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Thèse de Doctorat
DOI
https://doi.org/10.11606/T.5.1999.tde-24082005-143635
Document
Auteur
Nom complet
Marcos Tomanik Mercadante
Adresse Mail
Unité de l'USP
Domain de Connaissance
Date de Soutenance
Editeur
São Paulo, 1999
Directeur
Jury
Miguel Filho, Euripedes Constantino (Président)
Gentil Filho, Valentim
Kiss, Maria Helena Bittencourt
Porto, José Alberto Del
Vallada Filho, Homero Pinto
Titre en portugais
Transtorno obsessivo-compulsivo, tiques, síndrome de Tourette e outros transtornos psiquiátricos em pacientes com febre reumática, com ou sem Coréia de Sydenham.
Mots-clés en portugais
DIAGNÓSTICO DUPLO (PSIQUIATRIA)
FATORES DE RISCO
FEBRE REUMÁTICA/epidemiologia
SÍNDROME DE TOURETTE/epidemiologia
TRANSTORNO DA FALTA DE ATENÇÃO COM HIPERATIVIDADE/epidemiologia
TRANSTORNO OBSESSIVO-COMPULSIVO/diagnóstico
TRANSTORNO OBSESSIVO-COMPULSIVO/epidemiologia
Resumé en portugais
Transtornos psiquiátricos têm sido descritos com maior freqüência em pacientes com Coréia de Sydenham (CS) do que em pacientes com Febre Reumática(FR) sem CS. Os objetivos desse estudo forma o de verificar: se existe uma freqüência aumentada de transtornos psiquiátricos em pacientes com FR comparados a um grupo controle; se estes transtornos psiquiátricos apresentam freqüência aumentada em grupo de pacientes com Coréia de Sydenham, a manifestação da FR no Sistema Nervoso Central, comparado ao grupo de pacientes com FR sem CS; e, por fim, verificar a relação temporal entre o início destes diversos transtornos e o início da FR. Concluiu-se que a presença de FR está associada a uma maior freqüência de transtornos psiquiátricos, mesmo na ausência de CS. O TDHA e o TT, neste estudo, foram indicados como fatores de risco para o desenvolvimento de CS em pacientes com FR.
Titre en anglais
Obsessive-compulsive disorder, tic disorders, Tourette syndrome and other psychiatric disorders in rheumatic fever with or without Sydenham's Chorea patients
Mots-clés en anglais
ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY/epidemiology
OBSESSIVE-COMPULSIVE DISORDER/diagnostic
OBSESSIVE-COMPULSIVE DISORDER/epidemiology
RHEUMATIC FEVER/epidemiology
RISK FACTORS
TOURETTE SYNDROME/epidemiology
Resumé en anglais
Psychiatric disorders have been described as more frequent in Sydenham’s Chorea patients SC) than in rheumatic fever without SC (RF). The aim of this study was to investigate it the prevalence of psychiatric disorders in RF is associated with the occurrence of SC. Furthermore, age of onset of the various symptoms was determined in order to clarify the temporal relationship between the presence of psychiatric symptoms and either rheumatic fever or Sydenham’s Chorea. Using semi-structured diagnostic interviews for DSM-IV and ratings scales, the authors assessed 22 SC patients, 20 RF patients and 20 pediatric controls. Statistical Analyses were performed using Pearson chi-square (Fischer’s exact test for 2x2 tables) for comparisons of categorial variables. Comparisons of continuous variables among groups were carried out using ANOVA and the Student t-test, when only groups were analyzed. In order to establish the risk for the development of SC and OCD given to presence of other co-morbid conditions, a logistic regression was applied. The level of significance adopted was 0.05. Both the SC and RF groups showed a greater prevalence of psychiatric disorders. The SC sample showed higher frequency of major depression disorder (MDD) (x2 = 19,1, df = 2, p = 0,00007), tic disorder (TD) (x2 = 21,1, df = 2, p = 0,00001) and attention-deficit hyperactivity disorder (ADHD) (x2-21,7, df = 2, p = 0,0002). Although Obsessive-Compulsive Disorder (OCD) was not statiscally higher in the SC and RF groups, Obsessive-Compulsive Symptoms were more frequent in both RF and SC groups compared to the controls (x2 = 7,3, df = 2, p = 0,025). The age of onset for both ADHD and TD predicted the risk for development of SC. The risk of development of OCD in SC children was also associated with the age of onset of ADHD. RF seems to confer increased risk to develop neuropsychiatric disorders even in patients without SC. In this sample, ADHD and TD was an important risk factor for the occurrence of co-morbid illnesses.
 
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Date de Publication
2005-10-07
 
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