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PANS and PANDAS--a hitherto normal child suddenly develops severe OCD symptoms. These may include refusing to leave the house, engaging in constant checking and washing rituals, asking repeatedly if the door is locked, making odd facial movements, having full-on tantrums with kicking and screaming, wetting the bed, and being unable to perform in school. “I lost my child overnight” was, and is, a common refrain.
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How do you confidently diagnose a child that you suspect is presenting with PANDAS/PANS? (See lead article for definition.) And if you do make that diagnosis, how should treatment proceed? Child psychiatrist Erica Greenberg sees new cases almost every week. We turned to her for some boots-on-the-ground guidance.
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Diagnosing ADHD continues to be difficult, time-consuming, and expensive. Having an “objective,” valid test for ADHD would be of value to clinicians and families alike. Continuous performance tests (CPT) are gaining popularity as a complement to clinical examination, rating scales, and interviews with parents and teachers.
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Dr. Joshua Feder studied mathematics and medicine at Boston University, Psychiatry at Naval Regional Medical Center San Diego, serving the first Gulf War in child and adolescent psychiatry fellowship at Tripler Army Medical Center in Honolulu, and eventually became Chief of Child Psychiatry at the National Naval Medical Center in Bethesda, MD. Dr. Feder now practices in Solana Beach, California, and serves as Executive Medical Director at Positive Development, providing relationship-based support for families, with research at UCSD, SDSU, Fielding Graduate University, An Najah National University, Quicksilver Software, Autism Is inclusion program, and Programmatic Lead for the International Networking Group on Peace Building with Young Children, with projects in the US, Northern Ireland, and the Middle East. Dr. Feder co-authored the first American Academy of Child & Adolescent Psychiatry Practice Parameter on Autism and serves as Co-Chair of the Disaster & Trauma Committee at AACAP. Dr Feder was founding policy chair for the California Association for Infant Mental Health and advocates worldwide on access to care, climate policy, and peacebuilding. His recent books include Child Medication Fact Book for Psychiatric Practice, Second Edition (2023) and Prescribing Psychotropics (2021).
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