The sudden, acute onset of neuropsychiatric symptoms, high frequency of comorbidities (i.e., anxiety, behavioral regression, depression, and suicidality), and poor quality of life capture the PANS subgroup as suddenly and severely impaired youth. Identifying clinical characteristics of youth with PANS will allow clinicians to diagnose and treat this subtype of OCD with a more strategized and effective approach.

The food refusal associated with PANS is compared with symptoms listed for the new Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-V) diagnosis of avoidant/restrictive food intake disorder (ARFID). Treatment implications are discussed, as well as directions for further research.

Background: Genetic linkages with psychiatric disorders have been documented. In our clinical practice, we noticed a high propensity for blood disorders in female patients with certain neuropsychiatric phenomenon, specifically Tourette Syndrome (TS) or Trichotillomania (TTM). With this clinical observation, we hoped to better understand a possible genetic correlation, namely the role of chromosome 11 which encodes for both the B globulin gene and human dopamine receptor D4 (DRD4) gene. Method: This is a retrospective case series of six children found to have a blood disorder and neuropsychiatric diagnosis in our clinic. We used family interview, lab results, and the patient's medical chart for data collection Results: Our case series reveals six children with a repetitive neuropsychiatric disorder and a blood disorder. Conclusions: Currently, there are no definitive susceptibility genes that have been identified to date for TS or TTM. We postulate that blood disorders found on chromosome 11 may play a role as a susceptibility factor, particularly in females, for repetitive neuropsychiatric disorders.

We report 2 young children who are examples of the consequences of premature testing for Huntington disease. Premature testing of a child or fetus carries complex medical and psychological issues to both the child and the family that need to be considered and explored more than in an adult with Huntington disease. We suggest that a child at risk for juvenile Huntington disease not be tested until symptoms are progressive and consistent with the disease and all other mimickers are excluded. When testing is indicated, a multidisciplinary approach is essential to educate the family about the risks and benefits of testing and improve their coping skills when the final diagnosis is made.