New-Onset Panic, Depression with Suicidal Thoughts, and Somatic Symptoms in a Patient with a History of Lyme DiseaseReport as inadecuate




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Case Reports in Psychiatry - Volume 2015 2015, Article ID 457947, 4 pages -

Case Report

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

Silver Hill Hospital, New Canaan, CT 06840, USA

Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA

Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA

Received 2 January 2015; Accepted 14 March 2015

Academic Editor: Liliana Dell’Osso

Copyright © 2015 Amir Garakani and Andrew G. Mitton. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient’s panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected “chronic Lyme Disease” CLD despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptoms such as fatigue, myalgias, and neuropathy. We discuss the controversy surrounding the diagnosis of CLD and concerns and considerations in the treatment of suspected CLD patients with comorbid psychiatric diagnoses.





Author: Amir Garakani and Andrew G. Mitton

Source: https://www.hindawi.com/



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