P.A.N.D.A.S. and Child OCD

Pandas are adorable bamboo munching bears. P.A.N.D.A.S. on the other hand is Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Not cute.

P.A.N.D.A.S. is rare. Really quite rare. However, it exists and it is a thing.

This is not like the supposed link between autism and vaccinations…no this is studied and verifiable. It has even been recreated in mice.

Though it is real and recognizable it is still quite mysterious and while there is significant strength in the hypothesis there remains some controversy.

So what does P.A.N.D.A.S. have to do with child OCD??

In a P.A.N.D.A.S. case the child displays an abrupt, sudden onset of Obsessive Compulsive Disorder (OCD) symptoms shortly following experience of strep throat. Children in this situation are described as having severe obsessive thoughts and fears where before there were none.

When treated with antibiotic medication sometimes the symptoms of OCD decrease noticeably and sometimes they do not.

The resulting OCD experience is then treated the way other Child OCD is treated to read more click here.

P.A.N.D.A.S. onset OCD can be a bit different than other OCD presentations. In a P.A.N.D.A.S. case the use of antibiotic medications may decrease the symptoms and a recurrence of strep infection could suddenly worsen symptoms. While it is common for OCD symptom intensity to fluctuate in P.A.N.D.A.S. cases the symptoms are sometimes described as turning on and off.

Child psychologist with a little girl, a child is crying

In addition to the fluctuations of severity of symptoms there are often additional symptoms that occur alongside the OCD including ADHD symptoms, sudden experience of separation anxiety, mood changes, sleep disturbance, sudden onset night time bed wetting, joint pain, and changes in motor skills.

Research suggests that P.A.N.D.A.S. is caused when the child has a relatively rare reaction to their body’s antibodies to the streptococcal infection that causes brain swelling. That swelling then causes the symptoms and behaviors that are observed by the child’s family.

Why does this happen? The strep organism engages in cell “mimicry.” It is described as imitating other cells in the body to avoid detection by the body’s immune system as it gets established. Strep can imitate heart cells for example. The theory is that once the body detects the foreign body and sends out antibodies to fight them that sometimes the imitated cells can get caught in the crossfire. The result being that the antibodies begin to fight good cells that are just being mimicked by the strep hence the A in P.A.N.D.A.S that stands for autoimmune.

While there is still some question about P.A.N.D.A.S. they have been able to recreate OCD behaviors in lab mice by injecting streptococcal antibodies into their brains.

Generally strep throat is considered to be a relatively mild condition with today’s antibiotics though it is important to note that it is a moderately serious infection that can impact the heart. P.A.N.D.A.S. is is just another example of the potential ramifications of strep infections. I am not a medical doctor and am reporting this information based on my research. This is not the sort of topic into which I generally delve, but insofar as its impact on mental health and children it fascinates me.

Please consult a physician immediately if you think your child might have a strep infection, whether or not symptoms of obsessive compulsive disorder is present.

For more discussion about Obsessive Compulsive Disorder in Children click here.