1. A 3-to-15-year follow-up medical, neurological, psychiatric, and social-adjustment study has been conducted on 20 patients who were admitted to the children's ward of the psychiatric division of Bellevue Hospital.2. The social adjustment and psychiatric outcome of this group of patients were extremely poor.3. Several cases showed subsequent neurological findings suggestive of a permanent damage or long-continued organic brain disturbance by the rheumatic process. Further investigation in this area must be done before definite conclusions can be drawn.4. The poor social adjustment and psychiatric outcome appeared to depend upon the interaction of several factors, the relative roles of which can be determined only by future investigation. They were primarily: (1) social and emotional deprivation, (2) pre-existing disease other than the chorea, i.e., encephalitis and schizophrenia, (3) a low IQ, (4) a profound reading disability, (5) a prolonged serious illness that interfered with their normal education and personality development, (6) a possible permanent damage or long-continued organic brain disturbance by the rheumatic process.Abstract Teaser