The Question of ‘For Whom?’:The Boundaries and Limitations of the Biomedical Model in Defining and Legitimizing Pediatric Immune-Mediated Neuropsychiatric Disorders

Racial disparities in referrals for Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) reflect complex intersections of historical, clinical, and social factors. Key contributors include long standing inequities in access to care, with marginalized communities—especially Black, Indigenous, and People of Color (BIPOC)—experiencing delayed diagnosis or misdiagnosis. These disparities can also be traced back to the limitations of the biomedical model, which often fails to fully account for the social determinants of health and the lived experiences of affected populations while perpetuating objectivity and neutrality. As research into PANS evolves, questions about the sufficiency of the biomedical model in defining and legitimizing neuropsychiatric disorders triggered by infections become increasingly critical. The model’s reductionist approach often ignores the broader, context-specific factors that may contribute to the development and manifestation of such disorders. This work explores how physicians and psychiatrists can confront these challenges within the pediatric clinical setting by adopting more inclusive, culturally competent practices and integrating a biopsychosocial framework into diagnosis and treatment.