Obsessive compulsive behavior, hyperactivity, and attention deficit disorder in Sydenham chorea

Area of Science:

• Neuroscience
• Psychiatry
• Pediatric Rheumatology

Background:

• Sydenham chorea (SC) is a neuropsychiatric disorder often associated with streptococcal infections.
• Obsessive-compulsive disorder (OCD) and attention deficit and hyperactivity disorder (ADHD) are common in pediatric populations.
• The relationship between SC and these neurodevelopmental disorders requires further investigation.

Purpose of the Study:

• To investigate the prevalence of obsessive-compulsive behavior, OCD, and ADHD in patients with Sydenham chorea.
• To compare these prevalence rates with those in healthy subjects and patients with rheumatic fever without chorea.
• To explore the association between persistent Sydenham chorea and ADHD.

Main Methods:

• A cross-sectional study involving 50 healthy subjects, 50 patients with rheumatic fever without chorea, and 56 patients with Sydenham chorea.
• Assessment of obsessive-compulsive behavior, OCD, and ADHD using standardized diagnostic criteria.
• Comparison of symptom frequencies across the three study groups.

Main Results:

• Obsessive-compulsive behavior, OCD, and ADHD were significantly more frequent in the Sydenham chorea group (19%, 23.2%, 30.4%) compared to healthy subjects (11%, 4%, 8%) and rheumatic fever patients (14%, 6%, 8%).
• Attention deficit and hyperactivity disorder (ADHD) demonstrated a higher prevalence in individuals with persistent Sydenham chorea.
• Specific prevalence rates for each condition were detailed for the Sydenham chorea cohort.

Conclusions:

• Sydenham chorea is associated with an increased risk of developing obsessive-compulsive behavior, OCD, and ADHD.
• Neuropsychiatric comorbidities, including OCD and ADHD, should be screened for in patients diagnosed with Sydenham chorea.
• The findings highlight the complex interplay between autoimmune processes, basal ganglia dysfunction, and neurodevelopmental disorders.