title: Higher prevalence of obsessive-compulsive spectrum disorders in rheumatic fever.
abstract: OBJECTIVE
  This study aims to compare the prevalence of obsessive-compulsive spectrum disorders (OCSD) in psychiatric outpatients with and without a history of rheumatic fever (RF).
  
  
  METHODS
  An analytical cross-sectional study assessing a large sample of consecutive psychiatric outpatients at a Brazilian private practice was conducted during a 10-year period. Psychiatric diagnoses were made by a senior psychiatrist based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Best-estimate diagnosis procedure was also performed.
  
  
  RESULTS
  The total sample comprised 678 subjects, 13 of whom (1.92%) presented with a previous history of RF. This group showed a higher prevalence of subclinical obsessive-compulsive disorder (P=.025) and OCSD (P=.007) when compared to individuals with no such history.
  
  
  CONCLUSIONS
  A previous history of RF was associated with OCSD. These results suggest that clinicians should be encouraged to actively investigate obsessive-compulsive symptoms and related disorders in patients with a positive history of RF.
authors.affiliation: Department and Institute of Psychiatry, University of Sao Paulo Medical School, São Paulo, Brazil. pedrodealvarenga@gmail.com
authors.forename: Pedro Gomes
authors.initials: PG
authors.lastname: de Alvarenga
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Floresi
authors.forename: Albina R
authors.initials: AR
authors.lastname: Torres
authors.forename: Ana G
authors.initials: AG
authors.lastname: Hounie
authors.forename: Victor
authors.initials: V
authors.lastname: Fossaluza
authors.forename: André F
authors.initials: AF
authors.lastname: Gentil
authors.forename: Carlos A B
authors.initials: CA
authors.lastname: Pereira
authors.forename: Eurípedes C
authors.initials: EC
authors.lastname: Miguel
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002819:Chorea / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012213:Rheumatic Fever / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology