Youth with severe mental illness and complex non-somatic motor abnormalities: conflicting conceptualizations and unequal treatment.
Peter AnderssonLee E WachtelJohan LundbergEsmail JamshidiJohan BringMathias Rask-AndersenHåkan JarbinJussi JokinenAdrian E Desai BoströmPublished in: Npj mental health research (2022)
Two emerging diagnostic concepts promote distinct treatments for youth with acute-onset motor abnormalities and severe concurrent psychiatric symptoms: Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric catatonia. Both have institutional approval in parts of Europe and in the USA, meriting an unconditional comparison of supporting evidence. Here we report results of qualitative and quantitative analyses of literature and Swedish National Registry Data suggesting that (1) catatonic patients are liable to fulfilling diagnostic criteria for PANS, (2) three conservatively assessed PANS case-reports present with possible unrecognized catatonia, (3) lithium and electroconvulsive therapy usage frequencies in Swedish minors (exclusively recommended for severe mental illness) are strongly intercorrelated and unequally distributed across Swedish counties, (4) established severe mental disorders are rarely overtly considered amongst PANS-specific research and (5) best-available evidence treatments appear markedly superior for pediatric catatonia compared to PANS in both childhood and adolescence. Prioritizing treatments for pediatric catatonia in concerned subjects could markedly improve treatment outcomes.
Keyphrases
- mental illness
- mental health
- drug induced
- early onset
- end stage renal disease
- systematic review
- physical activity
- newly diagnosed
- respiratory failure
- depressive symptoms
- chronic kidney disease
- ejection fraction
- electronic health record
- machine learning
- radiation therapy
- prognostic factors
- mass spectrometry
- patient reported outcomes
- extracorporeal membrane oxygenation
- deep learning
- dna methylation
- neural network
- early life
- patient reported
- clinical evaluation