Obsessive-compulsive disorder, tic disorders, Tourette syndrome and other psychiatric disorders in rheumatic fever with or without Sydenham s Chorea patients / Transtorno obsessivo-compulsivo, tiques, síndrome de Tourette e outros transtornos psiquiátricos em pacientes com febre reumática, com ou sem Coréia de Sydenham.

AUTOR(ES)
DATA DE PUBLICAÇÃO

1999

RESUMO

Psychiatric disorders have been described as more frequent in Sydenham’s Chorea patients SC) than in rheumatic fever without SC (RF). The aim of this study was to investigate it the prevalence of psychiatric disorders in RF is associated with the occurrence of SC. Furthermore, age of onset of the various symptoms was determined in order to clarify the temporal relationship between the presence of psychiatric symptoms and either rheumatic fever or Sydenham’s Chorea. Using semi-structured diagnostic interviews for DSM-IV and ratings scales, the authors assessed 22 SC patients, 20 RF patients and 20 pediatric controls. Statistical Analyses were performed using Pearson chi-square (Fischer’s exact test for 2x2 tables) for comparisons of categorial variables. Comparisons of continuous variables among groups were carried out using ANOVA and the Student t-test, when only groups were analyzed. In order to establish the risk for the development of SC and OCD given to presence of other co-morbid conditions, a logistic regression was applied. The level of significance adopted was 0.05. Both the SC and RF groups showed a greater prevalence of psychiatric disorders. The SC sample showed higher frequency of major depression disorder (MDD) (x2 = 19,1, df = 2, p = 0,00007), tic disorder (TD) (x2 = 21,1, df = 2, p = 0,00001) and attention-deficit hyperactivity disorder (ADHD) (x2-21,7, df = 2, p = 0,0002). Although Obsessive-Compulsive Disorder (OCD) was not statiscally higher in the SC and RF groups, Obsessive-Compulsive Symptoms were more frequent in both RF and SC groups compared to the controls (x2 = 7,3, df = 2, p = 0,025). The age of onset for both ADHD and TD predicted the risk for development of SC. The risk of development of OCD in SC children was also associated with the age of onset of ADHD. RF seems to confer increased risk to develop neuropsychiatric disorders even in patients without SC. In this sample, ADHD and TD was an important risk factor for the occurrence of co-morbid illnesses.

ASSUNTO(S)

rheumatic fever/epidemiology transtorno da falta de atenÇÃo com hiperatividade/epidemiologia transtorno obsessivo-compulsivo/diagnóstico fatores de risco sÍndrome de tourette/epidemiologia attention deficit disorder with hyperactivity/epidemiology tourette syndrome/epidemiology obsessive-compulsive disorder/diagnostic risk factors febre reumÁtica/epidemiologia transtorno obsessivo-compulsivo/epidemiologia diagnÓstico duplo (psiquiatria) obsessive-compulsive disorder/epidemiology

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