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Am J Psychiatry 157:2036-2038, December 2000
© 2000 American Psychiatric Association


Brief Report

The Psychiatric Symptoms of Rheumatic Fever

Marcos T. Mercadante, M.D., Ph.D., Geraldo F. Busatto, M.D., Ph.D., Paul J. Lombroso, M.D., Lísia Prado, B.S., Maria C. Rosário-Campos, M.D., M.Sc., Raquel do Valle, M.Sc., Maria J. Marques-Dias, M.D., Ph.D., Maria H. Kiss, M.D., Ph.D., James F. Leckman, M.D., and Euripedes C. Miguel, M.D., Ph.D.

OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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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