PANDAS—Questions and Answers
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Inositol Safety: Clinical Evidences
European Review for Medical and Pharmacological Sciences 2011; 15: 931-936 Inositol safety: clinical evidences G. CARLOMAGNO, V. UNFER AGUNCO Obstetrics & Gynecology Center, Rome (Italy) Abstract. – Myo-inositol is a six carbon ent required by the human cells for the growth cyclitol that contains five equatorial and one axi- and survival in the culture. In humans and other al hydroxyl groups. Myo-inositol has been classi- species, Myo-inositol can be converted to either fied as an insulin sensitizing agent and it is L- or D-chiro-inositol by epimerases. Early stud- commonly used in the treatment of the Polycys- tic Ovary Syndrome (PCOS). However, despite ies showed that inositol urinary clearance was al- its wide clinical use, there is still scarce informa- tered in type 2 diabetes patients, the next step tion on the myo-inositol safety and/or side ef- was to link impaired inositol clearance with in- fects. The aim of the present review was to sum- sulin resistance (for a review see1). Because of marize and discuss available data on the myo-in- these properties, inositol have been classified as ositol safety both in non-clinical and clinical set- “insulin sensitizing agent”2. tings. The main outcome was that only the highest In the recent years, inositol has found more dose of myo-inositol (12 g/day) induced mild and more space in the reproductive clinical prac- gastrointestinal side effects such as nausea, fla- tice3-6. Indeed, since the main therapy for Poly- tus and diarrhea. The severity of side effects did cystic Ovary Syndrome (PCOS) is the use of in- not increase with the dosage. -
Anxiety Disorders of Childhood and Adolescence Jesse C
Anxiety Disorders of Childhood and Adolescence Jesse C. Rhoads, DO & Craig L. Donnelly, MD 1. Background, EpidEmiology and rElEvancE Anxiety symptoms are ubiquitous in youth. Clinicians need to be familiar with the normal developmental course of anxieties in youth and their consequent mastery by children in order to differentiate normative versus pathological anxiety. Anxiety symptoms do not necessarily constitute an anxiety disorder. Fear and anxiety are common experiences across childhood and adolescence. The clinician evaluating childhood anxiety disorders faces the task of differentiating the normal, transient and developmentally appropriate expressions of anxiety from pathological anxiety. Adept assessment and management of anxiety symptoms through reassurance, anticipatory guidance and psychoeducation of parents may forestall the development of full blown anxiety syndromes. Anxiety disorders are among the most common psychiatric disorders in children and adolescents affecting from 7-15% of individuals under 18 years of age. Anxiety disorders are not rare and often mimic or are comorbid with other childhood disorders. Symptoms such as school refusal, tantrums, or irritability may be less reflective of oppositional behavior than an underlying social phobia or generalized anxiety disorder. Given the uniqueness of each child and the complex interplay among the internal and external variables that drive anxiety, a multimodal approach to diagnosis and treatment is warranted. Anxiety disorders are a heterogeneous group of disorders that vary in their etiology, treatment, and prognosis. Given these differences, we will discuss each condition individually to help the primary care clinician in parsing out the necessary details of each disorder. Separation anxiety disorder The estimated prevalence of SAD is 4-5%, making it one of the most common childhood psychiatric disorders. -
Addison's Disease Elucidating PANDAS
PRACTICE BUILDING Naturopathic Specialty Practice: Keys to NATUROPATHIC DOCTOR NEWS & REVIEW Making It Successful ..........................>>10 Darin Ingels, ND VOLUME 10 ISSUE 4 April 2014 | Autoimmune / ALLER gy Medicine Sometimes specialty practices happen by accident. A case study and some tips help pave the way for Tolle Causam success. TOLLE CAUSAM Autoimmunity and the Gut: Elucidating PANDAS How Intestinal Inflammation Contributes to Autoimmune Disease .....................>>12 Follow-Up Discussion of an Immune-Mediated Jenny Berg, ND, LAc Kelly Baker, ND, LAc Intestinal flora influences our immune system’s Mental Illness ability to differentiate self from non-self. Steven Rondeau, ND, BCIA-EEG VIS MEDICATRIX NATURAE Allergy Elimination Technique: Simplified ANDAS is an acronym for “Pediatric Treatment of Difficult Cases ..............>>15 PAutoimmune Neuropsychiatric Sheryl Wagner, ND Disorder Associated with Streptococcus.” A few case studies illustrate the surprisingly broad This condition, which was initially application of NAET with patients. identified by Sue Swedo, MD, and DOCERE described in the American Journal of Autoimmune Infertility in Women: Psychiatry in 1998,1 is characterized by Part 2 ...................................................>>16 abrupt-onset obsessive-compulsive Fiona McCulloch, BSc, ND disorder (OCD) and/or other Intestinal support, autoimmune diet, and neuropsychiatric symptoms in a child. (See nutraceuticals help reverse a common cause of Table 1 for Swedo’s original diagnostic female infertility. criteria.) In my previous NDNR paper NATUROpaTHIC NEWS from 2010,2 I described the presentation, history and controversy surrounding this Association Spotlight: An Introduction newly identified syndrome. Since that to the ANRI and NORI .........................>>20 time, several other groups have sought Colleen Huber, NMD to better redefine this condition, and the Dr Huber introduces ANRI & NORI, organizations committed to the advancement of research & acronym, PANS, or Pediatric Acute-Onset education on chronic disease. -
Tic Disorders
No. 35 May 2012 Tic Disorders A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing, sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. The most common tic disorder is called "transient tic disorder" and may affect up to 10 percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient tics go away by themselves. Some may get worse with anxiety, tiredness, and some medications. Some tics do not go away. Tics which last one year or more are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a special, more unusual tic disorder called Tourette's Disorder. Children with Tourette's Disorder have both body and vocal tics (throat clearing). Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, and learning disabilities. They may act impulsively, and/or develop obsessions and compulsions. Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them. -
Anxiety Disorders in Children Revised 2020
Information about: Anxiety Disorders in Children Revised 2020 Vermont Family Network 600 Blair Park Road, Ste 240 Williston, VT 05495 1-800-800-4005 www.VermontFamilyNetwork.org Introduction According to The Child Mind Institute, “Children with anxiety disorders are overwhelmed by feelings of intense fear or worry that they are out of proportion to the situation or thing that triggers them. These emotional fears can be focused on separating from parents, physical illness, performing poorly, or embarrassing themselves. Or they can be attached to specific things, like dogs or insects or bridges.” We hope that this will give you a greater understanding of anxiety disorders and the ways that parents and professionals can support children at home, in school, and in the community. We have selected information from various sources and provided internet links when possible. The information we have presented was used by permission from various sources. We have provided links for you to find more, in-depth information at their sites. Contents Title Page Anxiety Disorders in Children and Adolescents 2 Additional Treatments and Guidance 2 The Anxious Child 3 Anxiety Quick Fact Sheet for School Personnel & 4 Parents/Guardians Children Who Won’t Go to School (Separation Anxiety) 6 Managing Anxiety with Siblings 6 Panic Disorder in Children and Adolescents 7 Parenting Tips for Anxious Kids 8 Getting Linked (local resources) 9 Advocating for Your Child: 25 Tips for Parents 10-12 Resources 13 Anxiety Disorders in Children and Adolescents What Are Anxiety Disorders? According to The National Alliance on Mental Illness (NAMI)*, “Anxiety disorders are the most common mental health concern in the United States. -
OCD Bingo Instructions
OCD Bingo Instructions Host Instructions: · Decide when to start and select your goal(s) · Designate a judge to announce events · Cross off events from the list below when announced Goals: · First to get any line (up, down, left, right, diagonally) · First to get any 2 lines · First to get the four corners · First to get two diagonal lines through the middle (an "X") · First to get all squares (a "coverall") Guest Instructions: · Check off events on your card as the judge announces them · If you satisfy a goal, announce "BINGO!". You've won! · The judge decides in the case of disputes This is an alphabetical list of all 29 events: Anxiety, Aviator, Brain, C.B.T., Clomipramine, Comorbidity, Compulsions, Counting, Cyclical, Hand-washing, Hepburn, History, Hughes, Indirect pathway, O.C.D., O.C.P.D., Obsessions, Persistent, Plane crash, Psychology, Recurrent, Screen Room, Scrupulosity, Stress, Tic Disorder, Washing, Y-BOCS, Zwangsneurose, phlebotomy. BuzzBuzzBingo.com · Create, Download, Print, Play, BINGO! · Copyright © 2003-2021 · All rights reserved OCD Bingo Call Sheet This is a randomized list of all 29 bingo events in square format that you can mark off in order, choose from randomly, or cut up to pull from a hat: Stress C.B.T. Hughes Hand-washing Aviator Tic Washing Obsessions O.C.D. Persistent Disorder Screen Psychology phlebotomy O.C.P.D. Scrupulosity Room Plane Compulsions Counting Zwangsneurose Comorbidity crash Clomipramine Y-BOCS Anxiety History Hepburn Indirect Cyclical Brain Recurrent pathway BuzzBuzzBingo.com · Create, Download, Print, Play, BINGO! · Copyright © 2003-2021 · All rights reserved B I N G O Screen Brain History Y-BOCS Aviator Room Zwangsneurose Hughes phlebotomy Persistent Anxiety Plane C.B.T. -
Nutritional and Herbal Supplements in the Treatment of Obsessive Compulsive Disorder
Open access Review Gen Psych: first published as 10.1136/gpsych-2019-100159 on 11 March 2020. Downloaded from Nutritional and herbal supplements in the treatment of obsessive compulsive disorder Canan Kuygun Karcı ,1 Gonca Gül Celik2 To cite: Kuygun Karcı C, Gül ABSTRACT pharmacotherapy with selective serotonin Celik G. Nutritional and herbal Obsessive- compulsive disorder (OCD) is a neuropsychiatric reuptake inhibitors (SSRI), the tricyclic supplements in the treatment disorder that is characterised by obsessions and antidepressant clomipramine, or serotonin of obsessive compulsive compulsions. The recommended treatments for OCD disorder. General Psychiatry noradrenaline reuptake inhibitors such as are cognitive– behavioural therapy using exposure and 8 9 2020;33:e100159. doi:10.1136/ venlafaxine or duloxetine. response prevention and/or pharmacotherapy. On the other gpsych-2019-100159 Limited effectiveness and possible side hand, some nutritional and herbal supplements may be effects of present treatments have lead to the Received 03 October 2019 effective in the treatment of OCD. Nutritional and herbal Revised 02 December 2019 supplements in OCD treatment will be reviewed in this search for alternative strategies. It is known Accepted 19 December 2019 paper. PubMed (Medline), Cochrane Library and Google that various nutritional deficiencies can Scholar databases were reviewed for the topic. There are be detected in patients with mental disor- some supplements that have been researched in OCD ders. Therefore, nutritional supplements treatment studies such as vitamin D, vitamin B12, folic are thought to be effective in treatment. acid, homocysteine, trace elements, N- acetyl cysteine, In this paper, use of nutritional and herbal glycine, myoinositol, St John’s wort, milk thistle, valerian supplements in the treatment of OCD will be root, curcumin and borage. -
Tourette's Syndrome
Tourette’s Syndrome CHRISTOPHER KENNEY, MD; SHENG-HAN KUO, MD; and JOOHI JIMENEZ-SHAHED, MD Baylor College of Medicine, Houston, Texas Tourette’s syndrome is a movement disorder most commonly seen in school-age children. The incidence peaks around preadolescence with one half of cases resolving in early adult- hood. Tourette’s syndrome is the most common cause of tics, which are involuntary or semi- voluntary, sudden, brief, intermittent, repetitive movements (motor tics) or sounds (phonic tics). It is often associated with psychiatric comorbidities, mainly attention-deficit/hyperac- tivity disorder and obsessive-compulsive disorder. Given its diverse presentation, Tourette’s syndrome can mimic many hyperkinetic disorders, making the diagnosis challenging at times. The etiology of this syndrome is thought to be related to basal ganglia dysfunction. Treatment can be behavioral, pharmacologic, or surgical, and is dictated by the most incapacitating symp- toms. Alpha2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine- receptor–blocking drugs are required for multiple, complex tics. Dopamine-receptor–blocking drugs are associated with potential side effects including sedation, weight gain, acute dystonic reactions, and tardive dyskinesia. Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected children. (Am Fam Physician. 2008;77(5):651-658, 659-660. Copyright © 2008 American Academy of Family Physicians.) ▲ Patient information: n 1885, Georges Gilles de la Tourette normal context or in inappropriate situa- A handout on Tourette’s described the major clinical features tions, thus calling attention to the person syndrome, written by the authors of this article, is of the syndrome that now carries his because of their exaggerated, forceful, and provided on p. -
Illinois Pandas/Pans Advisory Council
ILLINOIS PANDAS/PANS ADVISORY COUNCIL 2020 Report December 20, 2020 Compiled by: Wendy C Nawara, MSW Dareen Siri, MD, FAAAAI, FACAAI ILLINOIS PANDAS/PANS ADVISORY COUNCIL – 2020 REPORT TABLE OF CONTENTS ILLINOIS PANDAS/PANS ADVISORY COUNCIL ................................................................................. 3 UNDERSTANDING PANDAS/PANS ................................................................................................... 4 Clinical Presentation ........................................................................................................... 4 Epidemiology/Demographics .............................................................................................. 5 Etiology and Disease Mechanisms for PANDAS (Post-streptococcal symptoms) .......................... 6 STANDARD DIAGNOSTIC AND TREATMENT GUIDELINES ............................................................... 7 Absolute Criteria ................................................................................................................. 7 Major Criteria ...................................................................................................................... 7 Minor Criteria Group 1 ........................................................................................................ 7 Minor Criteria Group 2 ........................................................................................................ 7 Additional Supporting Evidence......................................................................................... -
Psychosocial Risk Factors and Treatment for Children and Adolescents with OCD
Psychosocial risk factors and treatment for children and adolescents with OCD Dr. Marian Kolta Psychologist The Royal Children’s Hospital Integrated Mental Health Program Learning Aims Outline: Define OCD Key associated comorbid disorders Psychosocial Risk Factors Psychosocial Treatment Obsessions and Compulsions Obsessions: Thoughts urges or images that are experienced as unwanted, intrusive and out-of-character Compulsions: Repetitive intentional behaviours or mental acts that are often linked to obsessions and serve to reduce discomfort or anxiety DSM Diagnostic Criteria Criteria A: Essential Components Recurrent obsessions or compulsions Obsessions z Not simple excessive worry about real-life problems z Person attempts to ignore or suppress or to neutralise them with some other thought or action z Person recognises that they are a product of their own mind (not thought insertion) Compulsions z Driven to perform behaviour or mental act z Aimed at reducing distress or preventing dreaded situation z Not realistically connected to what they are trying to prevent or clearly excessive DSM Diagnostic Criteria Criteria B: z The individual recognises the obsessive-compulsive symptoms are excessive or unreasonable Criteria C: z The obsessive-compulsive symptoms cause marked distress, are time consuming (>1hr/day), or significantly interferes with normal routine, functioning, or relationships Criteria D: z Not restricted to another Axis I disorder Criteria E: z Not due to direct physiological effects of a substance or general medication condition PrevalencePrevalence ofof OCDOCD The World Health Organisation lists obsessive-compulsive disorder as one of the five major causes of disability throughout the world. It is considered the fourth most common psychiatric condition, ranking after phobias, substance abuse disorders, and major depressive mood disorder. -
Cognitive-Behavioural Therapy of Obsessive- Compulsive Disorder
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Veterinary medicine - Repository of PHD, master's thesis UNIVERSITY OF ZAGREB SCHOOL OF MEDICINE Veronika Nives Zoric Cognitive-Behavioural Therapy of Obsessive- Compulsive Disorder GRADUATE THESIS Zagreb, 2017. This graduate thesis was made at the Department of Psychiatry KBC Zagreb, University of Zagreb School of Medicine, mentored by prof. dr. sc. Dražen Begić and was submitted for evaluation in the 2016/2017 academic year. Mentor: prof. dr. sc. Dražen Begić ABBREVIATIONS USED IN THE TEXT: Behaviour Therapy (BT) Bibliotherapy administered CBT (bCBT) Cognitive-Behavioural Therapy (CBT) Cognitive Therapy (CT) Computerized CBT (cCBT) Danger Ideation Reduction Therapy (DIRT) Deep Brain Stimulation (DBS) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Exposure and Response Prevention (ERP) Generalized Anxiety Disorder (GAD) International Classification of Disease (ICD-10) Internet-administered CBT (iCBT) Major Depressive Disorder (MDD) Monoamine Oxidase Inhibitors (MAO) Obsessive-Compulsive Disorder (OCD) Obsessive-Compulsive Personality Disorder (OCPD) Selective Serotonin Reuptake Inhibitor (SSRI) Serotonin; 5-hydroxytryptamine (5HT) Serotonin Reuptake Inhibitor (SRI) Subjective Units of Distress Scale (SUDS) Telephone administered CBT (tCBT) Tricyclic Antidepressants (TCA) Videoconferencing administered CBT (vCBT) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) TABLE OF CONTENTS 1. SUMMARY 2. SAŽETAK 3. INTRODUCTION ............................................................................................................ -
Sensory Phenomena Related to Tics, Obsessive-Compulsive Symptoms
Available online at www.sciencedirect.com ScienceDirect Comprehensive Psychiatry 62 (2015) 141–146 www.elsevier.com/locate/comppsych Sensory phenomena related to tics, obsessive-compulsive symptoms, and global functioning in Tourette syndrome ⁎ Yukiko Kanoa, , Natsumi Matsudab, Maiko Nonakab, Miyuki Fujioc, Hitoshi Kuwabarad, Toshiaki Konoe aDepartment of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-8655, Japan bDepartment of Child Psychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-8655, Japan cCourse of Clinical Psychology, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-0033, Japan dDisability Services Office, The University of Tokyo, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-0033, Japan eDepartment of Forensic Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo 187-8551, Japan Abstract Objectives: Sensory phenomena, including premonitory urges, are experienced by patients with Tourette syndrome (TS) and obsessive- compulsive disorder (OCD). The goal of the present study was to investigate such phenomena related to tics, obsessive-compulsive symptoms (OCS), and global functioning in Japanese patients with TS. Methods: Forty-one patients with TS were assessed using the University of São Paulo Sensory Phenomena Scale (USP-SPS), the Premonitory Urge for Tics Scale (PUTS), the Yale Global Tic Severity Scale (YGTSS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), and the Global Assessment of Functioning (GAF) Scale. Results: USP-SPS and PUTS total scores were significantly correlated with YGTSS total and vocal tics scores.