Psychiatric manifestations of Lyme borreliosis

J Clin Psychiatry. 1993 Jul;54(7):263-8.


Background: Lyme borreliosis (Lyme disease), a tick-borne spirochetal illness, has later manifestations that may include arthritic, neurologic, ophthalmologic, and cardiac symptoms. Recent reports suggest psychiatric symptoms may also be part of the clinical picture.

Method: Using a structured interview (SCID), we interviewed three patients who had developed a psychiatric disorder for the first time after infection with Borrelia burgdorferi.

Results: During Lyme borreliosis, one patient had major depression and panic disorder, one patient had an organic mood syndrome with both depression and mania, and the third patient had panic disorder. These disorders remitted after adequate antibiotic treatment.

Conclusion: While depression has been previously linked to neuroborreliosis, this is the first report to link panic disorder and mania with borrelial infection. Because of the rapid rise of Lyme borreliosis nationwide and the need for antibiotic treatment to prevent severe neurologic damage, mental health professionals need to be aware of its possible psychiatric presentations.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / etiology
  • Depressive Disorder / diagnosis
  • Depressive Disorder / etiology
  • Diagnosis, Differential
  • Female
  • Humans
  • Lyme Disease / complications*
  • Lyme Disease / diagnosis
  • Lyme Disease / psychology
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / etiology
  • Middle Aged
  • Neurocognitive Disorders / diagnosis
  • Neurocognitive Disorders / etiology
  • Panic Disorder / diagnosis
  • Panic Disorder / etiology
  • Psychiatric Status Rating Scales