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Childhood Sudden Onset OCD | Have You Considered PANDAS / PANS?

PANDAS / PANS can present with sudden onset OCD symptoms, typically presenting in children ages 3-14.


PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus) is the sudden, rapid-onset of obsessive compulsive (OC) behavior. Children may also present with additional movement and behavioral issues, including tics, sudden changes in eating patterns, and a significant increase in anxiety and panic. The condition of PANDAS is thought to be the result of the child’s immune system mistakenly attacking an area of the brain, the basal ganglia, rather than the Strep infection, causing the obsessive-compulsive symptoms and behavioral changes.

What is PANS?

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS); new research has suggested that strep is not the only infection that can cause nearly overnight symptoms of OCD, tics and anxiety, but that lyme, mycoplasma, mononucleosis, and the H1N1 flu virus can also prompt these behavioral changes.

PANDSA/ PANS Symptoms May Include:
  • Acute sudden onset of OCD
  • Challenges with eating (possible anorexia)child_pandas_Pans_help
  • Sensory issues such as sensitivity to clothes, sound, and light
  • Handwriting noticeably deteriorates
  • Urinary frequency or bedwetting
  • Small motor skills deteriorate
  • Tics
  • Inattentive, distractible, memory difficulties
  • Overnight onset of anxiety or panic attacks
  • Suddenly unable to separate from their caregiver, or to sleep alone
  • Screaming for hours on end
  • Fear of germs and other more traditional-looking OCD symptoms

Treatment For PANS/PANDAS

Best practices for PANS/PANDAS treatment is a treatment plan based on interventions through multiple providers; this includes seeking medical attention through a physician / pediatrician / ENT with significant experience with PANS/PANDAS treatment, while also seeking psychological care through a mental health clinician with experience in working with Obsessive-Compulsive symptoms.
Treatment often includes antibiotics, medication, and a specific type of cognitive-behavioral treatment called Exposure and Response Prevention (ERP) to address the obsessive-compulive symptoms.

Although PANS/PANDAS is in the preliminary stages of research, it is important to advocate for your child and seek services through qualified and experienced providers. Seeking treatment in a timely manner is crucial, as research indicates that children with PANS/PANDAS grow into adults with the most treatment resistant forms of OCD due to permanent basal ganglia damage.

Treatment for PANDAS / PANS in Orlando

At The Center For Anxiety and OCD at GroundWork Counseling in Orlando, our child Anxiety & OCD clinician is specifically trained in the most effective treatment methods for childhood OCD and obsessive compulsive behaviors, using research-based approaches such as Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP), working collaboratively with medical providers so that they can detect and treat the underlying infection.

It is important to interview your prospective therapist to find out if  they have knowledge of PANS / PANDAS and how they plan to treat the disorder, as many clinicians are not aware of the diagnosis nor understand the collaborative nature of effective treatment. It is also important to find out if the provider is  trained to do Exposure and Response Prevention (ERP), and where they received their training. Less than 1% of mental health professionals have received the proper training to provide empirically-supported treatment for OCD through ERP. Visit Our List Of Recommended Questions


If you would like to learn more about PANS/PANDAS and effective treatment options please visit:iocd

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