'Rheumatic' schizophrenia. An epidemiological study

It seems clear that rheumatic fever can involve the nervous system. Chorea is the most commonly recognized form of such involvement, but neurological symptoms suggestive of meningitis and encephalitis 3 as well as psychological symptoms 13,37 have also been observed. For nearly a century the literature has recognized the occasional presence of psychosis as an apparent symptom of rheumatic fever, 31 and from time to time the similarity of some of these psychoses to schizophrenia has been remarked. 4,19,23,27,31 The evidence of the present study suggests that far more may be involved than an occasional resemblance between rheumatic brain symptoms and schizophrenia. The hypothesis tested and supported here is that a large portion of schizophrenics, including many who present a typical schizophrenic course and symptomatology with no outstanding organic symptoms and no traditional signs of rheumatic fever , may nonetheless actually have psychoses