Study: 92% of Pediatric Bipolar Disorder Had Evidence of Tick-Borne Exposure

November 20, 2025

https://www.frontiersin.org/journals/child-and-adolescent-psychiatry/articles/10.3389/frcha.2025.1685016/full

ORIGINAL RESEARCH article

Front. Child Adolesc. Psychiatry, 05 November 2025

Sec. Developmental Psychopathology and Mental Health

Volume 4 – 2025 | https://doi.org/10.3389/frcha.2025.1685016

This article is part of the Research TopicSevere Mental Illnesses in Children: Unravelling Developmental Trajectories, Neuropsychiatric Impairments, and Chronic PainView all 3 articles

Investigating the frequency of tick-borne infections in a case series of 37 youth diagnosed with pediatric bipolar disorder

Rosalie Greenberg1,2*
  • 1Medical Arts Psychotherapy Associates, P.A., Summit, NJ, United States
  • 2Overlook Medical Center, Summit, NJ, United States

Introduction: This retrospective chart review examined 37 youth with pediatric bipolar disorder from a private practice in the Lyme-endemic state of New Jersey, expanding on findings from 27 previously reported cases to explore the potential contribution of tick-borne infections to disease etiology.

Methods: Diagnoses were based on DSM-IV-TR and DSM-V criteria using parent and child interviews, questionnaires, and school reports. Initial screening evaluated for possible PANDAS/PANS, with testing for Group A beta-hemolytic streptococcus, Borrelia burgdorferi, Babesia, Bartonella, and Mycoplasma pneumoniae. Lyme disease testing included ELISA, Western Blot (IgM/IgG), and immunoblots, interpreted per CDC guidelines. Other pathogens were assessed via IgM/IgG titers, anti-streptolysin O, anti-DNAase B, fluorescent in situ hybridization, and blood cultures. A positive diagnosis required both laboratory evidence and clinician confirmation.

Results: Babesia was detected in 51% (19/37), Bartonella in 49% (18/37), Mycoplasma pneumoniae in 38% (14/37), Borrelia burgdorferi in 22% (8/37), and Group A Streptococcus in 19% (7/37).

Overall, 92% (34/37) had evidence of tick-borne exposure, with 81% (30/37) meeting both laboratory and clinical criteria.

Discussion: More than three-quarters of the cohort demonstrated confirmed tick-borne infections. Overlaps between bipolar disorder and tick-borne illness—such as immune dysregulation, chronic symptomatology, and responsiveness to treatments like minocycline and anti-inflammatory agents—support further exploration of infectious contributors to pediatric bipolar disorder. While limited by its single-practice retrospective design, these findings suggest that tick-borne pathogens may play a role in the pathogenesis of bipolar symptoms in youth, warranting larger, controlled studies.

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Category:

Babesia, Bartonella, Lyme, Mycoplasma, PANS, Psychological Aspects, research

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