Association between obsessive compulsive disorder and streptococcal infection: A systematic review and meta-analysis of observational studies
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: The development of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections hypothesis has led to growing interest towards potential association between streptococcal infections and obsessive compulsive disorder (OCD). However, findings from previous studies are inconsistent.Aims and Objectives: Primary objective was to evaluate the association between streptococcal infections and risk of OCD. Secondary objectives were summarizing evidence related to post-streptococcal neuropsychiatric syndromes, severity of OCD symptoms and autoimmune biomarkers.Methodology: Based on PRISMA 2020 guidelines, we conducted a systematic literature search in databases such as PubMed/MEDLINE and Google Scholar from inception to 30th April 2026. Observational studies evaluating streptococcal infection and OCD related outcomes were included. A standardized form was used for data extraction. Meta-analysis was performed using a random-effects model and generic inverse variance method. Risk of bias was assessed using Newcastle–Ottawa Scale.Results: 11 studies were included in qualitative synthesis. 4 studies were eligible for meta-analysis. Possible association between streptococcal infection and OCD was observed which was statistically non-significant. Moderate heterogeneity was observed across studies. Large epidemiological studies suggested increased risk of OCD following streptococcal infection, whereas no significant temporal relationship was observed between infection and symptom exacerbation in prospective longitudinal studies. Also, biomarker-based studies yielded inconsistent findings.Conclusion: Meta-analysis demonstrated a non-significant trend toward increased odds of OCD following streptococcal infection. Several studies supported a possible immunological relationship. But due to methodological heterogeneity and inconsistent findings, current evidence remains inconclusive. Other prospective studies are needed to clarify the role of streptococcal infections in the pathogenesis of OCD.
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W7204991215