PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette's Syndrome, and in whom symptoms worsen following strep. infections such as "Strep throat" and Scarlet Fever. The children usually have dramatic, "overnight" onset of symptoms, including motor or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable or show concerns about separating from parents or loved ones. This abrupt onset is generally preceeded by a Strep. throat infection.
What is the mechanism behind this phenomenon? At present, it is unknown but researchers at the NIMH are pursuing a theory that the mechanism is similar to that of Rheumatic Fever, an autoimmune disorder triggered by strep. throat infections. In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and "attack" the heart valves, joints, and/or certain parts of the brain. This phenomenon is called "molecular mimicry", which means that proteins on the cell wall of the strep. bacteria are similar in some way to the proteins of the heart valve, joints, or brain. Because the antibodies set off an immune reaction which damages those tissues, the child with Rheumatic Fever can get heart disease (especially mitral valve regurgitation), arthritis, and/or abnormal movements known as Sydenham’s Chorea or St. Vitus Dance. In PANDAS, it is believed that something very similar to Sydenham’s Chorea occurs. One part of the brain that is affected in PANDAS is the Basal Ganglia, which is believed to be responsible for movement and behavior. Thus, the antibodies interact with the brain to cause tics and/or OCD, instead of Sydenham Chorea.
Do you think you or a loved one may have an Obsessive-Compulsive Disorder (OCD). Click for a short quiz from PsychCentral to help you evaluate the seriousness of the condition.
Have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly neat.
Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again.
Have unwanted thoughts and behaviors they can’t control.
Don’t get pleasure from the behaviors or rituals, but get brief relief from the anxiety the thoughts cause.
Spend at least an hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.
There is help for people with OCD. The first step is to go to a physician or health clinic to talk about symptoms. The physician will do an exam to make sure that another physical problem isn’t causing the symptoms. The physician may make a referral to a mental health specialist.
Physicians may prescribe medication to help relieve OCD. It’s important to know that some of these medicines may take a few weeks to start working. Medications can be prescribed by M.D.s (usually a psychiatrist) and in some states also by clinical psychologists, psychiatric nurse practitioners, and advanced psychiatric nurse specialists. Check with your state’s licensing agency for specifics.
The kinds of medicines used to treat OCD are listed below. Some of these medicines are used to treat other problems, such as depression, but also are helpful for OCD.
Antidepressants
Antianxiety medicines
Beta-blockers
Physicians also may ask people with OCD to go to therapy with a licensed social worker, psychologist, or psychiatrist. This treatment can help people with OCD feel less anxious and fearful.
There is no cure for OCD yet, but treatments can give relief to people who have it and help them live a more normal life. If you know someone with signs of OCD, talk to him or her about seeing a physician. Offer to go along for support. To find out more about OCD, call 1-866-615-NIMH (1-866-615-6464) to have free information mailed to you.
