Pediatric acute-onset neuropsychiatric syndrome is a clinical concept used to describe a subgroup of children with sudden onset of psychiatric and somatic symptoms. The diagnostic term and especially management of children differs depending on the clinical setting to which they present, and the diagnosis and management is controversial. The aim of this paper is to propose a clinical guidance including homogenous diagnostic work-up and management of paediatric acute onset neuropsychiatric syndrome within the Nordic countries. The guidance is authored by a Nordic-UK working group consisting of paediatric neurologist, child psychiatrists and psychologists from Denmark, Norway, Sweden and Great Britain, and is the result of broad consensus. Conclusion: Consensus was achieved in the collaboration on work-up and treatment of patients with paediatric acute-onset neuropsychiatric syndrome, which we hope
Functional somatic disorders (FSD) result from a complex interplay of biological, psychological, and social factors, the combination of which varies between individuals. Professional and academic communities recommend an integrative, biopsychosocial, and personalized approach in order to achieve early diagnosis, an appropriate understanding of predisposing, triggering, and maintaining factors, and effective treatment. In order to obtain an integrative understanding, constructing a case formulation is suggested to be an important skill for clinicians treating patients with complex health conditions—such as FSD. However, in daily practice, many clinicians are struggling to conceptualize and then implement the biopsychosocial approach into their work with children and their families. This sustains the risk of a fragmented understanding of the child’s symptoms and functioning, and consequently fragmentation of health care. As members of a multidisciplinary team of professionals who treat children and adolescents with complex FSD, we here describe and share our experience of a clinical conversational tool—the biopsychosocial board—that we use to promote communication and to achieve an integrative understanding of the patient’s symptoms. We highlight the clinician’s ability to facilitate and co-construct a biopsychosocial case formulation together with the patient and family because this in the next turn will function as a roadmap to effective and personalized treatment. Used in such a way, we find that our conversation tool has the potential to be an innovative and useful tool for broad diagnostic assessment and identification of effective treatment options tailored to the individual child.
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