Prevalence of Pediatric Acute-Onset Neuropsychiatric Syndrome and Associated Obsessive-Compulsive Symptoms in Youth with Avoidant/Restrictive Food Intake Disorder
RESEARCH IMPACT:
“Prevalence of Pediatric Acute-Onset Neuropsychiatric Syndrome and Associated Obsessive-Compulsive Symptoms in Youth with Avoidant/Restrictive Food Intake Disorder” highlights important overlap between ARFID, obsessive-compulsive symptoms, and features associated with PANS, particularly in individuals with fear-based food avoidance. The findings support the need for clinicians and researchers to assess obsessive fears, anxiety-driven food avoidance, and neuropsychiatric symptom patterns when evaluating restrictive eating presentations. By identifying potential shared mechanisms across these conditions, the study may help guide future research into more integrated diagnostic frameworks and targeted intervention strategies.
SUMMARY
“Prevalence of Pediatric Acute-Onset Neuropsychiatric Syndrome and Associated Obsessive-Compulsive Symptoms in Youth with Avoidant/Restrictive Food Intake Disorder” examined the prevalence of pediatric acute-onset neuropsychiatric syndrome (PANS), obsessive-compulsive (OC) symptoms, and infection history among adolescents and young adults with full or subthreshold avoidant/restrictive food intake disorder (ARFID). The investigators evaluated 37 participants using structured assessments of ARFID symptom profiles, OC symptom severity, and self-reported PANS/PANDAS-related symptoms and infections. The authors sought to better understand the overlap between restrictive eating behaviors, obsessive-compulsive features, and neuropsychiatric symptom patterns associated with PANS. Results demonstrated that while only 5% of participants met criteria for probable PANS, nearly half (46%) reported lifetime mild-to-severe OC symptoms. Researchers note the relatively low prevalence of PANS in the sample could be impacted by our inclusion of both young adult and subthreshold ARFID cases, which may not typically exhibit as pronounced PANS/PANDAS symptoms as pediatric cases.
Contamination-related obsessions and checking compulsions were among the most common presentations. The ARFID subtype characterized by fear of aversive consequences—such as fears of choking, vomiting, or contamination—was significantly associated with greater OC symptom severity, even after controlling for other ARFID profiles and body mass index. No significant associations between infections and OC severity were identified.
The findings highlight important overlap between ARFID, obsessive-compulsive symptoms, and features commonly observed in PANS. Anxiety, depressed mood, panic symptoms, and sensory sensitivities were frequently reported, underscoring the importance of careful differential diagnosis in youth presenting with restrictive eating and neuropsychiatric symptoms, particularly when obsessive fears or contamination concerns are prominent.
LINK TO PAPER: https://journals.sagepub.com/doi/10.1177/10445463261419065
CITATION
Breithaupt L, Ji C, Zhao Z, et al. Prevalence of Pediatric Acute-Onset Neuropsychiatric Syndrome and Associated Obsessive-Compulsive Symptoms in Youth with Avoidant/Restrictive Food Intake Disorder. Journal of Child and Adolescent Psychopharmacology. 2026;36(2):98-104. doi:10.1177/10445463261419065