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Plasma exchange and intravenous immunoglobulin improved symptoms in a subtype of obsessive compulsive disorder and tic disorders

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QUESTION: In children with infection triggered exacerbations of obsessive compulsive disorder (OCD) or tic disorders, how effective are plasma exchange and intravenous immunoglobulin (IVIG) in improving neuropsychiatric symptoms?

Design

Randomised {allocation concealed*}, partially blinded (clinicians and patients for IVIG and placebo)*, placebo controlled trial with 1 year of follow up.

Setting

US National Institute of Mental Health (NIMH) inpatient ward and outpatient clinic.

Patients

30 children who were 5–14 years of age (mean age 10 y, 63% boys) and met the DSM-III diagnosis for OCD, a tic disorder, or both. Other inclusion criteria were onset of neuropsychiatric signs and symptoms before puberty, history of sudden onset of signs and symptoms or an episodic course …

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