Elevated antibody binding to striatal cholinergic interneurons in patients with pediatric acute-onset neuropsychiatric syndrome.

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by the abrupt onset of significant obsessive-compulsive symptoms (OCS) and/or severe food restriction, together with other neuropsychiatric manifestations. An autoimmune pathogenesis triggered by infection has been proposed for at least a subset of PANS. The older diagnosis of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) describes rapid onset of OCD and/or tics associated with infection with Group A Streptococcus.

Prevalence of Neurological Soft Signs at Presentation in Pediatric Acute-Onset Neuropsychiatric Syndrome.

Importance: Studies of brain imaging and movements during REM sleep indicate basal ganglia involvement in pediatric acute-onset neuropsychiatric syndrome (PANS). Characterizing neurological findings commonly present in patients with PANS could improve diagnostic accuracy.

Objective: To determine the prevalence of neurological soft signs which may reflect basal ganglia dysfunction (NSS-BG) in youth presenting with PANS and whether clinical characteristics of PANS correlate with NSS-BG.

Psychometric Properties of the PANS 31-Item Symptom Rating Scale.

Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by sudden onset of obsessive-compulsive disorder and/or eating restriction with associated neuropsychiatric symptoms from at least two of seven categories. The PANS 31-Item Symptom Rating Scale (PANS Rating Scale) was developed to identify and measure the severity of PANS symptoms. The objective of this study was to define the psychometric properties of the PANS Rating Scale.

Evaluation of C4 Gene Copy Number in Pediatric Acute Neuropsychiatric Syndrome.

Pediatric acute-onset neuropsychiatric syndrome (PANS) is an abrupt-onset neuropsychiatric disorder. PANS patients have an increased prevalence of comorbid autoimmune illness, most commonly arthritis. In addition, an estimated one-third of PANS patients present with low serum C4 protein, suggesting decreased production or increased consumption of C4 protein.

Arthritis in Children with Psychiatric Deteriorations: A Case Series.

Pediatric acute-onset neuropsychiatric syndrome (PANS), pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, Sydenham chorea, and other postinfectious psychiatric deteriorations are thought to be caused by inflammatory/autoimmune mechanisms, likely involving the basal ganglia based on imaging studies. Patients have a relapsing-remitting course and some develop severe refractory psychiatric disease. We found that 55/193 (28%) of consecutive patients meeting PANS criteria developed chronic arthritis and 25/121 (21%) of those with related psychiatric deteriorations developed chronic arthritis.

Children With PANS May Manifest POTS.

Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by an abrupt-onset of severe psychiatric symptoms including OCD, anxiety, cognitive difficulties, and sleep issues which is thought to be a post-infection brain inflammatory disorder. We observed postural orthostatic tachycardia syndrome (POTS) which resolved with immunomodulation in a patient with Pediatric acute-onset neuropsychiatric syndrome (PANS). Here, we aim to present a case of POTS and to examine the prevalence of (POTS) in our PANS cohort, and compare the clinical characteristics of patients with and without POTS.

Psychotic symptoms in youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) may reflect syndrome severity and heterogeneity.

Objective: In the clinical syndrome Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), obsessive compulsive disorder (OCD) and/or food refusal symptoms have an abrupt-onset (over 48 h) coupled with at least two other specified neuropsychiatric symptoms. We aimed to characterize in detail for the first time, psychotic symptoms experienced by children with PANS as well as the impact of psychotic symptoms on disease severity and course of illness. We inform about the diagnosis of the clinical description: PANS and hope to improve evaluation, treatment, diagnostic validity and future investigation.

Aripiprazole-associated hiccups: a case and closer look at the association between hiccups and antipsychotics.

Unlabelled: Aripiprazole's pharmacologic properties (including dopamine 2 and 5-hydroxytryptamine 1A [5HT1A] receptor partial agonism and 5HT2A receptors antagonism) may be associated with the onset of hiccups.

Case Description: A 21-year-old, antipsychotic-naive patient with bipolar I disorder and remote brain trauma developed persistent hiccups following aripiprazole titration. Despite trials of metoclopramide and chlorpromazine, hiccups continued.

Geriatric dermatoses: a clinical review of skin diseases in an aging population.

Geriatric dermatoses are a challenging job for the physician in terms of diagnosis, management, and followup. Since skin of the elderly population is going through a lot of changes from both an intrinsic and extrinsic point of view, it is imperative for the physician to have a better understanding of the pathophysiology of geriatric skin disorders and their specific management, which differs slightly from an adult population. This review focuses on a brief introduction to the pathophysiological aspects of skin disorders in elderly, the description of some common geriatric skin disorders and their management and the new emerging role of psychodermatological aspects of geriatric dermatoses is also discussed.

Psychopathology, trauma and delinquency: subtypes of aggression and their relevance for understanding young offenders.

Objective: To examine the implications of an ontology of aggressive behavior which divides aggression into reactive, affective, defensive, impulsive (RADI) or "emotionally hot"; and planned, instrumental, predatory (PIP) or "emotionally cold." Recent epidemiological, criminological, clinical and neuroscience studies converge to support a connection between emotional and trauma related psychopathology and disturbances in the emotions, self-regulation and aggressive behavior which has important implications for diagnosis and treatment, especially for delinquent populations.

Method: Selective review of preclinical and clinical studies in normal, clinical and delinquent populations.

Prevalence differences of psychiatric disorders among youth after nine months or more of incarceration by race/ethnicity and age.

Despite high rates of psychiatric morbidity among young offenders, few studies look closely at prevalence rates in terms of race/ethnicity or developmental stage. Seven hundred and ninety (790) incarcerated young people with a mean age of 18+/-1.2 years were examined.

Prevalence of and gender differences in psychiatric disorders among juvenile delinquents incarcerated for nine months.

Objective: This study examined prevalence rates of psychiatric disorders among young offenders after they were incarcerated for nine months.

Methods: A total of 790 youths were surveyed, including a significant proportion of females (N=140, 18%), nine months after incarceration. The Structured Clinical Interview for DSM-IV with portions of the Diagnostic Interview for Children and Adolescents and the Structured Interview for DSM-IV Personality were used.

Divalproex sodium for the treatment of PTSD and conduct disordered youth: a pilot randomized controlled clinical trial.

We examined the efficacy of divalproex sodium (DVP) for the treatment of PTSD in conduct disorder, utilizing a previous study in which 71 youth were enrolled in a randomized controlled clinical trial. Twelve had PTSD. Subjects (all males, mean age 16, SD 1.

Baseline predictors of response to divalproex in conduct disorder.

Background: Successful treatment of conduct disorder remains difficult. On the basis of a positive response to divalproex among adolescent boys with conduct disorder, we conducted an analysis of the impact of baseline comorbid diagnoses and personality factors on the likelihood of treatment response to divalproex.

Method: Seventy-one adolescent boys with conduct disorder (DSM-IV) and a history of at least 1 offense against persons were randomly assigned to receive high- or low-dose divalproex for 7 weeks.

Pre-adjudicative and adjudicative competence in juveniles and young adults.

There are several different types of legal competence, such as competence to waive Miranda rights, competence to confess, and competence to stand trial. Although it can be surmised that many of the underlying factors that influence the different legal competencies are similar, little research has been conducted to empirically test this hypothesis. In the present study, juveniles' and young adults' understanding and appreciation of their Miranda rights and their ability to stand trial were measured.