Can You Catch Obsessive-Compulsive Disorder? (New York Times)

[Guest guest]

Here's a long and interesting article (today's paper) on

obsessive-compulsive disorder. Some researchers believe OCD can be

caused by infection and others don't.

Research discussed included that of E. Swedo, a pediatrician and

researcher at the National Institute of Mental Health. " Her most

recent publication, in the April 2005 issue of Biological Psychiatry,

describes a new study of prophylactic antibiotics, one in which

administration of the medication was more closely controlled. The

results: Those who received the antibiotics saw ''significant

decreases'' in strep infections and in ''neuropsychiatric

exacerbations'' over the course of a year. "

http://www.nytimes.com/2005/05/22/magazine/22OCD.html

Sue ,

Upstate New York by Swedow

[Guest guest]

Excellent find, Sue!

Here is the PubMed citation:

http://tinyurl.com/cxolf

PMID: 15820236

The first paragraph of the intro makes a case for why testing the

efficacy of antibiotics is a valid way to infer bacterial etiology.

I'd like to see that approach used in other chronic illnesses.

Interestingly, the Azithro group received only 500 mg once per

week.

Unfortunately, they didn't have a placebo group. The penicillin

group was expected to be an " active placebo " since a previous

trial with sub-optimal doses of penicillin wasn't shown to be very

effective. But it turned out to be effective this time. That's going

to invite some criticism. I've been cheerleading for Dr. Swedo for

some time, but crap, by current standards there is no ethical

problems for including a true placebo group (since abx aren't

standard of care for OCD anyway). One could simply argue that

the children were included in the study because they had in the

previous year significant Strep infections and OCD and that there

would necessarily be less the second year (during the abx) for

no other reason than that a high level of Strep and OCD would

not be sustained (even in the absence of abx).

Hopefully this will at least inspire a bigger trial, and one that

includes a placebo group.

Matt

> Here's a long and interesting article (today's paper) on

> obsessive-compulsive disorder. Some researchers believe

OCD can be

> caused by infection and others don't.

>

> Research discussed included that of E. Swedo, a

pediatrician and

> researcher at the National Institute of Mental Health. " Her

most

> recent publication, in the April 2005 issue of Biological

Psychiatry,

> describes a new study of prophylactic antibiotics, one in which

> administration of the medication was more closely controlled.

The

> results: Those who received the antibiotics saw ''significant

> decreases'' in strep infections and in ''neuropsychiatric

> exacerbations'' over the course of a year. "

>

> http://www.nytimes.com/2005/05/22/magazine/22OCD.html

>

> Sue ,

> Upstate New York by Swedow