(I would advise clicking on the print page for easier reading.)
December 01, 2007 Vol. 24 No. 14
Lyme Disease, Comorbid Tick-Borne Diseases, and Neuropsychiatric Disorders
By Robert C. Bransfield, MD
Many recall the phrase "To know syphilis is to know medicine." Now Lyme disease (Lyme borreliosis), the new "great imitator,"1 is the ultimate challenge to the breadth and depth of our knowledge. In psychiatry, we generally treat mental symptoms or syndromes rather than the underlying cause of a disorder.
A greater awareness of immune reactions to infections and other contributors to mental illness enhances our psychiatric capabilities.
Lyme disease, like syphilis, is caused by a spirochete with a multitude of pos-sible manifestations and 3 stages: early with dermatological symptoms, disseminated, and late stage.
Unlike Treponema pallidum, the cause of syphilis, the causative agent of Lyme disease, Borrelia burgdorferi, can be much more difficult to eliminate, diagnostic testing is less reliable, and interactive copathogens are major contributors in the pathophysiology.2,3
B burgdorferi is highly adaptable with 6 times as many genes as T pallidum and 3 times as many plasmids as any other bacteria that allow rapid genetic adaptations.4,5
It is a stealth pathogen that can evade the immune system and pathophysiological mechanisms.6,7
Knowingly or not, most psychiatrists have at some point been perplexed by patients with late-stage psychiatric manifestations of Lyme borreliosis. Several factors are associated with the risk of infection as well as the different manifestations of Lyme borreliosis (Table 1).
Frequent Contributor (1K+ posts)
Member # 8512
Good article - thanks!
I just sent the link off to my psychologist. If she reads the article, I suspect she will see me and probably many of her other clients represented here.
I have to remember that medical and naturopathic practitioners are not the only ones that need some education about what is happening out there in the Lyme World....
-------------------- Tracy .... Prayers for the Lyme Community - every day at 6 p.m. Pacific Time and 9 p.m. Eastern Time – just take a few moments to say a prayer wherever you are…. Posts: 2966 | From Colorado | Registered: Dec 2005
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sorry for the confusion......i know that dosen't help.....we are confused enough......
but i am new to all this..........i thought i was doing the right thing.
keebler.... thank you for re-doing the post....... also i don't know how or what to do for the
savely's.up front?? if anyone knows or wants to do that feel free....
truthfinder...... your welcome......
have a good day all..... mtree
-------------------- worrying about tomorrow takes its strength away from today Posts: 968 | From Point PLeasant , NJ | Registered: Jan 2008
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Honored Contributor (25K+ posts)
Member # 12673
mtree - no worries.
I had a hard time finding the link, too, but enjoyed getting sidetracked by the other articles which I would not have seen had just the direct link been posted.
For instance, this one: "Increase in Bipolar Diagnosis in Youth. . .- A recent analysis that found a 40-fold increase in the diagnosis of bipolar disorder in youth " ( well, I have to wonder if they consider evaluations for infections such as lyme.)
But, as many here are running on empty, direct links or copied text, broken up for easy reading is nice.
As for putting this up front, I don't know specifics as to how this happens but this seems a good article for everyone new to all this as an introduction. I was hoping if I mentioned it, someone would put it in the newbie section - but I'm too tired to pursue that myself.
The Savely article explains the differences in the IDSA and ILADS approaches offers much clarification as to the current climate in medical care. I think it's good to have this explanation early in the search for good care.
Clinical Advisor Clinical Feature Issue Story From the May 2007 issue of Clinical Advisor
CONTROVERSY CONTINUES TO FUEL THE "LYME WAR" By Virginia Savely, RN, FNP-C
As two medical societies battle over its diagnosis and treatment, Lyme disease remains a frequently missed illness. Here is how to spot and treat it.
"...If all cases were detected and treated in the early stages of Lyme disease, the debate over the diagnosis and treatment of late-stage disease would not be an issue, and devastating rheumatologic, neurologic, and cardiac complications could be avoided..."
. . . * Clinicians do not realize that the CDC has gone on record as saying the commercial Lyme tests are designed for epidemiologic rather than diagnostic purposes, and a diagnosis should be based on clinical presentation rather than serologic results.