OCD symptoms such as excessive handwashing may be caused by strep infections. Photocredit: Sciencelearn http://www.sciencelearn.org.nz/Contexts/Fighting-Infection/Sci-Media/Images/Washing-hands
Is there a link between strep throat and sudden onset obsessive compulsive disorder (OCD?) There is a rare condition known as PANDAS. No, there isn’t an army of lazy, bamboo-chewing bearish creatures behind you: it’s the snappy acronym for Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus.
The condition, which sees children quickly (and it’s that “quickly” which is key) developing OCD symptoms after being infected with strep, has seen some controversy, but now some studies show that the psychiatric illness may be set off by infections and the body’s own immune system. The studies include a 2010 Yale experiment in which it was demonstrated the children with OCD have worse symptoms after strep throat. With PANDAS, antibodies, used to fight infection, are believed to attack brain cells instead, resulting in symptoms of OCD. A 2003 study in Nature Medicine showed that strep antibodies are able to attach themselves to neurons, thereby releasing neurotransmitters which may cause OCD symptons, reported The Week. Doctors are split about how to treat it: some do it by antidepressants, others use antibiotics, which is controversial as it encourages resistance in bacteria. The consensus seems to be that whilst the link may be overplayed, it at least points researchers into new territories in helping to understand psychiatric disorders.
“The whole area of mental illness caused by infections is being looked at more closely because of PANDAS. If you can prevent lifelong suffering by using antibiotics or some acute intervention, that would be huge,” said Dr Michael A Jenike, a professor of psychiatry at Harvard Medical School, on The Seattle Times.
It’s not just strep throat. PANDAS was defined in 1998, by Dr Sue Swedo, said the OCD Foundation, which offers a guide to helping identify the condition. Significantly, her findings over the last decade have shown that while strep throat “seems to be a trigger, it may not be the only trigger.” Other possibilities include Lyme, Mono, Mycoplasma and flu.
Finding a cause for mental illness. The theory, though, is as yet unproved, but there is a possibility that some mental illnesses might be cured, reported The Seattle Times. Children often develop it within days or weeks of such simple infections, and the paper gave the example of a boy who insisted on his clothes being microwaved after catching the disease. Usually, said Dr Margo Thienemann, a child psychiatrist in California quoted in the paper, you don’t know what causes psychiatric illness. But with PANDAS you can see the cause.
But it doesn’t always happen. There is no test to help diagnose PANDAS, and there are no figures to show how many cases of OCD are linked to the condition. And in any case, most children don’t develop OCD symptoms after getting the disease. A study in the Journal of the American Academy of Child and Adolescent Psychiatry found no link between worsening symptoms of OCD and strep infections.
Though unproven, it may help wider issues. ”This disorder provides evidence for medical models of psychiatric illnesses, and for the idea that the brain = behavior. It is amazing and frightening that an illness that seems like a mere nuisance can lead to a severe behavioral change almost overnight. However, research and possible treatments appear promising, and this tiny disorder may contribute more to the body of neuropsychiatric knowledge than any other illness in the past,” said Cordelia Stearns on Serendip, the Bryn Mawr university newspaper.
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