms. Separation anxiety, impulsivity, irritability, inattention, and decline in handwriting were significantly more prevalent in the PANDAS group, compared with the non-PANDAS group. Separation anxiety and decline in school performance were present in all PANDAS children; however, the two were not related.
—Marguerite Spellman