Asbahr F R, Negrão A B, Gentil V, Zanetta D M, da Paz J A, Marques-Dias M J, Kiss M H
Department of Psychiatry, Hospital das Clinicas, University of São Paulo Medical School, Brazil.
Am J Psychiatry. 1998 Aug;155(8):1122-4. doi: 10.1176/ajp.155.8.1122.
The incidence and course of neuropsychiatric symptoms were determined in pediatric patients with rheumatic fever.
The Leyton Obsessional Inventory and National Institute of Mental Health Global Obsessive-Compulsive Scale were used to evaluate children and adolescents who had rheumatic fever with Sydenham's chorea (N=30) or without chorea (N=20). They were assessed three times over 6 months from the onset of rheumatic fever. Psychiatric diagnoses were also determined.
Obsessive-compulsive symptoms abruptly appeared and peaked during the 2 months after the onset of rheumatic fever in 21 patients with chorea (70.0%) and were absent in all patients without chorea. Obsessive-compulsive disorder (OCD) was diagnosed in five patients with chorea (16.7%).
The association between Sydenham's chorea and OCD supports suggestions that similar mechanisms involving the basal ganglia underlie both disorders. Obsessive-compulsive symptoms occurred at the beginning of rheumatic fever, so early psychopathological assessments are essential.
确定风湿热儿科患者神经精神症状的发生率及病程。
使用莱顿强迫观念量表和美国国立精神卫生研究所全球强迫症量表对患有风湿热伴Sydenham舞蹈症（n = 30）或无舞蹈症（n = 20）的儿童及青少年进行评估。自风湿热发病起6个月内对他们进行3次评估。同时确定精神科诊断结果。
21例有舞蹈症的患者（70.0%）在风湿热发病后2个月内强迫症状突然出现并达到高峰，而所有无舞蹈症的患者均未出现强迫症状。5例有舞蹈症的患者（16.7%）被诊断为强迫症。
Sydenham舞蹈症与强迫症之间的关联支持了以下观点，即涉及基底神经节的相似机制是这两种疾病的基础。强迫症状在风湿热发病初期出现，因此早期心理病理学评估至关重要。
