Inoff-Germain Gale, Rodríguez Romeo S, Torres-Alcantara Saul, Díaz-Jimenez María Juana, Swedo Susan E, Rapoport Judith L
Child Psychiatry Branch, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland 20892-1600, USA.
J Child Psychol Psychiatry. 2003 Jul;44(5):782-90. doi: 10.1111/1469-7610.00163.
Previous studies have documented that various behavioral disturbances accompany Sydenham's chorea, a neurologic variant of rheumatic fever. Further, an immunological marker associated with rheumatic fever (monoclonal antibody D8/17) has been reported to be elevated in several neuropsychiatric disorders, most frequently tics and obsessive-compulsive disorder. We examined this association in a community sample of children previously identified as being D8/17 positive or negative. It was hypothesized that D8/17 positivity would predict increased rates of tics and obsessive-compulsive disorder, even in the absence of Sydenham's chorea. Possible associations with other disorders accompanying Sydenham's chorea--hyperactivity, anxiety, and depression, also were explored.
From 1991 to 1995, 2631 children (mean age = 9.6 +/- 1.6 years) from a low socioeconomic area of Mexico City were screened for the D8/17 marker. In a 2- to 5-year follow-up of 240 of these children (108 positive and 132 negative), structured psychiatric interviews and rating scales were administered to the child and main caretaker. Assessments were conducted and scored blind to the child's D8/17 status.
No association was seen between D8/17 positivity and tics or OCD.
This study failed to provide support for the generalized use of D8/17 as a marker of susceptibility to tics and OCD in a community sample.
先前的研究已证明，风湿热的神经学变种—— Sydenham舞蹈病伴有各种行为障碍。此外，据报道，一种与风湿热相关的免疫标志物（单克隆抗体D8/17）在几种神经精神疾病中升高，最常见的是抽动症和强迫症。我们在一个先前被确定为D8/17阳性或阴性的儿童社区样本中研究了这种关联。据推测，即使没有Sydenham舞蹈病，D8/17阳性也可预测抽动症和强迫症的发病率增加。还探讨了与Sydenham舞蹈病伴随的其他疾病——多动、焦虑和抑郁的可能关联。
1991年至1995年，对来自墨西哥城一个社会经济地位较低地区的2631名儿童（平均年龄=9.6±1.6岁）进行了D8/17标志物筛查。在对其中240名儿童（108名阳性和132名阴性）进行的2至5年随访中，对儿童及其主要照顾者进行了结构化精神访谈和评定量表评估。评估是在不知道儿童D8/17状态的情况下进行和评分的。
未发现D8/17阳性与抽动症或强迫症之间存在关联。
本研究未能为在社区样本中普遍使用D8/17作为抽动症和强迫症易感性标志物提供支持。
