NIH Clinical Research Studies

Protocol Number: 02-M-0281

Active Accrual, Protocols Recruiting New Patients

Title:
The Characterization of Childhood Onset Obsessive Compulsive Disorder and the PANDAS Subgroup
Number:
02-M-0281
Summary:
The purpose of this study is to learn more about Obsessive-compulsive Disorder (OCD) in children. OCD usually has a slow onset, and symptoms that may remain at a stable level over time. A subset of children with OCD has a sudden onset and symptoms that fluctuate in severity over time. This study will also compare healthy children to those with OCD. This is an observational study; children who participate will not receive any new or experimental therapies.

OCD affects nearly 1% of the pediatric population. The symptoms of this illness can interrupt development, causing significant psychological distress and producing life-long impairments in social, academic, and occupational functioning. A subgroup of pediatric OCD has been designated by the acronym PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). This type of OCD is characterized by sudden symptom onset and a relapsing-remitting course of illness; exacerbation of symptoms occurs with scarlet fever or strep. throat infections. This study will identify factors that distinguish children with PANDAS OCD from children with non-PANDAS OCD, and will compare both groups to healthy children.

Children with OCD and their parents are screened with interviews and a review of the child's medical records. Participants have an initial evaluation that includes a psychiatric, physical and neuromotor exam, neuropsychological testing, psychological interviews, and a blood test. Structural magnetic resonance imaging (MRS) scans of the brain are also obtained. The MRS scan does not use radiation.

After the initial evaluation, children with OCD have follow-up visits every 6 weeks for 12 to 24 months. They are seen yearly for 8 years after the study. If they have a significant improvement or worsening of their symptoms, they are asked to make a maximum of two extra visits. Parents of OCD patients are called four times a year to discuss any changes in the child's condition between yearly visits. All participants have a 1-year follow-up visit upon study completion.

Sponsoring Institute:
National Institute of Mental Health (NIMH)
Recruitment Detail
Type: Active Accrual Of New Subjects
Gender: Male & Female
Referral Letter Required: No
Population Exclusion(s): None

Eligibility Criteria:
INCLUSION CRITERIA:

OCD Participants (N = 72)

1. Aged 4-18 years and living within a four-hour commute from NIH

2. Currently meet DSM-IV criteria for OCD.

3. Recent onset of symptoms (less than 6 months.)

Healthy Controls (N = 60-72)

1. Age and sex matched to ODC participants.

2. Must be free of current or past psychopathology.

EXCLUSION CRITERIA:

OCD Participants:

1. Diagnosis of schizophrenia, schizoaffective, bipolar, delusional, or psychotic disorder; autistic spectrum disorder or pervasive developmental disorder; neurologic disorder other than tics; or rheumatic fever.

2. Significant or unstable medical illness.

3. Full scale IQ less than 80.

Healthy Controls:

1. Full scale IQ less than 80.

2. Significant or unstable medical illness.

Special Instructions: Currently Not Provided
Keywords:
Tic Disorders
Neurophyschological
Immunology
Magnetic Resonance Imaging
Basal Ganglia
Obsessive-Compulsive Disorder
Children
Adolescents
Magnetic Resonance Spectroscopy
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated d
Recruitment Keywords:
Obsessive Compulsive Disorder
OCD
Healthy Volunteers
HV
Conditions:
Obsessive-Compulsive Disorder
Investigational Drug(s):
None
Investigational Device(s):
None

Contacts:
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:
Rosenberg DR, Keshavan MS, O'Hearn KM, Dick EL, Bagwell WW, Seymour AB, Montrose DM, Pierri JN, Birmaher B.

Frontostriatal measurement in treatment-naive children with obsessive-compulsive disorder. Arch Gen Psychiatry. 1997 Sep;54(9):824-30. PMID: 9294373

Rosenberg DR, Hanna GL. Genetic and imaging strategies in obsessive-compulsive disorder: potential implications for treatment development. Biol Psychiatry. 2000 Dec 15;48(12):1210-22. Review. PMID: 11137061

Saxena S, Brody AL, Schwartz JM, Baxter LR. Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatry Suppl. 1998;(35):26-37. Review. PMID: 9829024

Active Accrual, Protocols Recruiting New Patients

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