Group A streptococcal infections do not appear to trigger Tourette syndrome (TS) or obsessive-compulsive disorder (OCD), according to a case-control study by researchers in England, a finding at odds with some smaller studies conducted in the United States (Schrag A et al. Neurology. doi:10.1212/WNL.0b013e3181bd10fd [published online ahead of print September 30, 2009]).
The researchers extracted data on nearly 700 000 patients from a community-based sample of individuals aged between 2 years and 25 years, for a nested case-control study. Among the 129 individuals diagnosed with OCD, 116 diagnosed with TS or tics (108 and 18, respectively), and 4519 controls matched for age, sex, and practice, the researchers identified 20 OCD cases (15.5%) and 13 TS or tic cases (10.3%) exposed to a possible streptococcal infection in the 2 years prior to their diagnosis; similar rates were found among controls. Risk of a prior possible untreated (no antibiotic prescribed) strep infection in the 2 years prior to onset of the disorder was slightly higher in patients with OCD vs controls.
Stephenson J. Strep and OCD, Tourette. JAMA. 2009;302(15):1640. doi:https://doi.org/10.1001/jama.2009.1526
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