On Thursday, the International OCD Foundation (IOCDF) issued a warning that mental illnesses like OCD in children can be triggered by infections. Agency officials said, “If a parent recognizes these symptoms developing seemingly overnight, along with a glaring change in their child’s personality and/or behavior, they should immediately have their child tested for strep.”
There is a name for the type of disorder that the IOCDF was warning about. They are called PANDAS — or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. This unusual diagnosis is given to a group of children who suddenly develop Obsessive Compulsive Disorder or tic disorders (like Tourette’s Syndrome) after contracting infections such as strep throat or scarlet fever.
Swedo talked about treating it, saying, “If you treat it acutely with antibiotics, it will help quite quickly…But if a child gets another trigger, symptoms will return. If you have three episodes, the symptoms will become chronic.”
Swedo says there has been no research as yet to determine how often the sudden onset of the OCD disorder is preceded by strep or other infections, but she and Dr. Michael Jenike, a psychiatrist from Harvard Medical School who’s also been studying the problem, believe that current research in progress and their own observations indicate that the problem is more widspread than most people realize..
Jenike, who also chairs the IOCDF scientific advisory board, said “It could be dozens of kids a day in this country.”
New research suggests that strep may not be the only trigger to sudden OCD; it may be sparked by other infections, including chicken pox, Lyme disease — even the flu. This month, Swedo and other researchers have have expanded the definition of PANDAS to include more possible causes in a paper in the journal Pediatrics & Therapeutics. They are now calling it Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).
The trigger to the disorder is believed to be in the antibodies that are produced by the body normally to fight infection. In the case of a normal bacterial infection, the antibodies would attack the invading bacteria and help to purge them from the body. Researchers believe that in the case of PANDAS, patients’ antibodies may mistakenly attack the part of the brain that controls behaviors, emotions and physical movements.
The PANDAS diagnosis has been the subject of debate since it was first described in 1998. Parents who suspect their kids might have the disorder claim that they’re routinely discouraged by doctors who either aren’t familiar with the diagnosis or who do not accept it. Also, the American Academy of Pediatrics discourages the preventive administration of antibiotics for strep infections, advising treatment of active illness only.
Swedo assets that experts do agree on the existence of a subgroup of children who develop sudden, dramatic cases of OCD, along with a wide range of psychiatric and neural symptoms.
Swedo hopes the increased attention from the new PANS definition will expand awareness of the disorder among reluctant doctors. She said, “You have a treatable and perhaps preventable form of mental illness…While we’re debating, these kids could be being treated.”