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Int J Pediatr Otorhinolaryngol. 2017 Jan;92:38-44. doi: 10.1016/j.ijporl.2016.10.034. Epub 2016 Oct 31.

Improvement of psychiatric symptoms in youth following resolution of sinusitis.

Author information

1
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: tmahony@stanford.edu.
2
Pediatric Division of Otolarynthology, Stanford University School of Medicine, 730 Welch Road, Palo Alto, CA, 94304, USA. Electronic address: dsidell@stanford.edu.
3
Pediatric Division of Infectious Disease, Stanford University School of Medicine, 730 Welch Road, Palo Alto, CA, 94304, USA. Electronic address: drhayley@stanford.edu.
4
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: kbrown3@stanford.edu.
5
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: BFarhadian@stanfordchildrens.org.
6
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: MGustafson@stanfordchildrens.org.
7
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: jsherr@stanford.edu.
8
Pediatric Divisions of Child & Adolescent Psychiatry, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: mthiene@stanford.edu.
9
Pediatric Divisions of Allergy, Immunology, & Rheumatology, Stanford University School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA, 94304, USA. Electronic address: jfranko@stanford.edu.

Abstract

INTRODUCTION:

Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis.

METHODS:

We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis.

RESULTS:

10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up.

CONCLUSIONS:

Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed.

KEYWORDS:

Anxiety disorders; Behavior regression; Developmental regression; Obsessive-compulsive disorder; Sinusitis; Tic disorders

PMID:
28012531
DOI:
10.1016/j.ijporl.2016.10.034
[Indexed for MEDLINE]

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