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Patient Satisfaction and Treatments Offered to Swedish Patients with Suspected Pediatric Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.ORCID-id: 0000-0002-3587-6075
2019 (Engelska)Ingår i: Journal of child and adolescent psychopharmacology, ISSN 1044-5463, E-ISSN 1557-8992, Vol. 29, nr 8, s. 634-641Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are subtypes of Obsessive-Compulsive Disorder (OCD) with suggested autoimmune etiology. Immunomodulatory treatments have been introduced as treatment options. A recent systematic review concluded that the evidence for all treatment options for PANS and PANDAS is inconclusive. However, case reports and clinical experience suggest that antibiotics and immunomodulatory treatment may be helpful. Treatment may also affect the patients' satisfaction with health care services offered. This study aims to describe the treatments given to a cohort of Swedish patients with suspected PANS and PANDAS, the patient rated treatment effects, and to establish if any specific treatment predicts higher patient satisfaction.

Methods: Fifty-three patients (m = 33, f = 20, median age = 14, age range = 4-36) with suspected PANS or PANDAS were enrolled and assessed for PANS and PANDAS caseness, treatments given, treatment effects, global improvement, and patient satisfaction. Cases with confirmed and suspected PANS or PANDAS were compared regarding the frequency of treatments given and treatment effect. A linear regression model was used to see if treatments given or global improvement predicted patient satisfaction.

Results: Twenty-four participants fulfilled criteria for PANS or PANDAS and 29 did not. The most common treatments given were antibiotics (88%), nonsteroidal anti-inflammatory drugs (67%), cognitive behavioral therapy (53%), and selective serotonin reuptake inhibitors (42%). There were no major differences between confirmed and suspected cases regarding what treatments they had received or their effect. Patient satisfaction was predicted by overall clinical improvement at the time of assessment. Antibiotics and intravenous immunoglobulin (IVIG) were rated as the most successful treatments by participants and were associated with higher patient satisfaction.

Conclusions: It was more common that patients had received antibiotics than common psychiatric treatments for their psychiatric symptoms. Antibiotics and IVIG were experienced as effective treatments by the patients. Patient satisfaction was on average moderately low, and higher patient satisfaction was associated with global clinical improvement.

Ort, förlag, år, upplaga, sidor
Mary Ann Liebert, 2019. Vol. 29, nr 8, s. 634-641
Nyckelord [en]
Obsessive-compulsive disorder, patient satisfaction, pediatric acute-onset neuropsychiatric syndrome, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, treatment outcome
Nationell ämneskategori
Reumatologi och inflammation Pediatrik Psykiatri
Identifikatorer
URN: urn:nbn:se:oru:diva-73898DOI: 10.1089/cap.2018.0141ISI: 000465469300001PubMedID: 31009235OAI: oai:DiVA.org:oru-73898DiVA, id: diva2:1306538
Forskningsfinansiär
Vetenskapsrådet, 523-2011-3646Hjärnfonden, FO2015-0191
Anmärkning

Funding Agencies:

Bror Gadelius Minnesfond  

Psykiatrifonden  

Stockholm County Council (PPG projects)  20130671  20150150 

Tillgänglig från: 2019-04-24 Skapad: 2019-04-24 Senast uppdaterad: 2019-11-21Bibliografiskt granskad

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Bejerot, Susanne

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