| 1. |
- Gromark, C, et al.
(author)
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A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort
- 2022
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In: Child psychiatry and human development. - : Springer Science and Business Media LLC. - 1573-3327 .- 0009-398X. ; 53:2, s. 354-364
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Journal article (peer-reviewed)abstract
- Little is known about the long-term prognosis of children with pediatric acute-onset neuropsychiatric syndrome (PANS). Out of the 46 eligible patients from the Karolinska PANS cohort, 34 consented to participate in a follow-up (median 3.3 years). Participants underwent a thorough clinical evaluation and were classified according to their clinical course. Resulting groups were compared on clinical characteristics and laboratory test results. We observed significant reductions in clinician-rated PANS symptom severity and improved general function. Two patients were classified as remitted, 20 as relapsing–remitting, and 12 as having a chronic-static/progressive course. The latter group had an earlier onset, greater impairment and received more pharmacological and psychological treatments. Although remission was rare, the majority of children with PANS were significantly improved over the follow-up period but a non-negligible minority of patients displayed a chronic-static/progressive course and required additional treatments. The proposed definitions of flare and clinical course may be useful in future clinical trials.
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| 2. |
- Bejerot, Susanne, 1955-, et al.
(author)
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Pediatric autoimmune neuropsychiatric syndrome (PANS), developmental regression and autism
- 2017
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 41:Suppl., s. S123-S123
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Journal article (other academic/artistic)abstract
- Introduction: Pediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.Objectives: The aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.Methods: Participants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.Results: Twelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.Conclusions: Very early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.
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| 7. |
- Vilaplana-Perez, A., et al.
(author)
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Association of social anxiety disorder with objective indicators of educational attainment : A nation-wide register-based sibling control study
- 2019
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In: European Neuropsychopharmacology. - : Elsevier. - 0924-977X .- 1873-7862. ; 29:Suppl. 6, s. S150-S151
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Journal article (other academic/artistic)abstract
- Background: Social Anxiety Disorder (SAD) is a relatively frequent psychiatric disorder, with a lifetime prevalence of about 4% [1], which usually starts in adolescence [2]. As in the case of other mental disorders, [3] SAD has also been linked to academic impairment and school drop-out [4,5], but this previous research has a number of methodological limitations, mainly the use of modest sample sizes, retrospective designs, self-reported measures, and focusing in a single educational level.Aim: We aim to investigate the association between SAD and educational outcomes at all levels using objectively collected measures, controlling for a number of covariates and unmeasured factors shared between siblings.Method: Using the Swedish nationwide registers, we designed this population-based birth cohort study, which included 2,244,191 individuals born in Sweden between 1973 and 1997, who were followed up from 1991 until 2013. A total of 15,765 individuals had a record of SAD in the Swedish National Patient Register, according to the International Classification of Diseases, 10th edition. Logistic regression models tested the association between SAD and the prospectively-collected and objectively measured educational outcomes. These educational milestones included: the year grades in the final year of compulsory school, the eligibility to access upper secondary school after compulsory education (for both, vocational and academical programs), finishing upper secondary school, starting university, finishing a university degree, and completing post-graduate education. In order to reduce the impact of possible confounders, we took into account a number of covariates such as age, sex, maternal and paternal age at birth and year of birth. The impact of common psychiatric comorbidities of SAD was also taken into account. In order to control for unmeasured shared familial factors, we performed a sibling comparison analysis. We identified 786,766 families with 2 or more siblings, and identified 11,950 families with full siblings discordant for SAD.Results: Compared to the unexposed individuals, individuals with SAD were less likely to pass all subjects in the last year of compulsory school (adjusted odds ratios [aOR] ranging from 0.19 to 0.44). They were also less likely to access a vocational program or an academic program in upper secondary education (aOR=0.31 [95% CI, 0.30–0.33] and aOR=0.52 [95% CI, 0.51–0.55], respectively). SAD cases also had 81% lower odds of finishing upper secondary education (aOR=0.19 [95% CI, 0.19–0.20]), 53% lower odds of starting a university degree (aOR=0.47 [95% CI, 0.45–0.49]), 65% lower odds of finishing a university degree (aOR=0.35 [95% CI, 0.33–0.37]), and 42% lower odds of finishing postgraduate education (aOR=0.58 [95% CI, 0.43-0.80]). Results were attenuated but remained significant in fully adjusted sibling comparison models. When comorbidities were taken into account, results were maintained.Conclusion: SAD has an adverse impact on educational attainment throughout the life-span, even after controlling for confounders and factors shared between siblings.
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