OCD treatment may focus on immune system, research says

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Capital News Service

LANSING — A new way of using drugs that target the immune system rather than the central nervous system may help treat obsessive-compulsive disorder, researchers say.

The study in the journal Brain, Behavior and Immunity, discovered that people with OCD have increased levels of an immune cell known as Imood. Tests of 23 patients with OCD and 20 healthy volunteers found the rate of Imood cells was six times higher in the OCD patients.

That suggests a way of treating mental health disorders with physical health medications, according to the researchers.

To Antonia Caretto, a psychologist from Farmington Hills, this isn’t the first time scientists have found a correlation between mental and physical health.

“We’ve often known how health and how we treat our health can impact our mental health conditions,” she said. 

“I see a lot of stuff these days about the gut biome and inflammation and mental health issues, or digestive tract issues and autism — so many connections we don’t know about,” Caretto said. 

“There’s always been this unfortunate distinction between health and mental health, and that divide is narrowing as these studies happen and we see that it’s not so easy to think that they’re separate,” she said.

One of the most prevalent correlations is between OCD and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). The disease is identified when OCD, tic disorders or other anxiety disorders suddenly appear following a strep infection, such as strep throat and scarlet fever.

Jennie Shanburn, a former OCD Foundation of Michigan board member from Royal Oak, said, “I first showed signs of OCD when I was 3 or 4 years old. 

“Looking back, my mom has said that she thinks I was sick with probably strep throat around when I had a very sudden onset of [OCD] symptoms for a little kid like that,” Shanburn said.

“One day, I was eating and the second day I couldn’t eat because I thought the food was dirty. Looking back, it could be due to strep and PANDAS,” she said. “It was interesting that I had a textbook case.”

PANDAS isn’t the only disease that bridges a gap between mental and physical health.

“Interestingly, just in the past year, going through some alternative health testing, I found that I am a strep carrier. That’s also related to not only OCD, but increased anxiety and stuff like that,” Shanburn said.

Studies have shown that celiac disease and non-celiac related gluten sensitivities also correlate with OCD and other psychiatric conditions such as schizophrenia and depression. Shanburn also has celiac disease.

Caretto said, “People often come in and it’s never as simple as, ‘I have this thing,’” Caretto said. “People are more complex than that, and when they come in for OCD, they often have autoimmune disorders or digestive issues or other things that might, at first, seem unrelated, but probably are related.”

There are no cures for OCD, but it can be managed with medications. One of the most common is Anafranil, an antidepressant.

“This medication was created to treat depression, and they found that, among people who had depression and OCD symptoms, it also helped the OCD,” Caretto said. “It’s great when research not only helps advance what they’re trying to do, but also helps in some other way that was unexpected.”

Exposure with Response Prevention (ERP) therapy is the most effective manager, according to Caretto. ERP is successful in managing OCD in 85% of cases, her website says.

The combination of an antidepressant and exposure therapy is the most efficient, according to Caretto.

“The difference being that medication acts more quickly, but on the other hand, the behavior changes may be more durable,” Caretto said. “The medication may give you relief faster, but you have a greater chance of your symptoms returning when the medication is over.”

Shanburn said, “ERP is definitely the best and the most proven treatment for OCD. It’s exposing yourself to your fears and exposing yourself to your daily compulsions that you don’t want to do.”

Support groups are also effective. The OCD Foundation of Michigan hosts in-person and online support groups. 

“The best therapist that I’ve had had OCD himself, because you can only fully understand it if you have it,” Shanburn said. “I tried to find other people who had it and could understand what we’re going through.”

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