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Tijdschrift voor Psychiatrie 54 (2012) 3, 235 - 243

Review article

Signs and significance of a tick-bite: psychiatric disorders associated with Lyme disease

H.N. Sno

background In view of the increased prevalence of Lyme disease and the increased attention given to the disease in the media, psychiatrists are more likely to be confronted with patients with psychiatric disorders that may be linked to Lyme disease.
aim To present an overview of some diagnostic problems and psychiatric disorders that can occur in the context of Lyme disease.
method The literature was reviewed systematically with the help of Medline and Embase for the period 1990-October 2010 and relevant articles were studied that were mentioned in the reference lists of the articles selected.
results The most frequently discussed psychiatric disorders associated with Lyme disease are depressive and psychotic disorders and cognitive impairment with memory and concentration disorders. Medically unexplained symptoms can be attributed to hitherto unrecognised Lyme disease. The fear of contracting Lyme disease can in itself lead to psychiatric decompensation.
conclusion Further investigations into borrelia-infection are indicated in case of atypical psychiatric disorders and/or an atypical response to treatment and when the anamnesis and/or physical examination are suggestive of Lyme disease.

keywords Borrelia burgdorferi, guideline, Lyme disease, neuroborreliosis, tick-bite