Obsessive-compulsive and related symptoms in children and adolescents with rheumatic fever with and without chorea: a prospective 6-month study.
OBJECTIVE
The incidence and course of neuropsychiatric symptoms were determined in pediatric patients with rheumatic fever.


METHODS
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.
Department of Psychiatry, Hospital das Clinicas, University of São Paulo Medical School, Brazil. frasbahr@usp.br
F R
FR
Asbahr
A B
AB
Negrão
V
V
Gentil
D M
DM
Zanetta
J A
JA
da Paz
M J
MJ
Marques-Dias
M H
MH
Kiss
D000293:Adolescent; D017668:Age of Onset; D001479:Basal Ganglia / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002819:Chorea / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D010555:Personality Inventory; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012213:Rheumatic Fever / Q000453:epidemiology* / Q000503:physiopathology