Original articleObsessive-Compulsive Spectrum Disorders and Rheumatic Fever: A Family Study
Section snippets
Sample Selection
The ethical committee of the Clinical Hospital of the University of São Paulo approved this study. All subjects and their relatives gave their informed consent before entering in the study. Case probands were recruited from an RF outpatient clinic and control probands were recruited by research assistants from an orthopedic outpatient clinic at the University of São Paulo Medical School. Probands who agreed to participate and gave permission to contact their first-degree relatives (FDRs) were
Demographic and Clinical Characteristics
Demographic and clinical characteristics of the probands and relatives are shown in Table 1, Table 2, respectively. For a more detailed description of clinical features of the probands, see Hounie et al (2004).
The RF probands were more frequently affected with OCSD than were controls (Table 1). Table 3 shows the frequency and morbid risk of each OCSD in relatives of probands with and without RF. Although the frequency of each OCSD was not different in relatives of RF and controls, when these
Discussion
This is the first family study investigating psychiatric disorders in FDRs of RF probands. The results reported herein support the hypothesis that a familial relationship exists between RF and OCSDs. The rate of OCSDs among FDRs of RF probands was significantly higher than the rate among FDRs of controls. The rate of OCSDs was highest among FDRs of RF+OCSD probands. However, the rate of OCSD was also higher among FDRs of RF probands without an OCSD, although the difference was not statistically
Conclusions
The present findings suggest a familial relationship between RF and OCSDs. If these findings are replicated, clinicians should systematically obtain information about OCSD symptoms in their RF patients and family members. Similarly, the investigation of RF might be included in the psychiatric evaluation of OCSD patients. Further neuroimmunological and genetic studies are needed in order to confirm the present findings and to elucidate the mechanisms through which RF confers a high risk of OCSD
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2020, Neuroscience and Biobehavioral ReviewsCitation Excerpt :Arguably, the strongest evidence of the association between TS/CTD and autoimmune diseases originates from a handful of family studies suggesting that the first-degree relatives of individuals with TS or CTD have elevated rates of autoimmune diseases. A Brazilian family study (Hounie et al., 2007; Seixas et al., 2008) found that the rate of OCD and related conditions, including tic disorders, was significantly higher among first-degree relatives of individuals with rheumatic fever than among first-degree relatives of controls (14.7 % vs. 7.3 %) (Hounie et al., 2007), and the risk of OCD and related disorders was increased by the presence of either rheumatic fever or Sydenham’s chorea in another family member (Seixas et al., 2008). In another clinic-based study (Murphy et al., 2010), the mothers of 107 children and adolescents with OCD and/or tics were interviewed regarding their history of autoimmune diseases.
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2018, PsychoneuroendocrinologyThe link between autoimmune diseases and obsessive-compulsive and tic disorders: A systematic review
2016, Neuroscience and Biobehavioral ReviewsCitation Excerpt :The most common maternal ADs were UC, RA, thyrotoxicosis, and MS, although power was limited to examine the risk for many of the individual ADs (Dalsgaard et al., 2015). In two case-control family studies that analyzed the same Brazilian sample with different statistical approaches (Hounie et al., 2007; Seixas et al., 2008), the rate of obsessive-compulsive spectrum disorders, including OCD and tic disorders, was significantly higher among first degree relatives of individuals with RF (of whom 28 had SC and 31 did not) than among first degree relatives of controls. Thus, there is some preliminary evidence to suggest that ADs and OCD/tic disorders may co-aggregate in families but the available studies have been generally underpowered to examine the association with individual ADs and require replication.