Adult OCD

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Int J Psychiatry Med 2001;31(3):311-20

Obsessive-compulsive disorder and immunocompetence.

Dinn WM, CL, McGonigal KM, Raynard RC.

Boston University, Massachusetts, USA. dinn@...

OBJECTIVE: A postinfectious, autoimmune response may be associated with the

development of pediatric obsessive-compulsive disorder (OCD). According to

this model, antistreptococcal antibodies cross-react with basal ganglia

neurons following streptococcus infection. This autoimmune reaction disrupts

a basal ganglia-thalamocortical circuit and generates obsessive-compulsive

symptoms. One implication of this model is that prolonged immunologic stress

may be a risk factor for OCD. That is, immunologic stress may compromise the

blood-brain barrier and permit the influx of antistriatal antibodies into

the central nervous system. This article explores one part of this putative

relationship by investigating whether adult OCD patients, compared to

members of other psychiatric groups, demonstrate a higher incidence of

recurrent infections and other conditions suggestive of compromised immune

function. METHOD: To test this hypothesis, we conducted a medical records

review of 100 consecutive patients evaluated at a private psychiatric clinic

specializing in the treatment of anxiety disorders. Sixty-five patients met

diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD,

posttraumatic stress disorder, social anxiety disorder, generalized anxiety

disorder, panic disorder with agoraphobia, and dysthymic disorder. Each

medical record was reviewed for the presence of target syndromes or

presenting symptoms suggestive of compromised immune function. RESULTS:

Chart review revealed an increased rate of immune-related symptoms and

syndromes among OCD patients in comparison to other anxiety and mood

disorder groups. Groups did not differ significantly in the incidence of

non-immune symptoms and syndromes. CONCLUSION: Adult OCD patients appear to

have an increased rate of immune-related diseases above and beyond that seen

in other psychiatric disorders.

PMID: 11841128 [PubMed - in process]

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