Oczko-Grzesik Barbara, Kępa Lucjan, Puszcz-Matlińska Monika, Pudło Robert, Żurek Anna, Badura-Głąbik Teresa
Clinical Department of Infectious Diseases, Bytom, Medical University of Silesia, Katowice, Poland.
Department of Infectious Diseases, Specialistic Hospital No 1, Bytom, Poland.
Ann Agric Environ Med. 2017 Mar 1;24(1):33-38. doi: 10.5604/12321966.1229002.
Lyme borreliosis (LB) is a disease caused by the bacteria Borrelia burgdorferi. The most common symptoms are related to the skin, musculo-scelatal system, central and peripheral nervous system, rarely to the heart muscle and the eye, and may occur in the multistage course of the disease. LB may additionally be accompanied by psychopathological symptoms. The aim of the study is estimation of the cognitive and affective disorders occurence in patients with LB.
The study was carried out in the group of 121 patients (61 females, 60 males) aged 18-65; mean age 46 years. All patients were diagnosed with late-stage of LB: 46 patients (38%) with Lyme arthritis and 75 patients (62%) with neuroborreliosis. Evaluation of the cognitive and affective functioning of patients was performed on the basis of a standardized interview and test methods: the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and the Beck Depression Inventory (BDI).
Cognitive disorders occurred statistically significantly more often in patients with neuroborreliosis (14.7%) than in patients with Lyme arthritis (4.3%). A group of females with neuroborreliosis and a group of males with the same diagnosis demonstrated cognitive deficits significantly more often (23.3% and 8.9%, respectively), compared to groups of patients with Lyme arthritis (6.5% in females and no cognitive deficits in males). A significantly higher percentage of depressive disorders was also noted in the group of males and females with neuroborreliosis (50.7%), compared to the group of patients with Lyme arthritis (39.1%). The symptoms of depression were particularly frequent in the females with neuroborreliosis (60%). The severity of depression measured by BDI was mild or moderate in most cases. In the examined groups, more patients with neuroborreliosis (44%), both in females (36.7%) and males (48.9%), demonstrated anxiety disorders. The obtained results showed a higher frequency of affective disorders compared to cognitive deficits, both in patients with Lyme arthritis and neuroborreliosis.
An increased frequency of depressive and neurotic disorders was observed in patients with LB, particularly in patients with neuroborreliosis. Neurotic disorders, mainly adaptive, were most common in males with LB, while depressive disorders were more frequent in females. An increased frequency of cognitive deficits was observed in patients with neuroborreliosis, particularly in females.
莱姆病（LB）是由伯氏疏螺旋体细菌引起的一种疾病。最常见的症状与皮肤、肌肉骨骼系统、中枢和周围神经系统有关，很少涉及心肌和眼睛，且可能出现在疾病的多阶段病程中。莱姆病还可能伴有精神病理症状。本研究的目的是评估莱姆病患者认知和情感障碍的发生率。
该研究针对121名年龄在18 - 65岁的患者（61名女性，60名男性）进行；平均年龄46岁。所有患者均被诊断为莱姆病晚期：46名患者（38%）患有莱姆关节炎，75名患者（62%）患有神经型莱姆病。基于标准化访谈和测试方法对患者的认知和情感功能进行评估：简易精神状态检查表（MMSE）、画钟试验（CDT）和贝克抑郁量表（BDI）。
神经型莱姆病患者中认知障碍的发生率（14.7%）在统计学上显著高于莱姆关节炎患者（4.3%）。与莱姆关节炎患者组（女性为6.5%，男性无认知障碍）相比，神经型莱姆病女性患者组和同诊断的男性患者组出现认知缺陷的频率明显更高（分别为23.3%和8.9%）。神经型莱姆病男性和女性患者组中抑郁症的发生率（50.7%）也显著高于莱姆关节炎患者组（39.1%）。抑郁症症状在神经型莱姆病女性患者中尤为常见（60%）。在大多数情况下，用BDI测量的抑郁严重程度为轻度或中度。在被检查的组中，神经型莱姆病患者中更多患者（44%）表现出焦虑障碍，女性（36.7%）和男性（48.9%）均如此。所获得的结果表明，与认知缺陷相比，莱姆关节炎和神经型莱姆病患者中情感障碍的发生率更高。
观察到莱姆病患者中抑郁和神经症性障碍的发生率增加，特别是在神经型莱姆病患者中。神经症性障碍，主要是适应性障碍，在莱姆病男性患者中最为常见，而抑郁症在女性中更为频繁。神经型莱姆病患者中认知缺陷的发生率增加，特别是在女性中。
