The Flip Side of the Coin: Giftedness in Pediatric Acute-Onset Neuropsychiatric Syndrome

Background/Objectives: Individuals with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), an immune-modulated disorder, experience exacerbation-related neuropsychiatric symptoms, functional impairments, and high rates of developmental diagnosis. The literature describes links between giftedness and mental illness, and giftedness and autoimmune disorders. We sought to explore rates of giftedness among children with PANS as perceived by their caregivers, and to examine whether giftedness was related to PANS symptom severity, persistence, or duration. Methods: Data were extracted from a larger, 146-item survey, with 680 respondents meeting inclusion criteria of being a parent/guardian of a child with PANS and answering questions regarding perceived giftedness in empathy, social skills, verbal ability, reading, memory, math, creativity, or "other." Results: In all, 604 respondents indicated some type of giftedness; the categories of giftedness were each endorsed by 30-57% of respondents. We found no significant associations between giftedness and severity of worst symptoms, persistence of symptoms, or length of time since symptom onset, once Bonferonni corrections were applied. Significantly more females than males were identified as gifted in creativity, but no other sex-related differences were seen. Thematic analysis of optional comments revealed three themes: (1) Elaboration on Types of Giftedness; (2) Objective Basis for Perceptions of Giftedness; and (3) Impact of PANS on Giftedness. Conclusions: The rate of giftedness reported by parents of PANS subjects in this study is much higher than would be expected in the general population, even when adjusting generously for potential overestimation. This study of the "flip side" of PANS should serve as impetus for future studies regarding giftedness in this population; a robust finding of exceptionally high rates of giftedness would have implications for diagnosis, interpretation of symptoms (for example, perfectionism and social challenges) and disease management.