scholarly journals An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Drew H. Barzman ◽  
Hannah Jackson ◽  
Umesh Singh ◽  
Marcus Griffey ◽  
Michael Sorter ◽  
...  
Keyword(s):  
Treatment Options ◽  
Abrupt Onset ◽  
Acute Onset ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Acute Infections ◽  
The Family ◽  
Work Up ◽  
Severe Anxiety ◽  
Very High

Here we report a case of a 15-year-old female who had originally been diagnosed and treated unsuccessfully for schizophrenia, psychosis, severe anxiety, and depression. More in-depth history revealed an abrupt onset of her symptoms with remote acute infections and many exhibited characteristics of obsessive compulsive disorder with rituals. Work-up for underlying infectious, immunodeficiency, and autoimmune causes was unrevealing except for very high levels of anti-neuronal antibodies which have been linked to Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Treatment options were discussed with the family and it was decided to use a course of plasmapheresis based on previous studies demonstrating efficacy and its safety profile. After course of therapy, there was a dramatic resolution of her psychosis, OCD traits, and anxiety. She was able to stop all of her antipsychotic and anxiety medications and resume many of her previous normal daily activities. The effect of this treatment has been sustained to the present time. This case emphasizes the importance of exploring nontraditional treatments for severe, treatment-resistant mental illness which requires a multidisciplinary approach. Further research is warranted in larger populations to investigate pathomechanisms and treatment of PANs/PANDAs.

Why Can’t I Stop Thinking About It?

2015 ◽  
Vol 74 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Monique C. Pfaltz ◽  
Beatrice Mörstedt ◽  
Andrea H. Meyer ◽  
Frank H. Wilhelm ◽  
Joe Kossowsky ◽  
...  
Keyword(s):  
Thought Suppression ◽  
Positive Association ◽  
Repetitive Behaviors ◽  
Thought Processes ◽  
Obsessive Compulsive ◽  
Vulnerability Factor ◽  
Compulsive Disorder ◽  
Order Factor ◽  
Maladaptive Thought ◽  
Severe Anxiety

Obsessive-compulsive disorder (OCD) is a severe anxiety disorder characterized by frequent obsessive thoughts and repetitive behaviors. Neuroticism is a vulnerability factor for OCD, yet the mechanisms by which this general vulnerability factor affects the development of OCD-related symptoms are unknown. The present study assessed a hierarchical model of the development of obsessive thoughts that includes neuroticism as a general, higher-order factor, and specific, potentially maladaptive thought processes (thought suppression, worry, and brooding) as second-order factors manifesting in the tendency toward obsessing. A total of 238 participants completed questionnaires assessing the examined constructs. The results of mediator analyses demonstrated the hypothesized relationships: A positive association between neuroticism and obsessing was mediated by thought suppression, worry, and brooding. Independent of the participant’s sex, all three mediators contributed equally and substantially to the association between neuroticism and obsessing. These findings extend earlier research on hierarchical models of anxiety and provide a basis for further refinement of models of the development of obsessive thoughts.

scholarly journals Familial Clustering of Immune-Mediated Diseases in Children with Abrupt-Onset Obsessive Compulsive Disorder

2020 ◽  
Vol 30 (5) ◽  
pp. 345-346
Author(s):  
Avis Chan ◽  
Tiffany Phu ◽  
Bahare Farhadian ◽  
Theresa Willett ◽  
Margo Thienemann ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Abrupt Onset ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Immune Mediated ◽  
Familial Clustering

A Comparative Study of Family-Based and Patient-Based Behavioural Management in Obsessive-Compulsive Disorder

1990 ◽  
Vol 157 (1) ◽  
pp. 133-135 ◽  
Author(s):  
M. Mehta
Keyword(s):  
Social Adjustment ◽  
Obsessive Compulsive ◽  
Similar Treatment ◽  
Compulsive Disorder ◽  
Treatment Conditions ◽  
The Family ◽  
Group A ◽  
Personality Pattern ◽  
Family Based ◽  
Group B

Thirty obsessive-compulsive patients were randomly allocated to two treatment conditions. In group A a significant family member was trained to act as cotherapist at home, whereas in group B, only the patient was seen and given home assignments. All 30 patients received a similar treatment regime of systematic desensitisation, exposure, and response prevention. The family-based approach resulted in greater improvement in anxiety, depression, obsessive symptoms, and in social adjustment in occupational and household responsibilities. The personality pattern of the family members also appeared to influence outcome.

scholarly journals Drug treatment of obsessive-compulsive disorder

2010 ◽  
Vol 12 (2) ◽  
pp. 187-197 ◽  
Keyword(s):  
Drug Treatment ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Future Research ◽  
Considerable Proportion ◽  
Preliminary Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Rational Drug

Knowledge of pharmacotherapeutic treatment options in obsessive-compulsive disorder (OCD) has grown considerably over the past 40 years. Serotonergic antidepressants, such as selective serotonin reuptake inhibitors (SSRls) and clomipramine, are the established pharmacologic first-line treatment of OCD. Medium to large dosages and acute treatment for at least 3 months are recommended until efficacy is assessed. In case of significant improvement, maintenance treatment is necessary, Unfortunately, about half of the patients do not respond sufficiently to oral serotonergic antidepressants; augmentation with atypical antipsychotics is an established second-line drug treatment strategy. Alternatives include intravenous serotonergic antidepressants and combination with or switch to cognitive behavioral psychotherapy. Remarkably, a considerable proportion of OCD patients still do not receive rational drug treatment. Novel research approaches, such as preliminary treatment studies with glutamatergic substances, and trials with further drugs, as well as needed aspects of future research, are reviewed.

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