Psychiatric Manifestations of Lyme Borreliosis

Early descriptions of various disorders, now recognized as part of Lyme borreliosis, included various psychiatric symptoms. Although they occur frequently in Lyme disease patients, they are poorly documented in the literature. After dissemination to the central nervous system, Borrelia burgdorferi may remain quiescent for months to years before producing symptoms. The most frequent psychiatric manifestations of Lyme disease include irritability, emotional instability, depression and chronic fatigue syndrome, as well as memory deficits, hallucinations, delusions, symptoms of dementia and other psychical disturbances. Like syphilis, Lyme borreliosis may be associated with a wide spectrum of clinical manifestations, which have not yet been fully elucidated. As a result of delay in diagnosis and treatment, this initially treatable acute illness may assume a chronic, even irreversible form with devastating consequences in some cases.