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When Infection Triggers OCD

By Marla W. Deibler, PsyD

In 1998, Dr. Susan Swedo, a researcher at NIMH, first described in the scientific literature a subtype of OCD in which children demonstrated an abrupt onset of neuropsychiatric symptoms (OCD, tics, ADHD-like symptoms, anxiety) with a “saw-toothed” course, preceded by streptococcal infection.  This syndrome was termed PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.  In PANDAS, the body’s immune system is over-reactive to strep bacteria, leading to psychiatric and neurological symptoms.  Dr. Swedo continued to study this subgroup and investigated potential therapies, including intravenous immunoglobulin (IVIG), plasmapheresis, and antibiotic prophylaxis to prevent symptom exacerbations. PANDAS remained a little known and debated diagnosis.

Dr. Swedo, and more recently, other researchers as well, have dedicated themselves to understanding this phenomenon.

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When Infection Triggers OCD

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  1. What about an unremitting headache? My 8 year-old son had strep and in the recovery period developed a headache that plagued him for three years. At the time, I suggested several times to the pediatricians and neurologists who we saw for help that his headache might be related to the strep infection which immediately preceded this sudden condition. No one was interested in that possibility. He also developed some depression, but it seemed possible it was the result of his constant headache at the time. But now I wonder about that, too. This happened sixteen years ago, but the impact on his life (all of ours) was considerable. He was accused of malingering in spite of being an enthusiastic and outstanding student, and, as his mother, I was accused of having done things wrong. This new information is so interesting! I sincerely hope it will help others in a way that it might have been useful to our family.

  2. So glad to see more attention being paid to PANDAS. Thanks for helping to get the word out about this very real disorder!

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