Research Article
Rosalie Greenberg
Abstract
Objective: To explore possible links between tick-borne illness (TBI) and pediatric bipolar disorder (PBD) in a retrospective series of youth from a Northeast U.S. psychiatric private practice. Methods: PBD diagnosis in 27 youth (15 Bipolar I and 12 Bipolar II) was based on DSM-IV TR criteria following interviews with parents and children, questionnaires and school reports. Testing for Borrelia burgdorferi (Lyme disease), Babesia, Bartonella, Mycoplasma pneumoniae, Anaplasma and Ehrlichia occurred between February 2013 and July 2015. Lyme testing included an ELISA and Western Blot IgM/IgG and cultures; Babesia and Bartonella were ascertained by IgM/IgG antibody titers and fluorescent in-situ hybridization (FISH) tests. Other pathogen exposure was determined by IgM/IgG antibody titers. Testing was performed at LabCorp, Mayo Medical, IgeneX, Advanced Labs and/or Galaxy Diagnostics Laboratories. Clinical diagnoses were confirmed by physicians familiar with TBI. Data was summarized using descriptive statistics. Results: Eighty-one percent of the sample was male and 19% was female. Mean age at PBD diagnosis was 7.3 years. Exposure to one or more pathogens was found in 24/27 (89%) of the patients. Frequency of positive serology included: Babesia (n=16), Mycoplasma pneumoniae (n=11), Bartonella (N=8), and Lyme (n=6). Twenty-two of these 24 agreed to clinical evaluation and 92% (20/22) were diagnosed with TBI. Conclusion: The high rate of TBI in PBD patients presented here is provocative. If confirmed, this association may suggest gene-environment interactions and has implications for the prevention and treatment of PBD. Research evaluating TBI in bipolar cases vs. matched controls with other psychopathology and without psychiatric disease using standardized serological testing is needed.