Mom, My Throat Hurts
A Link Found Between Strep Infection and Obsessive-Compulsive Disorder in Children

Children tend to manifest illnesses in particular ways. Some always get ear infections, others develop croup, and still others tend to get strep throat repeatedly. Scientists have found that some obsessive-compulsive disorders (OCD) and tic disorders may be set off by the same infectious bacteria that cause strep throat.

While it is rare for children to develop OCD from strep, one in 1,000 children may develop OCD-related problems following a strep infection. The good news is that the infection itself can be treated successfully with antibiotics. Time, however, is an important factor in treatment. In children who do not exhibit a sore throat or fever with a strep infection, a sudden onset of OCD symptoms and /or tics should alert parents and doctors to the possibility of a hidden strep infection and the need for antibiotics.

Many pediatricians are still unfamiliar with the connection between strep and sudden-onset OCD. This association, discovered over a decade ago, is called PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection. Susan Swedo, MD, a member of the ADAA Scientific Advisory Board, helped discover the syndrome and heads the National Institute of Mental Health PANDAS research team. According to Dr. Swedo, about 1 in 10 young children with OCD fits the PANDAS criteria. These criteria are characterized by sudden, dramatic symptom onset and relapsing-remitting episodes, in which the child may be completely symptom-free one day, and unable to attend school the next day because of washing and repeating compulsions. Rapid diagnosis is helpful, because some children will improve after antibiotics treatment of the strep throat. Others are helped by the standard treatments for OCD, which generally involve serotonin-reuptake blocking medications and cognitive behavior therapy.

The relationship between strep infection and OCD is not the only one that connects mental disorders with physical causes. Advanced syphilis and lyme disease have both been linked to psychiatric syndromes, while strep is also thought to be possibly related to anorexia.