The Neuroimmune Psychiatric Disorders (NIPD) Clinic provides care for children, adolescents, and young adults with complex neurological and psychiatric disorders following an infection or in association with an immune disorder. Our team of providers works with a diverse group of specialties to help give our patients comprehensive care.
New patients
Currently, we can only provide consultations to patients in northern New England (Maine, Massachusetts, New Hampshire, and Vermont).
If you or your child should be seen in the NIPD Clinic, please have your primary care provider send a referral to our clinic. Once you have received your appointment, download the intake information form and age-appropriate questionnaire for your child below. Fill these out in advance and bring them to your child's first appointment with us.
Please refer to the following sections on this page:
Conditions we treat
We evaluate and treat the following conditions:
- Childhood post-infectious autoimmune encephalopathy (CPAE) or pediatric autoimmune neuropsychiatric disorder (PANS)
- Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS)
- Post infectious neuropsychiatric or neuroinflammatory conditions in adolescents and adults
- Neuropsychiatric illnesses associated with autoimmune conditions such as:
- Inflammatory bowel disease
- Lupus
What is PANS or PANDAS?
PANS are descriptive names for the same group of conditions. They happen when a child’s immune response to an infection causes inflammation in the brain. The inflammation can cause the sudden onset of behavioral, neurological, and personality changes. It's called 'sudden onset' because the changes occur quickly, usually within 2 to 3 days. These conditions are diagnosed in children aged 3 years to puberty. These sudden symptoms include one or both of the following:
- Obsessive-compulsive disorder (OCD)
- Avoidant restrictive food intake disorder (ARFID)
PANDAS is a subset of PANS where symptoms are triggered by a streptococcus infection, like strep throat. Children who have had a recent infection or illness are at the highest risk for any of these conditions - PANS or PANDAS. To be diagnosed with PANS or PANDAS, a child must have either OCD or ARFID and 2 or more of the following neuropsychiatric symptoms:
- Anxiety (often social or separation)
- Behavioral or developmental regression (for example, baby talk)
- Change in school performance, ADHD-like symptoms, memory, and cognitive changes
- Depression or mood swings
- Irritability or aggression
- Sensory or motor changes (for example, new tics)
- Trouble sleeping, bedwetting, or urinary accidents
Our services
We focus on helping patients, their families, and physicians understand these complex conditions. Please note that we can only provide consultations to patients in northern New England (Maine, Massachusetts, New Hampshire, and Vermont).
Our team provides:
- Comprehensive evaluation
- Consultation
- Ongoing care, if indicated
- Treatments that incorporate medical and behavioral health including:
- Managing medications
- Preventing and treating infection and inflammation
- Treating neuropsychiatric symptoms and providing family support with psychotherapy
As part of their evaluation or treatment, your child may see providers from one or more of these specialties:
- Child and adolescent psychiatry
- Pediatric immunology
- Pediatric nephrology and integrative medicine
- Our consulting pediatric nephrologist: Matthew Hand, DO
- Pediatric neurology
- Pediatric rheumatology
- Our consulting pediatric rheumatologist: Daniel Albert, MD
Additional resources
The Alex Manfull Fund
The Alex Manfull Fund supports awareness, education, and research to further understand the incidence, etiology, and best treatment of post-infectious neuroimmune disorders (aka PANDAS, PANS, and Autoimmune Encephalitis) with an emphasis on their manifestation in Adolescents and Young Adults.
Neuroimmune Foundation
Neuroimmune Foundation is a nonprofit organization dedicated to improving the diagnosis, treatment, and outcomes of people with PANS/PANDAS, autoimmune encephalitis, and related neuroimmune and inflammatory brain disorders. This is done through clinician education, research, advocacy, clinical resources, and support for patients and families.
NIMH (National Institute of Mental Health)
NIMH (National Institute of Mental Health) provides an authoritative overview of PANS and PANDAS. They provide symptoms, possible immune and infectious causes, diagnostic criteria, treatment options, prognosis, and current areas of research and uncertainty.
Pace Foundation
Pace Foundation is a nonprofit organization dedicated to improving the diagnosis, treatment, and quality of life of children with pediatric autoimmune neurological disorders, including PANS/PANDAS. Through advocacy, education, and research, the Pace Foundation supports patients, families, and healthcare professionals.
PANS/PANDAS Physicians Network
PANS/PANDAS Physicians Network provides evidence-informed clinical guidance, diagnostic, and treatment resources. They also provide research, education, and a practitioner directory to help healthcare professionals recognize, evaluate, and effectively treat PANS and PANDAS.
PANDAS Network
PANDAS Network is a national nonprofit organization dedicated to improving the diagnosis and treatment of PANS/PANDAS. Through scientifically reviewed education and resources, they provide support to families and patients. They also provide clinician education, advocacy, public awareness, and funding and promotion of research.
Stanford Immune Behavioral Health (IBH) / PANS Program
Stanford Immune Behavioral Health (IBH) / PANS Program is a multidisciplinary clinical and research program dedicated to understanding, diagnosing, and treating PANS and related neuropsychiatric conditions. The program investigates how infections, inflammation, and immune-system abnormalities affect brain and psychiatric health.
Research
We focus on improving diagnosis and treatment for patients with neuroinflammatory conditions. Our program includes ongoing clinical, epidemiological, and basic science research into tests and treatments. We are part of the PANS Research Network, as well as the CPAE Clinics of Excellence Network.
Recommended journal articles and publications
- Pollak T, Lennox B, Müller S et al. Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. The Lancet Psychiatry, 2019; 7, 93-108
- Chang K, Frankovich J, Cooperstock M, et al. Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Journal of Child and Adolescent Psychopharmacology. 2015;25(1):3-13. doi:10.1089/cap.2014.0084
- Thienemann M, Murphy T, Leckman J, et al. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I—Psychiatric and Behavioral Interventions. Journal of Child and Adolescent Psychopharmacology. 2017;27(7):566-573
- Frankovich J, Swedo S, Murphy T, et al. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies. Journal of Child and Adolescent Psychopharmacology. 2017;27(7):574-593
- Cooperstock MS, Swedo SE, Pasternack MS, Murphy TK. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Prevention of Infections. Journal of Child and Adolescent Psychopharmacology. 2017;27(7):594-606. doi:10.1089/cap.2016.0151
- Endres, D., Pollak, T.A., Bechter, K. et al. Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?. Transl Psychiatry 12, 5 (2022).
Referrals and appointments
- If your child is a returning patient: You may use myDH to communicate securely with your child's providers, request or change appointments, review your child's medical record, and more.
- If you are a health care professional: To make sure the child you are referring is seen in the NIPD Clinic, please make sure you include NIPD as part of the referral.
Our team
Meet our NIPD clinic providers
NIPD nursing team
- Cathrine Nania, RN, Research
- Samantha Sewall, RN, Clinic