In 2019, PBS produced a segment titled A Childhood Mystery: Pandas and Pans Disorder. At the time, these disorders were not well known, and presented significant challenges for the children suffering and their loved ones. For many parents or caregivers with a child experiencing PANS or PANDAS, the word “mystery” certainly hits home. Families report that their children begin exhibiting acute symptoms of OCD and/or behavioral issues seemingly overnight.
Since that segment aired, more information has come to light about PANS (Pediatric Acute Onset Neuropsychiatric Disorder) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). However, many parents, caregivers, medical professionals, and behavioral healthcare providers are still unaware of or unfamiliar with the signs and symptoms of these disorders.
What Is PANS?
PANS is defined as a sudden onset of obsessive-compulsive disorder (OCD) or severely restricted food intake. Research suggests that a range of viruses or bacteria, including pneumonia, Lyme disease, staph infections, and even the flu, have the potential to cause PANS.
Criteria for a clinical PANS diagnosis includes having at least two of the following symptoms:
- Anxiety
- Mood swings or depression
- Irritability, aggression, or oppositional behavior
- Regression in behaviors to a previous developmental stage
- Sudden deterioration in school performance
- Motor or sensory abnormalities, such as physical tics
- Somatic symptoms, like sleep disturbances or bedwetting
What Is PANDAS?
PANDAS is considered a subcategory of PANS. Like PANS, it involves the sudden onset of OCD-like symptoms and/or tics associated with a strep infection. Kids diagnosed with PANDAS display similar symptoms as those listed above, including:
- Abrupt onset of OCD symptoms (experienced by 89 percent of patients in one study) or dramatic, disabling tics
- Improvements and flare-ups of symptoms over time
- Neurological and neuropsychiatric abnormalities
Misdiagnosis of PANS/PANDAS
PANDAS and PANS are frequently misdiagnosed as a variety of mental health or neurodevelopmental disorders, such as OCD, Oppositional Defiant Disorder (ODD), ADHD, or Autism Spectrum Disorder.
If you suspect that a child may be experiencing symptoms of PANDAS or PANS, review the list of medical tests recommended by the PANDAS Network, a leading organization in the diagnosis and treatment of the disorders.
Even without a formal diagnosis, parents or caregivers may observe that their child’s symptoms of OCD, tics, or restrictive eating patterns seem to increase when they come into contact with specific triggers, such as stress, allergies, or certain foods.
Treatment for PANS/PANDAS
For families living with the symptoms of PANS/PANDAS, it can feel frightening and impossible to manage. But there is hope. If your child receives a diagnosis of PANDAS or PANS, treatment approaches include:
- A course of antibiotics to treat the underlying disorder: Your provider will give you specific treatment recommendations according to your child’s needs.
- Psychotherapy for OCD symptoms: Many researchers and experts recommend therapy to address obsessions and compulsions.
- Immune modulation treatments: Some research indicates that children experience a reduction in symptoms through this type of treatment.
Fortunately, understanding of PANS/PANDAS is growing, and families can turn to expert practitioners for support with both the behavioral and medical aspects of the diagnosis.
ERP Therapy for OCD Associated with PANS/PANDAS
While it cannot address any underlying medical issues associated with these disorders, psychotherapy can treat symptoms related to OCD. The gold-standard treatment for OCD is Exposure and Response Prevention (ERP) therapy, a type of Cognitive Behavioral Therapy (CBT).
ERP therapy gives both the child and their family tools for stopping the cycle of obsessions and compulsions, which will help relieve some of the distress associated with PANS/PANDAS. A review study published in the journal Neuroscience and Biobehavioral Reviews found that ERP therapy was very effective in 39 percent of PANS/PANDAS cases.
Resources for Families Dealing with PANS/PANDAS
The following organizations offer valuable resources for families exploring a potential diagnosis and/or seeking support with a current diagnosis.
- PANDAS Network
- International OCD Foundation (IOCDF)
- Neuroimmune Foundation
- The Child Mind Institute Complete Guide to PANS and PANDAS
Specialized OCD Treatment at Newport Healthcare
Newport Healthcare’s OCD treatment for teens and for young adults addresses scrupulosity and other forms of OCD using a whole-person approach. Our experts create an individualized treatment plan for each client that includes a wide variety of modalities, provided by a multidisciplinary care team.
Each client’s treatment plan for OCD includes:
- 4.5 hours daily of ERP therapy, delivered in individual sessions, group sessions, and exposure homework
- Psychiatric care and medication management
- Attachment-Based Family Therapy
- Experiential activities like art, music, and outdoor adventures
- A robust life skills component to support everyday functioning
Contact us today to learn more about our specialized OCD treatment and schedule an assessment for you or your loved one.
About Meredith Hettler
With over 10 years of experience in the behavioral healthcare field, Meredith holds a master’s in Marriage and Family Therapy/Counseling from Central Connecticut State University and an undergraduate degree in psychology from the University of Rhode Island. Her experience in the field includes working with individuals ranging from early childhood through geriatrics, treating a wide array of mental health, behavioral, and relational needs.
Meredith is trained in Exposure and Response Prevention therapy, Attachment-Based Family Therapy, Cognitive Behavioral Therapy, and Dialectical Behavioral Therapy. She is also a certified yoga instructor. She specializes in working with adolescents and young adults.