Abstract:
: Objective: Pediatric autoimmune neuropsychiatric disorder associated with Streptococcus pyogenes infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) are emerging immune-mediated encephalopathies characterized by sudden onset of seemingly inexplicable complex neuropsychiatric symptoms, including obsessions, compulsions, and heterogeneous tics, which occur in children. Main goal of this study was to report our experience in a large cohort of Italian children affected by either PANDAS or PANS and treated long term with an antibiotic regimen similar to that used for acute rheumatic fever. Patients and Methods: The clinical charts of a cohort of 371 consecutive Italian children, 345 with PANDAS (93.0%) and 26 with PANS (7.0%), were retrospectively evaluated. Antistreptococcal, antinuclear antibodies, and serologic evaluation for a group of common autoantibodies and microbial agents were also assessed. A strict differential diagnosis with other autoimmune diseases displaying neuropsychiatric manifestations was performed. Results: Antistreptolysin O and anti-DNase B antibody titers were tested and were positive in all PANDAS subjects, but negative in PANS. Anti-Mycoplasma pneumoniae antibodies and anti-Epstein-Barr virus Nuclear Antigen antibodies were found positive in 11 (42.3%) and 5 (19.2%) patients with PANS, respectively. Among PANDAS cases, a clear streptococcal infection was clinically evident at the onset of neurological symptoms in only 74 patients (21.4%), whereas the relationship with Streptococcus pyogenes was confirmed by serologic tests in the other 271 (78.6%). All patients fulfilling the diagnostic criteria for PANDAS (n = 345) received amoxicillin/clavulanic acid for 10-21 days at diagnosis, while those who were diagnosed with PANS (n = 26) received treatment according to the causative agent. Thereafter, all PANDAS/PANS patients received prophylaxis with benzathine benzylpenicillin for an overall period of at least 5 years to prevent subsequent potential streptococcal infections. To date, 75.0% of PANDAS patients (n = 258) have shown an improvement of neurologic symptoms, mainly observed within 3-5 months of treatment for PANDAS cases, while 88.4% of PANS patients (n = 23) have improved after 6-12 months. Infection-related relapses of neurologic manifestations were observed in both PANDAS and PANS patients (n = 167 out of 371; 45% of the total cohort) in the long term. Conclusions: Our study has confirmed the usefulness of the preliminary diagnostic criteria for PANDAS and PANS, revealing also the importance of early diagnosis to reduce the risk of evolution toward disabling chronic neurologic sequelae. Long-term antibiotic prophylaxis has resulted in a substantial benefit to reduce neurological symptoms for the majority of PANDAS and PANS patients over a 7-year period.
journal_name
J Child Adolesc Psychopharmacoljournal_title
Journal of child and adolescent psychopharmacologyauthors
Lepri G,Rigante D,Bellando Randone S,Meini A,Ferrari A,Tarantino G,Cunningham MW,Falcini Fdoi
10.1089/cap.2018.0151subject
Has Abstractpub_date
2019-10-01 00:00:00pages
608-614issue
8eissn
1044-5463issn
1557-8992journal_volume
29pub_type
杂志文章abstract::Although sensory deficits are frequently observed in autistic individuals, pharmacologic interventions targeting these abnormalities are lacking. The goal of this investigation was to assess the effectiveness of aripiprazole in targeting sensory deficits in children and adolescents with autism. Using an outpatient cli...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2010.0103
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare the depression and burnout levels of mothers of children having attention-deficit/hyperactivity disorder (ADHD) between the child's pre- and posttreatment periods. METHOD:The study sample consisted of 40 children aged between 4 and 10 years and their mothers. Initially, 40 cases p...
journal_title:Journal of child and adolescent psychopharmacology
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doi:10.1089/cap.2017.0050
更新日期:2018-06-01 00:00:00
abstract::Atomoxetine and stimulants have both been demonstrated effective as single agents for treatment of attention deficit hyperactivity disorder in children, adolescents, and adults. However, attention deficit hyperactivity disorder symptoms in some patients do not respond adequately to single-agent treatment with these me...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/104454604773840571
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:Previous studies have suggested that the sum of Attention, Aggression, and Anxious/Depressed subscales of Child Behavior Checklist (CBCL-PBD; pediatric bipolar disorder phenotype) may be specific to pediatric bipolar disorder (BP). The purpose of this study was to evaluate the usefulness of the CBCL and CBCL...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2008.067
更新日期:2009-02-01 00:00:00
abstract::Urinary catecholamine excretion was assessed in 15 boys with attention-deficit/hyperactivity disorder (ADHD) and 16 normal controls during a defined physical and mental task. Dihydroxyphenylalanine, dopamine, norepinephrine (NE), epinephrine (EPI), 3,4-dihydroxyphenylacetic acid, and 3,4-dihydroxyphenylglycol (DOPEG) ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1996.6.63
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:The use of methylphenidate (MPH) in the treatment of attention-deficit/hyperactivity disorder (ADHD) is widely accepted; however, there is increased concern regarding its abuse potential. Few studies have examined the reinforcing effects of drugs in individuals receiving them for clinical purposes. This study...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1089/cap.2005.15.729
更新日期:2005-10-01 00:00:00
abstract:: Objective: To examine the role of Guanfacine Extended Release (GXR) in the management of behavioral disturbances in patients with Prader-Willi Syndrome (PWS). Methods: Twenty from a total of 27 individuals with genetically conf...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2018.0102
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to investigate the effect of methylphenidate (MPH) on response interference, as measured by the Stoop Color and Word Test, in children with attention deficit hyperactivity disorder (ADHD). Response interference is a core component of response inhibition that has been shown to be imp...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1089/104454602762599844
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The present study examined the course of ADHD over 24 months in a preschool population. METHOD:n=48 preschoolers with ADHD, aged 3.0-5.11 years, subjects included in a larger sample of preschoolers with depression and other disorders (n=306) were comprehensively assessed at 3 annual time points over 24 month...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2010.0045
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adoles...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2014.0042
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To examine the basal thyroid function in pediatric Obsessive Compulsive Disorder (OCD) versus controls, and to explore the relation between baseline thyroid measures and response to clomipramine treatment, and the effects of treatment on thyroid hormones. METHODS:Sixteen children and adolescents with DSM-III...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1089/cap.2005.15.581
更新日期:2005-08-01 00:00:00
abstract::Self-report instruments commonly used to assess depression in adolescents have limited or unknown reliability and validity in this age group. We describe a new self-report scale, the Kutcher Adolescent Depression Scale (KADS), designed specifically to diagnose and assess the severity of adolescent depression. This rep...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/104454602760219153
更新日期:2002-07-01 00:00:00
abstract::This article surveys the development of human hepatic P450 cytochromes (CYPs) involved in xenobiotic metabolism from the fetus through the life span and explores possible clinical consequences of developmental issues. These hepatic P450 CYPs come "on line" at different times during fetal and infant development, and ea...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,评审
doi:10.1089/cap.1998.8.161
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Patterns of benzodiazepine (BZD) use and long-term use among young adults are not well known. Our aim was to study trends in BZD use and long-term use among 18-25-year-old young adults by gender and active substance in a nationwide retrospective longitudinal register-based setting. METHODS:All Finns aged 18-...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2017.0140
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:Recent studies have focused on the role of inflammatory cascades as one of the possible etiologic factors of bipolar disorder. We hypothesize that celecoxib, through its anti-inflammatory properties, may have a therapeutic role in acute bipolar mania. PATIENTS AND METHODS:Forty-two adolescent inpatients with...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2016.0207
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:A recent 12-week controlled comparison demonstrated the superiority of clozapine to "high-dose" olanzapine in adolescents with treatment-refractory schizophrenia. In the present study, the authors conducted a 12-week, open-label, follow-up study to examine changes in lipid and glucose metabolism in youths mai...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2007.0089
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the preliminary effectiveness and safety of lamotrigine for the treatment of depressive episodes in adolescents. METHODS:This was a 12 week retrospective chart review of lamotrigine treatment among 37 adolescents (mean age 16.3±1.3 years) with depressive episodes ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2013.0121
更新日期:2014-06-01 00:00:00
abstract::Bipolar disorder (BP) in youth is an impairing psychiatric disorder associated with high rates of relapse and recurrence. High rates of psychiatric and medical co-morbidities account for additional illness burden in pediatric BP. The elevated risk of overweight and obesity in this population is of particular concern. ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2010.0104
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To assess the effect of Osmotic-Release Oral System (OROS) methylphenidate (MPH) on a variety of measures evaluating academic performance, cognition, and social behavior in children with attention-deficit/hyperactivity disorder (ADHD). METHODS:This double-blind, randomized, placebo-controlled, crossover labo...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1089/cap.2010.0047
更新日期:2011-04-01 00:00:00
abstract::This study examined the contributions of childhood symptom dimensions and aspects of methylphenidate (MPH) treatment to the prediction of young adult outcomes in boys who were referred to a child psychiatry outpatient clinic. They were diagnosed with hyperkinetic reaction of childhood/minimal brain dysfunction, and gi...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1999.9.169
更新日期:1999-01-01 00:00:00
abstract::ABSTRACT Current concerns about antidepressant efficacy in children and adolescents are reminiscent of the history of adult studies. Such awareness should temper these concerns, especially in view of the enormous progress in the last two decades of studies of adult depression. A number of methodologie, nosologie, deve...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1992.2.31
更新日期:1992-04-01 00:00:00
abstract::ABSTRACT A report of neuroleptic malignant syndrome (NMS) in an adolescent patient with bipolar disorder is presented, and findings from a literature review of 35 child and adolescent cases (presenting before age 19) are compared with the reported experience in adults. Fever, rigidity, altered mental status, and tachy...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.1992.2.183
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze changes in the prevalence and incidence of antidepressant use among children and adolescents in Finland post October, 2003. METHOD:The sample comprised all children and adolescents in Finland aged < or =19.0 years (n = 27,676) who collected one or more reimbursed prescrip...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2009.0040
更新日期:2010-04-01 00:00:00
abstract::Autism spectrum disorder (ASD) is commonly associated with a host of challenging behaviors. Pharmacotherapy is indicated if psychosocial and educational interventions fail. Atypical antipsychotics have the strongest evidence base so far, with both risperidone and aripiprazole being FDA approved. Unfortunately, their u...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2016.0182
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the 52-week safety/tolerability of oral olanzapine for adolescents with schizophrenia or bipolar mania and compare effectiveness of a standard versus intense behavioral weight intervention in mitigating risk of weight gain. METHODS:Patients 13-17 years old with schizophrenia (Brief Psychiatric R...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/cap.2016.0010
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this article was to systematically review the literature on stimulant and atomoxetine combination therapy, in particular: 1) Characteristics of patients with attention-deficit/hyperactivity disorder (ADHD) given combination therapy, 2) treatment strategies used, 3) efficacy and effectiveness, a...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,评审
doi:10.1089/cap.2012.0093
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To examine fatty acid profiles, their response to omega-3 fatty acid (Ω3) supplementation, and associations with clinical status and treatment response in youth with mood disorders. METHODS:In a placebo-controlled 2X2 design, 7-14 year-olds (N = 95) in parallel pilot trials (depression N = 72; bipolar N = 23...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2016.0123
更新日期:2017-04-01 00:00:00
abstract::Low concentrations of the neurotransmitter serotonin and its 5-hydroxyindoleacetic acid metabolite in the central nervous system have been associated with increased aggressive behavior in animals and humans. Controlled clinical trials of serotonin agonists in depressed adults have suggested that aggressive behavior is...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1089/cap.1997.7.31
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hyperkinetic conduct disorder (HCD) has been identified as a common psychiatric diagnosis among children and adolescents. This disorder affects many life aspects of both child and family. The aim of this study was to examine the efficacy of the selective norepinephrine reuptake inhibitor (SNRI), ...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1089/cap.2005.15.259
更新日期:2005-04-01 00:00:00
abstract::Children and adolescents with bipolar disorder (BD) have a high incidence of comorbid attention-deficit/hyperactivity disorder (ADHD). In this paper, we report a consecutive case series on 7 patients with pediatric BD and ADHD who were treated with atomoxetine-and all but one were also treated in conjunction with mood...
journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章
doi:10.1089/cap.2005.15.996
更新日期:2005-12-01 00:00:00