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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