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The role of Borrelia in mental health

Many people are unaware that there can be a direct connection between Borreliosis and mental illness.

Scientists and physicians in many different countries have discovered that a significant number of people with mental illness and diseases of the nervous system can be cured, or their condition improved, by treatment with antibiotics. In other words, bacteria can make people mentally ill as well as physically ill.

The connection

Around the world, certain cases of Schizophrenia, Multiple Sclerosis, Alzheimer's disease, and even Stroke, have been found to have something in common with each other; namely, Borrelia bacteria.

Borrelia spirochaetes are similar to Treponema spirochaetes (the causative agent of Syphilis), which were once a major cause of mental ill-health before the days of penicillin. Both bacteria are large and spiral in shape (spirochaetes) but, unlike Syphilis, Borreliosis can be hard to detect so might not even be considered when trying to find the cause of a patient’s ill-health.

Physical effects on the brain or nervous system

Borreliosis can cause a vast range of symptoms, from mild flu-like aches, fever, or skin rashes, to heart-block and paralysis. But this nasty bacterium can also cause a rapid onset of psychosis.

Bacteria such as Streptococcus species (which normally live harmlessly in our throats, skin and other tissue) are able to invade our brains. Likewise, Borrelia can enter the central nervous system, causing severe and sometimes life-threatening complications. Victims can suffer from meningitis, hallucinations, panic disorders, and manic depression. Some physicians believe that Borrelia can cause anorexia or episodes of uncontrollable rage (sometimes referred to as ‘Lyme rage’).

Psychological effects of prolonged suffering

The neuropsychiatric manifestation of a Borrelia infection is not the only problem. Mental illness can also occur due to the patient suffering from debilitating symptoms for months or years on end. This may arise from an inadequately treated infection, or from immunologic mechanisms that are triggered by the infection. Some patients are unable to cope with the lack of quality of life, and sadly this can sometimes result in suicide.

Worldwide studies provide evidence

Evidence of the link, between cases of mental illness or brain disease and Borreliosis infection, is found in a number of medical studies published in recent literature. Descriptions of these studies are given in following pages, and include:

  1. US study on the psychiatric effects of Borreliosis in children.
  2. Case study of suspected ALS patient in Austria.
  3. Psychotropic drug failure in Dutch patient with psychosis.
  4. Study of psychiatric patients in Prague.
  5. Case study of German patient with schizophrenia-like symptoms.
  6. Boston study of patients with memory and concentration deficit.
  7. Japanese case study - An autopsied report.
  8. Psychiatric and neurological presentations of Borrelial infection.
  9. Post-mortem brain tissue samples of Alzheimer's patients.
  10. Geographical and Seasonal study of MS and schizophrenia.
  11. Borrelia antibodies in CFS patients.
  12. Aggression and Lyme disease.
  13. Special report: Highlights of the 2000 Institute on Psychiatric Services.

References for each case study are provided on the same page as the description.


Case studies linking Borrelia and mental health (1)

The following descriptions of cases and studies, show a clear connection between Borrelia and mental health disorders.

This page contains descriptions (a) to (g), other descriptions are on the Cases and studies (h) to (m) page.

a) US study on the psychiatric effects of Borreliosis in children.

In a controlled study undertaken at Columbia University Department of Psychiatry, 20 children were examined following known infection of Borrelia burgdorferi (Bb), and were found to have significantly more psychiatric and cognitive difficulties. Their cognitive abilities were found to be below that of 20 matched healthy control subjects, even taking into account any effects due to anxiety, depression and fatigue during education. The study also discussed the long-term effects of the children's infection with Borrelia, which brought about neuropsychiatric disturbances and caused significant psychosocial and academic impairment.

b) Case study of suspected ALS patient in Austria.

An elderly lady treated at the Emperor Franz Josef hospital, Vienna, was initially admitted with suspected Motor Neuron Disease. Testing of fluid from her spinal column indicated the presence of Bb. Following antibiotic treatment, improvement was seen in the patient's clinical symptoms, and further testing of spinal fluid demonstrated a positive response to the antibiotic treatment. The preliminary diagnosis of amyotrophic lateral sclerosis (ALS) was revised to one of chronic neuroborreliosis, the term given to infection of the central nervous system (CNS) by Bb.

c) Psychotropic drug failure in Dutch patient with psychosis.

A 64-year old woman was admitted to the psychiatric ward of the Sophia Ziekenhuis at Zwolle in Holland. She was suffering from psychosis, with visual hallucinations, disorientation in time and space, and associative thinking. Psychotropic drugs failed to produce any improvement in her condition and, further, neurological symptoms developed. A lumbar puncture revealed the presence of Bb and, after treatment with penicillin, all of her psychiatric and neurological symptoms were resolved. From the history, which the woman was then able to communicate, it appeared she had been bitten by ticks. Her husband aged 66, passed through a similar episode of disease.

d) Study of psychiatric patients in Prague.

In a comparative study carried out at the Prague Psychiatric Center, the blood of 926 psychiatric patients, and that of 884 healthy control subjects, was screened for four different types of antibodies to Bb. Of 499 matched pairs (meaning of similar age and gender but from patient and control group respectively) 166 (33%) of the psychiatric patients and 94 (19%) of the healthy comparison subjects were seropositive in at least one of the four test assays for Bb. This study supports the hypothesis that there is an association between an infection of Bb and psychiatric morbidity.

e) Case study of German patient with schizophrenia-like symptoms.

At the University of Rostock in Germany, a 42-year old female patient presented with schizophrenia-like symptoms but a complete lack of neurological signs. A brain scan and investigation of the spinal fluid led to the diagnosis of Lyme disease. There was complete relief of symptoms after antimicrobial therapy.

f) Boston study of patients with memory and concentration deficit.

In a study of patients at a Boston, MA hospital, scientists looked at patients with a history of Lyme disease who had been treated with short courses of antibiotics. As well as many physical symptoms, such as musculoskeletal impairment, the patients were found to have highly significant deficits in concentration and memory. Those who had received treatment early in the course of the illness had less long-term impairment.

g) Japanese case study - An autopsied report.

At the Kanazawa University School of Medicine in Japan, a 36-year old woman with severe chronic Encephalomyelopathy was shown to have a very high level of antibodies to Bb. She showed severe cerebellar ataxia (walking and balance difficulties due to disease in the cerebellum) and profound mental deterioration. An autopsy 4 years later identified the presence of spirochaetes throughout the brain and spinal cord which, together with the antibody evidence, demonstrated that the Lyme bacteria had caused this encephalitic form of neuroborreliosis.


References

  1. A Controlled Study of Cognitive Deficits in Children with Chronic Lyme disease.
    Tager, F.A., Fallon, B.A., Keilp, J., Rissenberg, M., Jones, C.R., Liebowitz, M.R.
    J Neuropsychiatry Clin. Neurosci. 2001; Fall; 13(4): 500-7.
  2. ALS- Like Sequelae in Chronic Neuroborreliosis.
    Hansel, Y., Ackerl, M., Stanek, G.
    Wien. Med. Wochenschr. 1995; 145(7-8): 186-8.
  3. Lyme Psychosis.
    van den Bergen, H.A., Smith, J.P., van der Zwan, A.
    Ned. Tijdschr. Geneeskd. 1993; 137(41): 2098-100.
  4. Higher Prevalence of Antibodies to Borrelia burgdorferi in Psychiatric Patients than in Healthy Subjects.
    Hajek, T., Paskova, B., Janovska, D., Bahbouh, R., Hajek, P., Libiger, J., Hoschl, C.
    Am. J. Psychiatry 2002; 159(2): 297-301.
  5. Borrelia burgdorferi Central Nervous System Infection Presenting as Organic Psychiatric Disorder.
    Hess, A., Buchmann, J., Zettel, U.K., et al.
    Biol. Psychiatry 1999; 45(6): 795.
  6. The Long-term Clinical Outcomes of Lyme disease. A Population-based Retrospective Cohort Study.
    Shadick, N.A., Phillips, C.B., Logigian, E.L., Steere, A.C. et al.
    Ann. Intern. Med. 1994; 121(8): 560-7.
  7. Borrelia burgdorferi Seropositive Chronic Encephalomyelopathy: Lyme Neuroborreliosis? An Autopsied Report.
    Kobayashi, K., Mizukoshi, C., Aoki, T., Muramori, F.et al.
    Dement. Geriatr. Cogn. Disord. 1997; 8(6): 384-90.

Case studies linking Borrelia and mental health (2)

The following abstracts show a clear connection between Borrelia and mental health disorders.

This page contains descriptions (h) to (m), other descriptions are on the Cases and studies (a) to (g) page.

h) Psychiatric and neurological presentations of Borrelial infection.

Dr B. A. Fallon and his team at Columbia University Medical Centre in New York, conducted extensive studies on both adults and children with Lyme disease. They described numerous psychiatric and neurological presentations of the disease, and demonstrated that it can mimic attention deficit hyperactivity disorder (ADHD), depression, and multiple sclerosis. In another study, the same team found that panic disorder and mania could be caused by Borrelial infection.

i) Post-mortem brain tissue samples of Alzheimer's patients.

Scientists from Vancouver, Canada, and Lausanne, Switzerland, recently investigated post-mortem brain tissue samples from 14 patients who had suffered from Alzheimer's disease and compared them with 13 controls. All of the brains from the Alzheimer's patients were infected with Borrelia-type organisms, compared to none in the controls. From 3 of the Alzheimer's cases, genetic and molecular analyses of these spirochaetes were conducted to prove beyond doubt that they were Borrelia.

j) Geographical and Seasonal study of MS and schizophrenia.

Following the detailed statistical analysis of all published literature on schizophrenia (with the criterion that each study had to have detailed histories for at least 3000 patients) Swiss scientist, Dr Mark Fritzsche, was able to demonstrate that: "globally there is a striking correlation between seasonal and geographical clusters of both Multiple Sclerosis and Schizophrenia with the worldwide distribution of the Lyme bacteria." Yearly birth-excesses of such illnesses were found to mirror, with an intervening nine-month period, both the geographical and seasonal patterns of various types of Ixodes tick. He also went on to say, "In addition to known acute infections, no other disease exhibits equally marked epidemiological clusters by season and locality, nurturing the hope that prevention might ultimately be attainable".

k) Borrelia antibodies in CFS patients.

A study by the Department of Neurology at the University Hospital of Saarland in Homburg, Germany, demonstrated an association with Borrelia bacteria and Chronic Fatigue Syndrome (CFS). Blood samples were investigated from 1,156 healthy young males, with samples from the CFS patients being unidentified from those of the controls. The tests identified a significant number of CFS sufferers who had Borrelia antibodies, even though other clinical signs of Borreliosis were absent. It was stated that antibiotic therapy should be considered in patients with Chronic Fatigue Syndrome who show positive Borrelia serology.

l) Aggression and Lyme disease.

Dr R. C. Bransfield in New Jersey, discovered that a significant number of Lyme patients exhibit aggression. Patients were described as having decreased frustration tolerance, irritability, and some episodes of explosive anger which he terms "Lyme rage". In relatively rare cases there was uncontrollable rage, decreased empathy, suicidal tendencies, suicide, homicidal tendencies, interpersonal aggressiveness, homicide and predatory aggression.

m) Special report: Highlights of the 2000 Institute on Psychiatric Services.

It has been well documented in numerous published medical studies that Borreliosis is associated with personality disorders and many forms of mental illness such as anxiety, depression, confusion, and aggressive behaviour, mild to moderate cognitive deficits, fatigue, memory loss and irritability. Consequently, the American Psychiatric Association recommends that specialist doctors, and councillors alike, should seek to rule out Borreliosis as a possible differential diagnosis, before commencing any form of psychological intervention.


References