The psychology of 'post-Lyme disease syndrome' and 'not Lyme'.

Abstract

Abstract Previous studies have shown that there are Lyme disease patients who after treatment with proper antibiotic regimens had developed post-antibiotic therapy symptoms that they and their doctors attributed to Lyme disease. The ongoing controversy over a diagnosis many think does not actually exist continues to rage, and has entered the realm of rejection of science and facts by some practitioners, patients and even legislators. This chapter explores the psychological aspects of symptom persistence in patients who attribute their ongoing complaints to 'chronic Lyme disease'. It discusses the possible existence of a complex interplay among biological, psychological and social factors that might better help understand the problem and explain the pathogenesis of complaints. Patients who ascribe ongoing symptoms to 'chronic Lyme disease' vary in terms of Lyme disease status and commitment to the diagnosis of chronic Lyme disease, and can be assigned to one of the following groups: patients who have current Lyme disease (present infection with Borrelia burgdorferi), who may or may not have been treated with antibiotics previously; patients who once had substantiated Lyme disease, but no longer have active infection with B. burgdorferi (having either 'post-Lyme disease syndrome' or another unrelated medical condition); and patients who never had documentable Lyme disease, but believe, to varying degrees, that Lyme disease is the cause of their ongoing complaints ('not Lyme'). All these groups of patients are described in this chapter.