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Truly Collaborative Care Delivering Personalized Treatment


How Infections Can Prompt OCD Behavior

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

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.

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.

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.

Treatment is Still Possible

Alongside any medical treatments that might be utilized (e.g. antibiotics, infusions, OCD medications) it appears that Cognitive Behavioral Therapy (CBT) protocols that are employed for OCD, in general, are also indicated for this population, including Exposure and Response Prevention (ERP). CBT can also be utilized to address the tics and other problems that may exist. Given the sudden and unexpected onset of symptoms, addressing the questions and concerns of parents and other family members is paramount. Implementing CBT as soon and consistently as possible after symptoms develop should also be strongly considered.

We encourage you to call us at (954) 280-3226 to learn more.

Inspirational Stories

  • “NBI has changed my life and i am so grateful to Dr. Moritz, Dr. Bechor, Dr. Spielman, and the entire NBI team.”


  • “The excellent care I received at the hands of NBI’s skilled and experienced practitioners made a real difference.”


  • “My life changed for the better, plain and simple.”


  • “Went above and beyond for me and my family, and would not accept anything less than seeing me through to a healthy life.”


  • “I finally found doctors who understood me and my thoughts. I had felt so alone, helpless and scared. After meeting Dr Moritz I was at ease, she and the other doctors at NBI were all trained in the treatment of OCD.”


  • CogMed Working Memory Training
  • Association of Psychology Postdoctoral Internship Centers (APPIC
  • American Board of Professional Psychology
  • International OCD Foundation