Grabe Hans Joergen, Spitzer Carsten, Lüdemann Jan, Guertler Lutz, Kramer Axel, John Ulrich, Freyberger Harald Juergen, Völzke Henry
Department of Psychiatry and Psychotherapy, Ernst Moritz Arndt University Greifswald, Germany.
Nord J Psychiatry. 2008;62(5):386-91. doi: 10.1080/08039480801984230.
Undiagnosed chronic Lyme disease caused by Borrelia burgdorferi is considered a differential diagnoses in medically unexplained symptoms like arthralgias, distal paresthesias, depressive symptoms, lack of concentration and fatigue. The aims of the study were to assess the association of mental and physical complaints with seropositivity for anti-Borrelia IgG in a general population sample. Seropositivity indicated an infection with Borrelia in the past. The Study of Health in Pomerania was conducted in a community living in a region with endemic Lyme disease. Mental and physical complaints were assessed on 38 items with the von Zerssen's complaint scale. IgG antibodies to Borrelia were determined by ELISA in 4264 individuals. Seropositivity was analyzed applying two cut-off scores (>5 and >10 IU/ml). IgG antibodies to Borrelia were found positive in 388 subjects (9.1%) applying the >5 IU/ml cut-off and in 130 subjects (3.0%) applying the >10 IU/ml cut-off. In multivariate analyses (MANCOVA), both definitions of seropositivity were not associated with increased mental or physical complaints while adjusting for gender, age, employment status, rural residency, physical activity, diabetes mellitus and number of chronic diseases. In the general population, seropositivity for anti-Borrelia IgG antibodies was not associated with an increase of self-rated mental or physical complaints or impairments. Therefore, clinicians should not overvalue seropositivity for anti-Borrelia IgG as a medical cause for unexplained mental or physical complaints.
由伯氏疏螺旋体引起的未确诊慢性莱姆病被视为关节痛、远端感觉异常、抑郁症状、注意力不集中和疲劳等医学上无法解释症状的鉴别诊断之一。本研究的目的是在一般人群样本中评估精神和身体不适与抗伯氏疏螺旋体IgG血清阳性之间的关联。血清阳性表明过去曾感染过伯氏疏螺旋体。波美拉尼亚健康研究是在一个莱姆病流行地区的社区中进行的。使用冯·泽尔森症状量表对38个项目的精神和身体不适进行评估。通过酶联免疫吸附测定法（ELISA）测定了4264名个体的抗伯氏疏螺旋体IgG抗体。应用两个临界值（>5和>10 IU/ml）分析血清阳性情况。应用>5 IU/ml临界值时，388名受试者（9.1%）的抗伯氏疏螺旋体IgG抗体呈阳性；应用>10 IU/ml临界值时，130名受试者（3.0%）的抗伯氏疏螺旋体IgG抗体呈阳性。在多变量分析（多因素协方差分析）中，在对性别、年龄、就业状况、农村居住情况、身体活动、糖尿病和慢性病数量进行校正后，血清阳性的两种定义均与精神或身体不适增加无关。在一般人群中，抗伯氏疏螺旋体IgG抗体血清阳性与自我报告的精神或身体不适或损伤增加无关。因此，临床医生不应高估抗伯氏疏螺旋体IgG血清阳性作为无法解释的精神或身体不适的医学原因。
