Application of Exposure Plus Response Prevention for Obsessive Compulsive Disorder Related to Pediatric Acute-Onset Neuropsychiatric Syndrome

ABSTRACT

Pediatric obsessive-compulsive disorder (OCD) often produces significant and chronic impairment for patients and their families. A subset of youths with OCD experience rapid-onset, severe OCD symptoms with multiple co-occurring neuropsychiatric problems, motor/sensory impairments, and dietary restrictions temporally linked to infectious disease, termed pediatric acute-onset neuropsychiatric syndrome (PANS). Although medical treatment for youths in this clinical subgroup has gained attention in recent years, literature detailing the evidence-based psychological treatment of such cases remains sparse. We describe the application of exposure plus response prevention (ERP), a cognitive-behavioral approach with extensive research support for pediatric and adult OCD, for a pediatric patient who presented for treatment with a multidisciplinary team of infectious disease, psychiatry, and psychology. This case report details the flexible application of ERP, as guided by a social-ecological framework wherein the patient, family, and broader community were all integral to treatment. This case study emphasizes the importance of future research on PANS-suspected pediatric OCD cases, as well as the utility of flexible application of ERP, guided by an ecological framework.

KEYWORDS:

• Obsessive-compulsive disorder
• pediatric acute-onset neuropsychiatric syndrome
• exposure plus response prevention

Disclosure statement

Written release was provided from the family to publish these findings.