Article

The Psychiatric Symptoms of Rheumatic Fever

Yale University, New Haven, Connecticut, United States
American Journal of Psychiatry (Impact Factor: 12.3). 01/2001; 157(12):2036-8. DOI: 10.1176/appi.ajp.157.12.2036
Source: PubMed

ABSTRACT

This study examined the frequency and age at onset of psychiatric disorders among children with rheumatic fever, Sydenham's chorea, or both and a comparison group.
Twenty children with rheumatic fever, 22 with Sydenham's chorea, and 20 comparison children were assessed by means of a semistructured interview and rating scales for tic disorders and obsessive-compulsive disorder.
Obsessive-compulsive symptoms were more frequent in both the Sydenham's chorea and rheumatic fever groups than in the comparison group. The Sydenham's chorea group had a higher frequency of major depressive disorder, tic disorders, and attention deficit hyperactivity disorder (ADHD) than both the comparison and rheumatic fever groups. ADHD symptoms were associated with a higher risk of developing Sydenham's chorea.
Both the rheumatic fever and Sydenham's chorea groups were associated with a higher risk of developing neuropsychiatric disorders than the comparison group. ADHD appears to be a risk factor for Sydenham's chorea in children with rheumatic fever.

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Available from: James F Leckman, Jan 25, 2016
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    • "There are numerous descriptions of an association between infection, chronic inflammation of the CNS, and schizophrenia (Anderson et al., 2013). For example, symptoms of schizophrenia have been described in the encephalitic form of MS (Felgenhauer, 1990), in viral CNS infection with herpes simplex virus type 1 (HSV-1; Chiveri et al., 2003), HSV-2 (Oommen et al., 1982), and measles (Hiroshi et al., 2003) and also in autoimmune processes such as poststreptococcal disorders (Mercadante et al., 2000; Bechter et al., 2007; Kerbeshian et al., 2007; Teixeira et al., 2007), lupus erythematodes, and scleroderma (van Dam, 1991; Müller et al., 1992, 1993; Nikolich-Zugich, 2008). "
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    • "Choreiform movements that represented an overall worsening of neurological performance were noted to occur about 3 months following a tic exacerbation (Murphy et al. 2004). This type of lag is consistent with the finding that OCD symptoms precede the appearance of any motoric manifestation by days or weeks in patients with RF (Mercadante et al. 2000). The presence of neurological soft signs, such as choreiform movements and pronator sign/drift, are a frequently observed comorbidity among childhood onset OCD, tics, and ADHD; the significance of neurological soft signs in relationship to GAS infections has never been prospectively examined until recently (Murphy et al. 2007). "
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