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. 2022 Apr;53(2):354-364.
doi: 10.1007/s10578-021-01135-4. Epub 2021 Feb 9.

A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort

Caroline Gromark  1   2   3 , Eva Hesselmark  4   5 , Ida Gebel Djupedal  5 , Maria Silverberg  5 , AnnaCarin Horne  6   7 , Robert A Harris  4 , Eva Serlachius  4   5 , David Mataix-Cols  4   5
Affiliations

A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort

Caroline Gromark et al. Child Psychiatry Hum Dev. 2022 Apr.

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.

Keywords: Immunopsychiatry; OCD; PANDAS; PANS; Tourette.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart of participant inclusion, and groupings based on clinical course
Fig. 2
Fig. 2
Distribution of clinician-rated CGASa and CGI-Sb scores at baseline and follow-up, and of CGI-Ic scores at follow-up. aCGAS: Children’s Global Assessment Scale. bCGI-S: Clinical Global Impression—Severity scale. cCGI-I: Clinical Global Impression—Improvement scale
See this image and copyright information in PMC

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