NIH Looks into the Causes of Sudden Onset OCD

March 22, 2012

NIH Looks into the Causes of Sudden Onset OCD

[caption id="attachment_1274" align="alignleft" width="225" caption="Image courtesy of nattavut"][/caption] Obsessive-Compulsive Disorder, an anxiety disorder more popularly known by its acronym OCD, can be a debilitating disease. Many OCD patients are literally trapped inside of their own minds, knowing that the compulsive, repetitive behaviors that define their illness are wrong, yet powerless to stop them. Generally, a diagnosis of OCD is given around adolescence or young adulthood, however, the symptoms that lead up to that diagnosis are present for years. Often, young children with OCD can mask their compulsions because the degree of their anxiety is lower than that of adults and older children with a broader knowledge of the world. However, when OCD symptoms appear suddenly in children and teens the initial shock of this lifestyle change can be hard to understand or follow. Many professionals believe that OCD has both biological and psychological roots, which naturally leads to the concept of a sudden-onset of the disease. Parents, educators and friends will need to work along with medical personnel to help the child cope with their mental-new prison, all the while questioning what happened to this otherwise happy, well-adjusted child. Getting to the root of that cause is the goal of a new study commissioned by the National Institutes of Health (NIH). Looking at the criteria and causes of a more well-known sudden onset OCD called PANDAS (or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus), researchers Susan Swedo, M.D, from the National Institutes of Mental Health, James Leckman, M.D., from Yale University, and Noel Rose, M.D., Ph.D. from Johns Hopkins University, are working on a definition as well as a cause of what they have labeled PANS (or Pediatric Acute-onset Neuropsychiatric Syndrome). A New Definition While the cause of PANDAS is a specific reaction to the strep bacteria, the associated cause of PANS is completely unknown. For now, the definition of this disorder is based simply upon the previous condition, with the absence of strep as its predecessor. More specifically, a child or teen with PANS will present with all of the following:
  • An abrupt and dramatic onset of OCD symptoms or anorexia (a closely-related condition)
  • Concurrently present at least two additional acute neuropsychiatric symptoms that are similarly severe. These include: mood swings and depression; anxiety; developmental regression; aggression, irritability/oppositional behaviors; sensory or motor abnormalities; somatic signs and symptoms; sudden deterioration in learning abilities or school performance.
  • Symptoms that cannot be explained by a known medical or neurologic disorder.
In this last criterion, PANS differentiates itself from PANDAS and has opened up a new dimension of research designed to aid parents, caregivers and educators in helping the child or teen with sudden onset OCD adapt. A Hopeful Treatment While continuing to look for the cause of PANS, the researchers above have also collaborated with Madeline Cunningham of the University of Oklahoma to look into a treatment specific to sudden-onset of OCD associated with strep (PANDAS). There is hope that the success of these trials with intravenous immunoglobulin (IVIG) can subsequently be applied to PANS treatment as the causes of this condition are more clearly defined. Currently, the NIH has commissioned continued studies on both fronts. Source: Swedo, SE, Leckman JF, Rose, NR. (2012) Research Subgroup to Clinical Syndrome: Modifying the PANDAS criteria to describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics. 2:2. doi: 10.4172/2161-0665.1000113



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