https://www.mdpi.com/2227-9032/7/3/105  Go here for full paper)

Open AccessReview

Proposed Lyme Disease Guidelines and Psychiatric Illnesses

1
Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
2
Independent Researcher, Dorset BH23 5BN, UK
3
General Counsel Red Paladin, Piscataway, NJ 08854, USA
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(3), 105; https://doi.org/10.3390/healthcare7030105 (registering DOI)
Received: 6 August 2019 / Revised: 3 September 2019 / Accepted: 4 September 2019 / Published: 9 September 2019
(This article belongs to the Special Issue Lyme Disease and Related Tickborne Infections)
The Infectious Disease Society of America, American Academy of Neurology, and American Academy of Rheumatology jointly proposed Lyme disease guidelines. Four areas most relevant to psychiatry were reviewed—the disclaimer, laboratory testing, and adult and pediatric psychiatric sections. The disclaimer and the manner in which these guidelines are implemented are insufficient to remove the authors and sponsoring organizations from liability for harm caused by these guidelines. The guidelines and supporting citations place improper credibility upon surveillance case definition rather than clinical diagnosis criteria. The guidelines fail to address the clear causal association between Lyme disease and psychiatric illnesses, suicide, violence, developmental disabilities and substance abuse despite significant supporting evidence.
If these guidelines are published without very major revisions, and if the sponsoring medical societies attempt to enforce these guidelines as a standard of care, it will directly contribute to increasing a national and global epidemic of psychiatric illnesses, suicide, violence, substance abuse and developmental disabilities and the associated economic and non-economic societal burdens.
The guideline flaws could be improved with a more appropriate disclaimer, an evidence-based rather than an evidence-biased approach, more accurate diagnostic criteria, and recognition of the direct and serious causal association between Lyme disease and psychiatric illnesses.View Full-Text
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**Comment**
In plain English this means the latest Lyme Guidelines once again place too much emphasis on criteria used for surveillance (positive blood serology, EM rash, etc) and not enough on symptoms used for clinical diagnosis: https://madisonarealymesupportgroup.com/2017/09/05/empirical-validation-of-the-horowitz-questionnaire-for-suspected-lyme-disease/
On top of this, the paper states the guidelines fail to address a clear causal association between Lyme disease and psychiatric illness.
If they are implemented as stands, we are in a world of trouble.

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