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Obsessive compulsive disorder in adults with rheumatic heart disease

Published online by Cambridge University Press:  24 June 2014

Ashfaq-U-Rahaman
Affiliation:
Department of Psychiatry, NIMHANS, Bangalore, India
Y. C Janardhan Reddy*
Affiliation:
Department of Psychiatry, NIMHANS, Bangalore, India
Prabhavathi
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiology, Bangalore, India
Pramod Kumar Pal
Affiliation:
Department of Neurology, NIMHANS, Bangalore, India
*
Dr Y. C. Janardhan Reddy, Obsessive Compulsive Disorder Clinic, Department of Psychiatry, NIMHANS, Bangalore 560029, India. Tel: 0091-80-26995278, 26995306; Fax: 0091-80-26564822; E-mail: [email protected], [email protected]

Abstract

Objective:

There are considerable data on the possible association between streptococcal infection and obsessive compulsive disorder (OCD), particularly the relation between Sydenham’s chorea (SC) and OCD. However, neuropsychiatric sequelae related to streptococcal infection are mainly reported in children. In this preliminary study, we examined prevalence of OCD in a group of adult subjects with established rheumatic heart disease (RHD). We hypothesized that the rate of OCD would be higher than the known general population rates.

Method:

One hundred adult subjects with RHD were evaluated for OCD and other comorbid psychiatric disorders using well-known psychiatric assessment tools. A qualified psychiatrist conducted the assessments. The diagnoses were made according to DSM-IV criteria.

Results:

The rate of clinical OCD and subclinical OCD was 10% and 3%, respectively (n = 13), a rate much higher than the 1–3% rate reported in general population. Of the 13 subjects, only three had a history of SC (23%).

Conclusions:

OCD could be a long-term sequel in adults with a history of rheumatic fever in childhood, even in the absence of frank chorea. The findings call for systematic research in this little explored area.

Type
Brief Report
Copyright
Copyright © 2007 Blackwell Munksgaard

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References

Swedo, SE, Rapoport, JL, Cheslow, DL, Leonard, HL, Ayous, EM, Hosier, DM. High prevalence of obsessive-compulsive symptoms in patients with Sydenham’s chorea. Am J Psychiatry 1989;146:246249. Google ScholarPubMed
Swedo, SE, Leonard, HL, Garvey, MAet al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry 1998;155:264271. Google Scholar
Kim, SW, Grant, JE, Kim, SIet al. A possible association of recurrent streptococcal infections and acute onset of obsessive-compulsive disorder. J Neuropsychiatry Clin Neurosci 2004;16:252260. CrossRefGoogle ScholarPubMed
Giedd, JN, Rapoport, JL, Garvey, MA, Perlmutter, S, Swedo, SE. MRI assessment of children with obsessive-compulsive disorder of tics associated with streptococcal infection. Am J Psychiatry 2000;157:281283. CrossRefGoogle ScholarPubMed
Murphy, TK, Sajid, MW, Goodman, WK. Immunology of obsessive-compulsive disorder. Psychiatr Clin North Am 2006;29:445470. CrossRefGoogle ScholarPubMed
Saxena, S, Rauch, SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am 2000;23:563586. CrossRefGoogle ScholarPubMed
Whiteside, SP, Port, JD, Abramowitz, JS. A meta-analysis of functional neuroimaging in obsessive-compulsive disorder. Psychiatry Res 2004;132:6979. CrossRefGoogle ScholarPubMed
Mercadante, MT, Busatto, GF, Lombroso, PJet al. The psychiatric symptoms of rheumatic fever. Am J Psychiatry 2000;157:20362038. CrossRefGoogle ScholarPubMed
Swedo, SE. Sydenham’s chorea. A model for childhood autoimmune neuropsychiatric disorders. JAMA 1994;272:17881791. CrossRefGoogle ScholarPubMed
Asbahr, FR, Ramos, RT, Costa, AN, Sassi, RB. Obsessive-compulsive symptoms in adults with history of rheumatic fever, Sydenham’s chorea and type I diabetes mellitus: preliminary results. Acta Psychiatr Scand 2005;111:159161. CrossRefGoogle ScholarPubMed
Sanyal, SK. Longterm sequelae of the first episode of acute rheumatic fever during childhood. In: Moss, AJ, Adams, FH, Emmanouilides, GC, eds. Heart disease in infants, children and adolescents. Lippincott Williams & Wilkins, 1995; 14161440. Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KHet al. The Mini International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59 (Suppl. 20):2023. Google ScholarPubMed
Goodman, WK, Price, LH, Rasmussen, SAet al. The Yale-Brown Obsessive-Compulsive Scale. I: development, use, and reliability. Arch Gen Psychiatry 1989;46:10061011. CrossRefGoogle ScholarPubMed
Paul, DL, Hurst, CR. Schedule for Tourette and Behavioral syndromes: adult form version A3-Yale Family Genetic Study of Tourette Syndrome. New Haven, Connecticut: Yale Child Study Center, 1996. Google Scholar
Jenkins, R, Bebbington, P, Brugha, Tet al. The National Psychiatric Morbidity Surveys of Great Britain–strategy and methods. Psychol Med 1997;27:765774. CrossRefGoogle ScholarPubMed
Karno, M, Golding, JM, Sorenson, SB, Burnam, MA. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry 1988;45:10941099. CrossRefGoogle ScholarPubMed
Weissman, MM, Bland, RC, Canino, GJet al. The cross-national epidemiology of obsessive-compulsive disorder. J Clin Psychiatry 1994;55 (Suppl. 3):510. Google ScholarPubMed
Hounie, AG, Pauls, DL, Mercadante, MTet al. Obsessive-compulsive spectrum disorders in rheumatic fever with and without Sydenham’s chorea. J Clin Psychiatry 2004;65:994999. CrossRefGoogle ScholarPubMed
Bodner, SM, Morshed, SA, Peterson, BS. The question of PANDAS in adults. Biol Psychiatry 2001;49:807810. CrossRefGoogle ScholarPubMed
Dinn, WM, Harris, CL, McGonigal, KM, Rayanard, RC. Obsessive-compulsive disorder and immunocompetence. Int J Psychiatry Med 2001;31:311320. CrossRefGoogle ScholarPubMed