Maxwell Sarah P, Brooks Chris, McNeely Connie L, Thomas Kevin C
School of Economic, Political & Policy Sciences, University of Texas at Dallas, Richardson, TX 75080, USA.
Laboratory for Human Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
Healthcare (Basel). 2022 Jun 23;10(7):1178. doi: 10.3390/healthcare10071178.
Public health reports contain limited information regarding the psychological and neurological symptoms of tick-borne diseases (TBDs). Employing a mixed-method approach, this analysis triangulates three sources of symptomology and provides a comparison of official public health information, case reports, medical literature, and the self-reported symptoms of patients with Lyme disease and other TBDs. Out of the fifteen neuropsychiatric symptoms reported in the medical literature for common TBDs, headaches and fatigue and/or malaise are the only two symptoms fully recognized by public health officials. Of TBDs, Lyme disease is the least recognized by public health officials for presenting with neuropsychiatric symptoms; only headaches and fatigue are recognized as overlapping symptoms of Lyme disease. Comparisons from a patient symptoms survey indicate that self-reports of TBDs and the associated symptoms align with medical and case reports. Anxiety, depression, panic attacks, hallucinations, delusions, and pain-ranging from headaches to neck stiffness and arthritis-are common among patients who report a TBD diagnosis. Given the multitude of non-specific patient symptoms, and the number and range of neuropsychiatric presentations that do not align with public health guidance, this study indicates the need for a revised approach to TBD diagnosis and for improved communication from official public health sources regarding the wide range of associated symptoms.
公共卫生报告中关于蜱传疾病（TBDs）的心理和神经症状的信息有限。本分析采用混合方法，对三种症状来源进行三角测量，并比较了官方公共卫生信息、病例报告、医学文献以及莱姆病和其他蜱传疾病患者的自我报告症状。在医学文献中报道的常见蜱传疾病的15种神经精神症状中，头痛以及疲劳和/或不适是公共卫生官员完全认可的仅有的两种症状。在蜱传疾病中，公共卫生官员对莱姆病出现神经精神症状的认知度最低；只有头痛和疲劳被认为是莱姆病的重叠症状。患者症状调查的比较表明，蜱传疾病及其相关症状与医学报告和病例报告相符。焦虑、抑郁、惊恐发作、幻觉、妄想以及从头痛到颈部僵硬和关节炎的疼痛，在报告患有蜱传疾病的患者中很常见。鉴于患者有众多非特异性症状，以及神经精神症状表现数量和范围与公共卫生指南不符，本研究表明需要修订蜱传疾病的诊断方法，并改善官方公共卫生部门关于广泛相关症状的沟通。
