Can an infection trigger OCD?

Girl cleaning kitchen with sponge and rubber gloves

At the age of 7, Garrett Pohlman came home from the first day of second grade and was “a totally different person,” his mother said. Garrett experienced a sudden and dramatic onset of obsessive-compulsive disorder and other symptoms. He was weeping and terrified to go back to school.

At the time, Garrett had also been battling case after case of strep throat. His mother, Diana Pohlman, thought there might be a connection.

Doctors and psychiatrists have long debated whether there is a link between infections and certain psychiatric disorders, including OCD.

During the past few years, the notion has been earning more recognition in the scientific community. Resources have followed, including the creation in 2012 of a Stanford University clinic dedicated to studying and treating the condition, known most commonly as PANS, for pediatric acute-onset neuropsychiatric syndrome.

About 1% of children and adolescents in the U.S. have OCD, which can include symptoms such as fears of contamination and repetitive actions such as hand-washing. But since no large population studies have been done on the condition, no one knows how many of those cases might be considered PANS. Not all pediatric specialists agree PANS is a distinct disorder.

Some doctors say that children should be tested for infections such as strep throat if they experience dramatic and sudden-onset OCD to see if treatment with antibiotics improves symptoms. In some cases where pediatric patients have multiple relapses associated with strep infections, long-term use of antibiotics might be effective in preventing them, the doctors say.

Others contend that, until the data show a stronger connection, children should get standard care for OCD, usually cognitive-behavioral therapy and antidepressants.