A potential role for infection as a trigger for neuropsychiatric symptoms is supported by epidemiological evidence of an association between throat infections and mental disorders, in particular OCD (Orlovska et al. 2017). Although controversial, definitive evidence for causative pathogenic autoantibodies in humans is lacking (Dale et al. 2005; Morer et al. 2008) and PANDAS—together with pediatric acute-onset neuropsychiatric syndrome (PANS)—may account for as few as 5% of children attending some general pediatric OCD outpatient clinics (Jaspers-Fayer et al. 2017).
