1994 Articles

Psychiatric Aspects of Lyme Disease in Children and Adolescents: A Community Epidemiologic Study in Westchester, New York

Fallon, Brian A.; Bird, Hector R.; Hoven, Christina; Cameron, Daniel J.; Liebowitz, Michael R.; Shaffer, David

To date, no community study has examined the psychiatric aspects and or sequelae of Lyme disease (LO) among children. As part of a community epidemiologic 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 LO question. Of the 36, 29 also agreed to take part in a follow-up interview. Sixteen of the 29 children had had physician-diagnosed LO as well as either an erythema migrans rash or a positive serology. Fifteen of these 16 received treatment within I 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 month~ after symptom onset. This child experienced 5 years of mtermittent 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 month<; 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.