Paper - Psychiatric aspects of Lyme disease in children and adolescents

Brian A. Fallon, MD, MPH, Hector Bird, MD, Christina Hoven, DrPH, Daniel Cameron, MD, MPH, Michael R. Liebowitz, MD, and David Shaffer, MD. Psychiatric aspects of Lyme disease in children and adolescents: A community epidemiologic study in Westchester, New York. Journal of Spirochetal and Tick-Borne Diseases. Vol. 1, No. 4, 1994. pp. 98-100.

To date, no community study has examined the psychiatric aspects and or sequelae of Lyme disease (LD) among children. As part of a community epidemilogic study of psychiatric disorders among children ages 9 through 17 in a Lyme endemic county, parents were asked whether their child had ever been diagnosed as having LD, and 10.1% (36/357) responded yes to the LD question. Of the 36, 29 also agreed to take part in a follow-up interview. Sixteen of the 29 children had had physician-diagnosed LD as well as either an erythema migrans rash or a positive serology. Fifteen of these 16 received treatment within 1 month of symptom onset; none of these 15 children were symptomatic longer than 4 months. Only one child had physical symptoms at the time of the interview; she was not treated until 4 months after symptom onset. The child experienced 5 years of intermittent arthritis, cognitive deficits, emotional problems, severe fatigue, and a deterioration in school performance. Courses of oral antibiotics were at first associated with a good response, followed by a resurgence of symptoms months later.

The lifetime prevalence of LD by history among children ages 9 through 17 in an endemic area may be at least 44.8/1000. In general, when LD is diagnosed early, it responds well to treatment. Delayed diagnosis and treatment may lead to a chronic course.