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Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute‐Onset Neuropsychiatric Syndrome (PANS).

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Title: Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute‐Onset Neuropsychiatric Syndrome (PANS).
Authors: Kapphahn, Cynthia, Peet, Brianna, Gao, Jaynelle, Chan, Avis, Farhadian, Bahare, Ma, Meiqian, Silverman, Melissa, Tran, Paula, Schlenk, Noelle, Thienemann, Margo, Frankovich, Jennifer
Source: International Journal of Eating Disorders. Jul2025, Vol. 58 Issue 7, p1219-1232. 14p.
Subjects: Age of onset, Food consumption, Body mass index, Questionnaires, Retrospective studies, Descriptive statistics, Eating disorders, Behavior disorders in children, Pediatrics, Longitudinal method, Aggression (Psychology), Food habits, Obsessive-compulsive disorder in children, Medical records, Acquisition of data, Electronic health records, Sudden onset of disease, Comparative studies, Data analysis software, Diet therapy, Diet in disease, Mental depression
Abstract: Objective: Abrupt onset restrictive food intake can be a cardinal symptom of pediatric acute‐onset neuropsychiatric syndrome (PANS). However, few reports detail eating restriction patterns and baseline eating behaviors in patients with PANS, which we aim to address. Additionally, we aim to compare PANS eating restriction with ARFID. Methods: Retrospective chart review of 130 patients with PANS, aged 4–18 years, presenting for initial assessment at Stanford's PANS/Immune Behavioral Health (IBH) Clinic. Data were abstracted from electronic medical records (EMR) and parent/child questionnaires which included symptom ratings and psychometric scores. Baseline eating restriction and abrupt onset changes in eating associated with PANS flares were studied. Results: Over half (56%) of the PANS patients developed abrupt‐onset restricted food intake during flare prompting clinic entry. Of youth with restricted intake, 48% had selective eating, 41% had low appetite/interest in food, 37% feared aversive consequences (26% swallowing/choking/vomiting concerns, 16% feared contamination), and 4% overweight concerns. Youth with restricted intake had high levels of emotional lability and/or depression (96%), irritability, aggression, or oppositional behaviors (89%), behavioral/developmental regression (60%), cognitive impairment (69%), and sensory amplification (64%). Baseline eating restriction was noted in 16 (12%), with 9 altering eating behaviors during flare. Conclusions: Eating restriction is common during PANS flares, reasons align with 3 main presentations of ARFID: Selective eating, low appetite/interest, and fear of aversive consequences. High levels of other neuropsychiatric symptoms are noted in youth with PANS and eating restriction during flares. Twelve percent of PANS patients have baseline eating restriction; over half of whom alter eating behaviors during the flare. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute‐Onset Neuropsychiatric Syndrome (PANS).
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Eating+Disorders%22">International Journal of Eating Disorders</searchLink>. Jul2025, Vol. 58 Issue 7, p1219-1232. 14p.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Abrupt onset restrictive food intake can be a cardinal symptom of pediatric acute‐onset neuropsychiatric syndrome (PANS). However, few reports detail eating restriction patterns and baseline eating behaviors in patients with PANS, which we aim to address. Additionally, we aim to compare PANS eating restriction with ARFID. Methods: Retrospective chart review of 130 patients with PANS, aged 4–18 years, presenting for initial assessment at Stanford's PANS/Immune Behavioral Health (IBH) Clinic. Data were abstracted from electronic medical records (EMR) and parent/child questionnaires which included symptom ratings and psychometric scores. Baseline eating restriction and abrupt onset changes in eating associated with PANS flares were studied. Results: Over half (56%) of the PANS patients developed abrupt‐onset restricted food intake during flare prompting clinic entry. Of youth with restricted intake, 48% had selective eating, 41% had low appetite/interest in food, 37% feared aversive consequences (26% swallowing/choking/vomiting concerns, 16% feared contamination), and 4% overweight concerns. Youth with restricted intake had high levels of emotional lability and/or depression (96%), irritability, aggression, or oppositional behaviors (89%), behavioral/developmental regression (60%), cognitive impairment (69%), and sensory amplification (64%). Baseline eating restriction was noted in 16 (12%), with 9 altering eating behaviors during flare. Conclusions: Eating restriction is common during PANS flares, reasons align with 3 main presentations of ARFID: Selective eating, low appetite/interest, and fear of aversive consequences. High levels of other neuropsychiatric symptoms are noted in youth with PANS and eating restriction during flares. Twelve percent of PANS patients have baseline eating restriction; over half of whom alter eating behaviors during the flare. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=187574233
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1002/eat.24388
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      – Code: eng
        Text: English
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    Subjects:
      – SubjectFull: Age of onset
        Type: general
      – SubjectFull: Food consumption
        Type: general
      – SubjectFull: Body mass index
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Retrospective studies
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      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Eating disorders
        Type: general
      – SubjectFull: Behavior disorders in children
        Type: general
      – SubjectFull: Pediatrics
        Type: general
      – SubjectFull: Longitudinal method
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      – SubjectFull: Aggression (Psychology)
        Type: general
      – SubjectFull: Food habits
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      – SubjectFull: Obsessive-compulsive disorder in children
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      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Acquisition of data
        Type: general
      – SubjectFull: Electronic health records
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      – SubjectFull: Sudden onset of disease
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      – SubjectFull: Mental depression
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      – TitleFull: Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute‐Onset Neuropsychiatric Syndrome (PANS).
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              Text: Jul2025
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