Childhood disorder prompts study of infection link to mental illness

[bemildred]

Brody Kennedy was a typical sixth-grader who loved to hang out with friends in Castaic and play video games. A strep-throat infection in October caused him to miss a couple of days of school, but he was eager to rejoin his classmates, recalls his mother, Tracy.

Then, a week after Brody became ill, he awoke one morning to find his world was no longer safe. Paranoid about germs and obsessed with cleanliness, he refused to touch things and showered several times a day. His fear prevented him from attending school, and he insisted on wearing nothing but a sheet or demanding that his mother microwave his clothes or heat them in the dryer before dressing.

So began a horrific battle with a sudden-onset mental illness that was diagnosed as pediatric autoimmune neuropsychiatric disorder associated with streptococcus, or PANDAS. The puzzling name describes children who have obsessive-compulsive disorder that occurs suddenly — and often dramatically — within days or weeks of a simple infection, such as strep throat.

"He washed his hands over and over and was using hand-sanitizer nonstop," said Tracy Kennedy, who has home-schooled her 11-year-old son since early November. "He had never been like this before. Ever. He just woke up with it."

http://www.latimes.com/health/la-he-ocd-strep-20111205,0,1049449.story

[MADem]

1. Isn't that the oddest thing.... nt

[kestrel91316]

2. Or....maybe his having a severe infectious disease caused his family to

obsess about germs and they indoctrinated that fear into him???

Because he became phobic about GERMS, not the millions of other things he could have obsessed about.

[gkhouston]

3. It was strep, not Ebola. I don't see any reason to think his family

went ultra-wacko on hygiene and somehow caused the change. Germ phobias seem to be pretty common among OCD sufferers.

[HysteryDiagnosis]

4. Maybe, maybe not.

http://www.ncbi.nlm.nih.gov/pubmed/21486169

J Child Adolesc Psychopharmacol. 2011 Apr;21(2):177-82. Epub 2011 Apr 12.
Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus in identical siblings.
Lewin AB, Storch EA, Murphy TK.
Source

Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida College of Medicine, St. Petersburg, Florida 33701, USA. [e-mail]
Abstract

Termed pediatric autoimmune neuropsychiatric disorders associated with Streptococcus (PANDAS), these cases of childhood-onset obsessive compulsive disorder and tic disorders resemble the presentation of Sydenham chorea, in that they have an acute onset following a group A beta-hemolytic streptococcal infection (group A Streptococcus), with accompanying neurological signs, and an episodic or sawtooth course. Familial associations of this subgroup of patients remain understudied. This report provides phenotypic descriptions of three youth with PANDAS as well as their genetically identical siblings (in two cases of twins and one case of triplets).

]These cases highlight the potential for environmental influences for discordant presentations in genetically identical siblings. Despite identical genetics, presentations showed marked variation across siblings (from a full PANDAS presentation to asymptomatic). Further research into environmentally driven influences such as postinfectious molecular mimicry and epigenetic factors that may influence the manifestation of these pediatric neuropsychiatric disorders will promote our understanding of their prevention and treatment.

PMID:
21486169