Tick Borne Infections and Pediatric Bipolar Disorder

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Abstract: 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 practice.

Methods: PBD diagnosis in 17 youth (10 Bipolar I and 7 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 - May 2015. Lyme testing included an ELISA, a Western Blot IgM/IgG and in some a culture; 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. Clinical diagnoses were confirmed by physicians familiar with TBI. Data was summarized using descriptive statistics.

Results: Eighty-two percent of the sample was male; 18% were female. Mean age at BPD diagnosis was 7.2 years. Exposure to one or more tick-borne pathogens was found in 15/17 (88%). Frequency of positive serology included: Babesia (n=9), Mycoplasma Pneumoniae (n=9), Bartonella (N=6), and Lyme (n=3). Seventy-one percent (12/17) of PBD youth were positive by both laboratory measures and clinician assessment.

Conclusions: 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.