Can strep or another infection cause some children or adolescents to develop symptoms of Obsessive-Compulsive Disorder (OCD)?

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Drs. Susan Swedo, Henrietta Leonard, and Judith Rapoport of The National Institute of Mental Health considered this question. They examined cases when OCD, often accompanied by tics, had an unusually rapid onset following a strep infection, or similar medical problem. The terms PANDAS, and later PANS, were coined to describe such cases. PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, PANS means Pediatric Acute-onset Neuropsychiatric Syndrome.

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This group of patients studied often had also developed, seemingly “overnight,” dramatic changes in their behaviors, emotional expression, and habits, even in their academic abilities.

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Yet, understanding these cases and how to treat them remains very complicated—even experts often disagree about how best to proceed. Before considering diagnosing PANDAS/PANS, it is important to rule out other medical conditions that could create similar clinical presentations. However, it is common to use laboratory tests, like having blood drawn, to see if strep or another sort of infection is, or has been, present.