Psychiatric aspects of Lyme disease in children and adolescents: A community
epidemiologic study in Westchester, New York Brian A. Fallon, MD, MPH; Hector Bird, MD;
Christina Hoven, DrPH; Daniel Cameron, MD, MPH; Michael R. Liebowitz, MD; and David
Shaffer, MD. JSTD 1994; 1:98-100.
To date, no community study has examined the psychiatric aspects and or sequelae of Lyme
disease, LD, among children. As part of a community epidemilogic 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 LD question.
Of the 36, 29 also agreed to take part in a follow-up interview. Sixteen of the 29 children
had physician-diagnosed LD as well as either an erythema migrans rash or a positive serology.
Fifteen of these 16 rec eived treatment within 1 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 months after symptom onset. The child
experienced 5 years of intermittent 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 months 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.