Obsessive-Compulsive and Related Symptoms in Children and Adolescents With Rheumatic Fever With and Without Chorea: A Prospective 6-Month Study

• Published in: The American journal of psychiatry 1998-08, Vol.155 (8), p.1122-1124
• Main Authors: Asbahr, Fernando R., Negrão, André B., Gentil, Valentim, Zanetta, Dirce M.T., da Paz, José A., Marques-Dias, Maria J., Kiss, Maria H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult and adolescent clinical studies; Age of Onset; Anxiety disorders. Neuroses; Bacterial arthritis and osteitis; Bacterial diseases; Basal Ganglia - physiopathology; Biological and medical sciences; Child; Child psychology; Child, Preschool; Children; Children & youth; Chorea - epidemiology; Chorea - physiopathology; Comorbidity; Factors; Female; Fever; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Neuroses; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - epidemiology; Obsessive-Compulsive Disorder - physiopathology; Obsessive-compulsive disorders; Obsessive-Compulsive neuroses; Personality Inventory; Prospective Studies; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Rheumatic diseases; Rheumatic Fever - epidemiology; Rheumatic Fever - physiopathology; Sydenham's chorea
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.155.8.1122

OBJECTIVE: The incidence and course of neuropsychiatric symptoms were determined in pediatric patients with rheumatic fever. METHOD: The Leyton Obsessional Inventory and National Institute of Mental Health Global Obsessive-Compulsive Scale were used to evaluate children and adolescents who had rheumatic fever with Sydenham's chorea (N=30) or without chorea (N=20). They were assessed three times over 6 months from the onset of rheumatic fever. Psychiatric diagnoses were also determined. RESULTS: Obsessive-compulsive symptoms abruptly appeared and peaked during the 2 months after the onset of rheumatic fever in 21 patients with chorea (70.0%) and were absent in all patients without chorea. Obsessive-compulsive disorder (OCD) was diagnosed in five patients with chorea (16.7%). CONCLUSIONS: The association between Sydenham's chorea and OCD supports suggestions that similar mechanisms involving the basal ganglia underlie both disorders. Obsessive-compulsive symptoms occurred at the beginning of rheumatic fever, so early psychopathological assessments are essential. (Am J Psychiatry 1998; 155:1122-1124)