Value-Based Management of Pediatric Acute-Onset OCD: A Case Consistent With Possible Pediatric Acute-Onset...

Area of Science:

• Neuroscience
• Pediatric Psychiatry
• Infectious Disease

Background:

• Obsessive-compulsive disorder (OCD) can present abruptly in adolescents.
• Pediatric acute-onset neuropsychiatric syndrome (PANS) is a potential diagnosis for sudden neuropsychiatric symptom onset.
• Value-based care models aim to optimize patient outcomes while managing costs.

Purpose of the Study:

• To describe a case of abrupt-onset OCD in a 14-year-old male following influenza A infection.
• To evaluate the diagnostic framework of possible PANS in this presentation.
• To illustrate a value-based care approach in managing severe pediatric neuropsychiatric conditions.

Main Methods:

• Case report of a 14-year-old male with sudden severe OCD symptoms post-influenza A.
• Consideration of differential diagnoses including traditional pediatric OCD and possible PANS.
• Implementation of pharmacotherapy (fluoxetine) under involuntary hold due to severity.
• Transition to intensive outpatient therapy post-stabilization.

Main Results:

• The patient experienced functional decline and severe OCD symptoms.
• Pharmacotherapy with fluoxetine led to stabilization.
• The patient transitioned successfully to intensive outpatient therapy.
• A value-based care approach reduced the need for prolonged higher levels of care.

Conclusions:

• Recognizing possible PANS is crucial for appropriate evaluation and timely intervention in abrupt-onset neuropsychiatric conditions.
• A value-based care model, emphasizing efficient diagnostics and coordinated transitions, can reduce costs without compromising outcomes.
• While antibody testing was not performed, the presentation suggests a possible PANS framework was beneficial for management.