Obsessive-compulsive symptoms among patients with Sydenham chorea.
BACKGROUND
Among patients with tic disorders, a distinctive clinical profile of obsessive-compulsive symptomatology has been described. The present investigation was designed to document the phenomenology of obsessive-compulsive symptoms (OCS) among patients with Sydenham chorea (SC), the neurologic variant of rheumatic fever. We hypothesized that OCS occurring in association with SC would be similar to those among patients with tic disorders.


METHODS
The authors studied the presence of OCS in 73 patients with SC by using the Yale-Brown Obsessive-Compulsive Scale at the Pediatric Clinics of the University of Sao Paulo Medical Center in Sao Paulo, Brazil (n = 45) and at the National Institute of Mental Health in Bethesda, Maryland (n = 28).


RESULTS
The most frequent symptoms observed among subjects with comorbid SC and OCS were aggressive, contamination, and somatic obsessions and checking, cleaning, and repeating compulsions. A principal component factor analysis yielded a five-factor solution (accounting for 64.5% of the total variance), with contamination and symmetry obsessions and cleaning compulsions loading highly.


CONCLUSIONS
The symptoms observed among the SC patients were different from those reported by patients with tic disorders but were similar to those previously noted among samples of pediatric patients with primary obsessive-compulsive disorder.
Asbahr
Fernando R
FR
Department of Psychiatry, Laboratory of Medical Investigation (LIM-23), University of São Paulo Medical School, Brazil. frasbahr@usp.br
Garvey
Marjorie A
MA
Snider
Lisa A
LA
Zanetta
Dirce M
DM
Elkis
Helio
H
Swedo
Susan E
SE
D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002819:Chorea / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000209:etiology*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012213:Rheumatic Fever / Q000209:etiology; D018709:Statistics, Nonparametric