Some Suspect OCD Link to Strep in Kids

May 21, 2005 — -- What started out as a sore throat for Maury Cronauer two years ago developed into a frightening cascade of symptoms.

She began to exhibit bizarre behavior -- blurting out disturbing thoughts, obsessively washing her hands until her skin was raw. Her parents were completely baffled -- and frightened.

"When she would wake up in the morning we weren't sure what Maury we were going to get," said her mother, Michelle Cronauer.

A Surprising Diagnosis

Obsessive compulsive disorder afflicts millions of Americans, creating in them irrational fears and obsessions, such as fear of germs, fear of plastic utensils, or a constant need to wash one's hands.

It also affects approximately 1 percent of children, including Maury, now 6 years old.

What was most surprising to the Cronauers was that doctors linked Maury's obsessive compulsive behavior to a common ailment in children -- strep throat.

The theory is not yet widely accepted in the medical community, but it has been gaining more support.

The likely relationship, which is the subject of a New York Times Magazine cover story this Sunday, has been coined PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

While experts believe the condition is relatively rare -- striking about one in 1,000 children -- it could explain unusual symptoms in some kids following strep throat.

"We think that the strep causes obsessive compulsive disorder by creating antibodies that get mixed up and attack the child's own brain," said Dr. Susan Swedo of the National Institutes of Mental Health.

Antibiotic Treatment Helps Many

Dr. Christina Johns, an emergency room physician Children's National Medical Center in Washington, D.C., said doctors are seeing an association between strep and OCD in children but says that the link needs more study.

Johns said parents shouldn't panic but should be watchful if their child suffers from an infection and then begins exhibiting strange behavior.

"If you see your child taking more time getting ready for school or showing odd behavior, talk to your doctor," she said.

In the meantime, doctors say many children show marked improvement in OCD symptoms after antibiotic treatment.

Maury has been on antibiotics for two years now, and her obessive compulsive symptoms are gone.

Michelle Cronauer says the change is dramatic.

"We have our daughter back," she said. "She's always laughing, always playing."