Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder

Loren K. Mell, Robert Davis, David Owens

Research output: Contribution to journalArticle

153 Citations (Scopus)

Abstract

Objective. Reports have suggested that streptococcal infection may be etiologically related to pediatric autoimmune neuropsychiatric disorders (PANDAS), but there are few good epidemiologic studies to support this theory. Using population-based data from a large West-Coast health maintenance organization, we assessed whether streptococcal infection was associated with increased risk for obsessive-compulsive disorder (OCD), Tourette's syndrome (TS), or tic disorder. Methods. This is a case-control study of children 4 to 13 years old receiving their first diagnosis of OCD, TS, or tic disorder between January 1992 and December 1999 at Group Health Cooperative outpatient facilities. Cases were matched to controls by birth date, gender, primary physician, and propensity to seek health care. Results. Patients with OCD, TS, or tic disorder were more likely than controls to have had prior streptococcal infection (OR: 2.22; 95% CI: 1.05, 4.69) in the 3 months before onset date. The risk was higher among children with multiple streptococcal infections within 12 months (OR: 3.10; 95% CI: 1.77, 8.96). Having multiple infections with group A β-hemolytic streptococcus within a 12-month period was associated with an increased risk for TS (OR: 13.6; 95% CI: 1.93, 51.0). These associations did not change appreciably when limited to cases with a clear date of onset of symptoms or with tighter matching on health care behavior. Conclusion. These findings lend epidemiologic evidence that PANDAS may arise as a result of a postinfectious autoimmune phenomenon induced by childhood streptococcal infection.

Original languageEnglish (US)
Pages (from-to)56-60
Number of pages5
JournalPediatrics
Volume116
Issue number1
DOIs
StatePublished - Dec 1 2005

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Tic Disorders
Tourette Syndrome
Streptococcal Infections
Obsessive-Compulsive Disorder
Delivery of Health Care
Health Maintenance Organizations
Streptococcus
Contraception
Case-Control Studies
Epidemiologic Studies
Outpatients
Pediatrics
Physicians
Health

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder. / Mell, Loren K.; Davis, Robert; Owens, David.

In: Pediatrics, Vol. 116, No. 1, 01.12.2005, p. 56-60.

Research output: Contribution to journalArticle

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