Taken together, these data raise the possibility of an association between childhood-onset OCD and central nervous system infection or inflammation together with poststreptococcal autoimmunity. Delineation of clinical patterns of disease aggregation may provide mechanistic insight into this disease. Further multicenter controlled studies—in addition to larger population-based studies—are needed to characterize medical comorbidities in pediatric OCD and may aid in the development of therapeutic strategies targeting the immune response.
