Objective:

Lyme borreliosis is a tick-borne infectious disease that may confer an increased risk of mental disorders, but previous studies have been hampered by methodological limitations, including small sample sizes. The authors used a nationwide retrospective cohort study design to examine rates of mental disorders following Lyme borreliosis.

Methods:

Using Denmark’s National Patient Register and the Psychiatric Central Research Register, and including all persons living in Denmark from 1994 through 2016 (N=6,945,837), the authors assessed the risk of mental disorders and suicidal behaviors among all individuals diagnosed with Lyme borreliosis in inpatient and outpatient hospital contacts (N=12,156). Incidence rate ratios (IRRs) were calculated by Poisson regression analyses.

Results:

Individuals with Lyme borreliosis had higher rates of any mental disorder (IRR=1.28, 95% CI=1.20, 1.37), of affective disorders (IRR=1.42, 95% CI=1.27, 1.59), of suicide attempts (IRR=2.01, 95% CI=1.58, 2.55), and of death by suicide (IRR=1.75, 95% CI=1.18, 2.58) compared with those without Lyme borreliosis. The 6-month interval after diagnosis was associated with the highest rate of any mental disorder (IRR=1.96, 95% CI=1.53, 2.52), and the first 3 years after diagnosis was associated with the highest rate of suicide (IRR=2.41, 95% CI=1.25, 4.62). Having more than one episode of Lyme borreliosis was associated with increased incidence rate ratios for mental disorders, affective disorders, and suicide attempts, but not for death by suicide.

Conclusions:

Individuals diagnosed with Lyme borreliosis in the hospital setting had an increased risk of mental disorders, affective disorders, suicide attempts, and suicide. Although the absolute population risk is low, clinicians should be aware of potential psychiatric sequelae of this global disease.

中文翻译：

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莱姆疏螺旋体病与精神障碍和自杀行为的关联：丹麦全国队列研究

客观的：

莱姆疏螺旋体病是一种蜱传传染病，可能会增加精神障碍的风险，但之前的研究受到方法学限制（包括样本量小）的阻碍。作者使用一项全国性的回顾性队列研究设计来检查莱姆疏螺旋体病后精神障碍的发生率。

方法：

作者使用丹麦的国家患者登记册和精神病学中央研究登记册，包括 1994 年至 2016 年居住在丹麦的所有人员 (N = 6,945,837)，评估了所有在住院和住院期间诊断为莱姆疏螺旋体病的人的精神障碍和自杀行为风险。门诊医院联系人（N=12,156）。通过泊松回归分析计算发生率比率 (IRR)。

结果：

莱姆疏螺旋体病患者任何精神障碍 (IRR=1.28, 95% CI=1.20, 1.37)、情感障碍 (IRR=1.42, 95% CI=1.27, 1.59) 和自杀企图 (IRR=2.01, 95% CI=1.58, 2.55) 和自杀死亡 (IRR=1.75, 95% CI=1.18, 2.58) 与没有莱姆疏螺旋体病的患者相比。诊断后 6 个月的时间间隔与任何精神障碍的最高发生率相关 (IRR=1.96, 95% CI=1.53, 2.52)，诊断后的前 3 年与最高的自杀率相关 (IRR=2.41 , 95% CI = 1.25, 4.62)。莱姆疏螺旋体病发作不止一次与精神障碍、情感障碍和自杀未遂的发病率比率增加有关，但与自杀死亡无关。

结论：

在医院环境中被诊断为莱姆疏螺旋体病的个体患精神障碍、情感障碍、自杀未遂和自杀的风险增加。尽管绝对人群风险很低，但临床医生应该意识到这种全球疾病的潜在精神后遗症。