No one knows for certain what causes OCD. We know what areas of the brain are implicated in OCD, but the rest seems up for discussion. We need more research to understand this disorder. Some kids have OCD symptoms due to an umbrella of issues under PANDAS/PANS. Research is showing that inflammation in the brain can impact mental health and cause neuropsychiatric symptoms, including OCD. Many kids have autoimmune issues, infections such as strep or have had environmental exposure to things like mold or Lyme that can cause an inflammatory response.