Obsessive-Compulsive Disorder in Children

Have you noticed your child frequently washing his hands, setting things in order over and over, or checking and rechecking locks? Does he express anxiety about persistent, unwanted thoughts? Or perhaps you've noticed your child has developed a repetitive, involuntary muscle twitch in his face or shoulder. These are the classic symptoms of obsessive-compulsive (OCD) and tic disorders, two neurological conditions often appearing together.

A physician can diagnose and recommend treatment for the conditions. While this may alleviate some of your concern, undoubtedly you'll wonder why your child has developed one or both of these disorders.

According to an emerging theory, when obsessive-compulsive and/or tic disorders appear in a child, they may be caused by a seemingly unrelated common bacterial infection. Called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcus), the theory holds that group A streptococcus bacteria somehow alter the neurological system in some children, causing one or both of the disorders.

The results of a recent study support this theory. Twenty-five children with obsessive-compulsive and/or tic disorder were divided into two groups – those whose symptoms showed dramatic fluctuations and those whose symptoms were relatively stable. The researchers regularly analyzed blood samples from the children for the presence of group A strep antibodies. The antibodies indicated the immune system was fighting the bacterial infection. The researchers found the children with fluctuating OCD and/or tic symptoms had elevated antibody levels more frequently. Furthermore, almost all children with severe symptoms had elevated antibody levels. From this data, the researchers believe dramatic increases in obsessive-compulsive and tic severity may be related to a group A strep infection.

Although the results of this small study do not bring any immediate changes to the prevention and treatment of obsessive-compulsive and tic disorders in children, you will likely see future studies involving antibiotic interventions to prevent symptom exacerbations. Keep your eyes open for the results of these studies and talk with your child's physician about the implications.

October 2004 Update

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