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Relationship of Obsessive-Compulsive Disorder (OCD) to Sydenham Chorea (And Rheumatic Fever)

Reference Findings/ Critique
[Swedo1989] High Prevalence of Obsessive-Compulsive Symptoms in Patients with Sydenham’s Chorea.

Findings: (N=23, C=14) Children with prior Sydenham chorea had significantly more obsessive thoughts, compulsive behaviors, and interference than subjects with rheumatic fever without SC.
Critique: Sample size is small but there are few SC cases in US (under 200 cases)

[Swedo1993] Sydenham’s Chorea: Physical and Psychological Symptoms of St. Vitus’ Dance

Findings: (N=11) Obsessive Compulsive symptoms noted in 9 of subjects. Behavioral abnormalities appeared several days/weeks before chorea. Antineuronal antibodies noted in 10 of 11 subjects.
Critique: none noted

[Swedo1994] Sydenham’s Chorea. A Model for Childhood Autoimmune Neuropsychiatric Disorders.

Findings: (case study) 7 year old subject has increased clumsiness and difficulty in handwriting coincident with behavioral abnormalities (compulsive handwashing and separation anxiety) prior to onset of chorea. Paper raises whether an association exists between pathogenesis of behavioral abnormalities and resulting chorea.
Critique: case study

[Murphy2000] On defining Sydenham’s chorea: where do we draw the line?

Findings: (commentary) Article discusses whether diagnostic boundary of Sydenham’s chorea should be expanded to include primarily neuropsychiatric presentations now classified as cases of obsessive-compulsive disorder or Tourette’s syndrome.
Critique: More research needed

[Mercadante2000] The Psychiatric Symptoms of Rheumatic Fever.

Findings: (N=42, C=20) Obsessive-compulsive symptoms were more frequent in both the Sydenham’s chorea and rheumatic fever groups than in the comparison group.
Critique: Experiment is underpowered to reach conclusion regarding risk factors for SC.

[Asbahr2005] Obsessive-compulsive symptoms among patients with Sydenham chorea.

Findings: (N=73) Symptoms among SC patients were different from reported patients with tic disorders but similar to pediatric patients with OCD. Symptoms were tightly clustered along five factorswith contamination, symmetry obsessions and cleaning compulsions standing out.
Critique: tic disorder controls with OCD were from reported literature