Prevalence of pediatric acute-onset neuropsychiatric syndrome (PANS) in children and adolescents with eating disorders

Abstract

Plain English summary The connections and overlap between eating disorders and obsessive–compulsive disorder (OCD) are complicated and not fully understood. A syndrome described in the past decade (pediatric acute-onset neuropsychiatric syndrome; PANS) is characterized by a sudden, dramatic onset of food restriction and/or obsessive–compulsive symptoms in combination with several other behavioural and cognitive changes; a related condition is associated with sudden onset obsessive–compulsive symptoms or tics after streptococcal infection (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection; PANDAS). Rates of PANS and PANDAS have been reported in OCD and tic populations but not in eating disorders. We set out to screen a group of youth at a pediatric eating disorders program for lifetime symptoms of PANS and PANDAS. Among 100 eating disorder affected-youth in this study, approximately half (52%) met criteria for PANS, and none met criteria for PANDAS. However, the overlap between several PANS diagnostic criteria items and effects of starvation on both cognition and behaviour clouds the potential utility of this putative subtype within eating disorders populations.

Keywords

• Pediatric acute onset neuropsychiatric syndrome
• Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections
• Eating disorder
• Prevalence