March 2010. Volume 6. Number 1

Tics and obssesive-compulsive disorder in children are not associated with streptococcal infections

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Schrag A, Gilbert R, Giovannoni G, Robertson MM, Metcalfe C, Ben-Shlomo Y. Streptococcal infection, Tourette síndrome, and OCD. Is there a connection? Neurology. 2009;73:1256-63
Reviewers: Flores Antón B1, González Rodríguez MP2.
1Hospital Universitario de Fuenlabrada. Madrid. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Beatriz Flores Antón. Email: befloan@gmail.com
Reception date: 03/03/2010
Acceptance date: 03/03/2010
Publication date: 25/03/2010

Abstract

Authors’ conclusions: the present study does not support a strong relationship between streptococcal infections (SI) a neuropsychiatry syndromes such as obsessive-compulsive disorder (OCD), Tourette syndrome (TS) and tics in a large community-based sample of children and young adults between 2 and 25 years.

Reviewers’ commentary: this is a case-control study of a large primary care database, with a considerable number of patients. They compared cases of children with tic or OCD diagnoses to controls, and studied possible exposure to SI in the 2 to 5 years prior to tic/OCD diagnosis. The limitations include the possibilities of diagnostic misclassification of both the exposures and the behavioural outcomes. The diagnosis of SI was based on clinical impression, without bacterial culture. And the diagnosis of behavioural outcomes was based on general practitioner records, and therefore the validity of diagnosis could no be confirmed. However the results are in consonance with other publications and argue against a strong causal relationship between SI and clinical symptoms of tics or OCD at least in the majority of cases.

How to cite this article

Flores Antón B, González Rodríguez MP. Los niños con tics y trastorno obsesivo compulsivo no tienen antecedente de infección por estreptococo. Evid Pediatr.2010;6:9.

AVC | Critically appraised articles

Schrag A, Gilbert R, Giovannoni G, Robertson MM, Metcalfe C, Ben-Shlomo Y. Streptococcal infection, Tourette síndrome, and OCD. Is there a connection? Neurology. 2009;73:1256-63
Reviewers: Flores Antón B1, González Rodríguez MP2.
1Hospital Universitario de Fuenlabrada. Madrid. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Beatriz Flores Antón. Email: befloan@gmail.com
Reception date: 03/03/2010
Acceptance date: 03/03/2010
Publication date: 25/03/2010

How to cite this article

Flores Antón B, González Rodríguez MP. Los niños con tics y trastorno obsesivo compulsivo no tienen antecedente de infección por estreptococo. Evid Pediatr.2010;6:9.

References

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  2. Mell LK, Davis RL, Owens D. Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder. Pediatrics. 2005;116:56-60.
  3. Kurlan R, Jonson D, Kaplan E and the Tourette Síndrome study Group. Streptococcal infection and exacerbations of childhood tics and obsessive-compulsive symptoms: a prospective blinded cohort study. Pediatrics. 2008;121:1188-97.
  4. Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST et al. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2009;119:1541-51.
25/03/2010

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