Psychiatric disorders in first-degree relatives of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
OBJECTIVE
To determine the rates of psychiatric disorders in the first-degree relatives of children with infection-triggered obsessive-compulsive disorder (OCD) and/or tics (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections; PANDAS).


METHODS
The probands of this study were 54 children with PANDAS (n = 24 with a primary diagnosis of OCD; n = 30 with a primary diagnosis of a tic disorder). One hundred fifty-seven first-degree relatives (100 parents [93%] and 57 siblings [100%]) were evaluated for the presence of a tic disorder. One hundred thirty-nine first-degree relatives (100 parents [93%] and 39 of 41 siblings over the age of 6 [95%]) were evaluated with clinical and structured psychiatric interviews to determine the presence of subclinical OCD, OCD, and other DSM-IV Axis I disorders.


RESULTS
Twenty-one probands (39%) had at least one first-degree relative with a history of a motor or vocal tic; 6 mothers (11%), 9 fathers (19%), and 8 siblings (16%) received this diagnosis. Fourteen probands (26%) had at least one first-degree relative with OCD; 10 mothers (19%), 5 fathers (11%), and 2 siblings (5%), received this diagnosis. An additional 8 parents (8%) and 3 siblings (8%) met criteria for subclinical OCD. Eleven parents (11%) had obsessive-compulsive personality disorder.


CONCLUSIONS
The rates of tic disorders and OCD in first-degree relatives of pediatric probands with PANDAS are higher than those reported in the general population and are similar to those reported previously for tic disorders and OCD. Further study is warranted to determine the nature of the relationship between genetic and environmental factors in PANDAS.
Lougee
L
L
Pediatrics and Developmental Neuropsychiatry Branch, NIMH, Bethesda, MD 20892-1255, USA. PANDAS@codon.nih.gov
Perlmutter
S J
SJ
Nicolson
R
R
Garvey
M A
MA
Swedo
S E
SE
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D020274:Autoimmune Diseases of the Nervous System / Q000235:genetics* / Q000276:immunology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009679:Nuclear Family / Q000523:psychology*; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000235:genetics* / Q000276:immunology; D015995:Prevalence; D012494:Sampling Studies; D013290:Streptococcal Infections / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000382:microbiology; D013297:Streptococcus pyogenes; D013981:Tic Disorders / Q000453:epidemiology* / Q000235:genetics* / Q000276:immunology; D014481:United States / Q000453:epidemiology