Megan Brooks

May 08, 2012

May 8, 2012 (Philadelphia, Pennsylvania) — Chronic lyme disease (CLD) has been linked to attention-deficit hyperactivity disorder (ADHD) in adults, new research shows.

"The association between ADHD and CLD has not been identified previously," principal investigator Joel L. Young, MD, medical director, Rochester Center for Behavioral Medicine, Rochester, Michigan, told Medscape Medical News. The survey results also corroborate earlier findings of a relationship between CLD and anxiety and depression, he said.

Dr. Joel Young

Dr. Young presented his research here at the American Psychiatric Association's 2012 Annual Meeting.

Participants for the survey were drawn from the 2009 Michigan Lyme Disease Association Conference. A total of 58 adults with CLD and a control group of 26 adults without CLD participated. The mean age was 48 to 49 years in both groups.

On the AD/HD Self-Report Scale (ASRS), adults with CLD endorsed more ADHD symptoms than control participants. Results were significant for both inattentive and hyperactive subunits and the combined type, Dr. Young reported.


Table: ASRS Subscale Scores by Group

ASRS Subscale Lyme Group Control Group P Value
Inattentive type 11.6 7.2 <.0001
Hyperactive/Impulsive 21.6 14.1 <.0001
Combined 33.0 21.7 .0001


Novel Finding

"Cognitive deficits associated with CLD have been demonstrated before," Dr. Young said, "although this is the first survey to identify a linkage between these two conditions."

As expected, the CLD group had statistically significantly higher scores on the Fatigue Severity Scale (FSS) than the control group. The CLD group also had "dramatically higher" rates of dysthymia, generalized anxiety, major depression, and somatization.

Dr. Young said the correlation between ADHD and CLD "is novel in the research literature. Symptoms of CLD include persistent fatigue and unexplainable generalized pain. We conclude that many individuals who are diagnosed with CLD might have ADHD (inattentive type). We believe that many are diagnosed with CLD inaccurately and that ADHD symptoms might better explain their persistent pain and fatigue," he added.

Dr. Young emphasized that there is currently "little consensus about the validity of CLD. Most clinicians agree that there is a phenomenon of acute Lyme disease, but there is no consensus about whether it is a chronic condition. I believe that patients who have these symptoms often get the diagnosis of CLD because there is no other explanation for their chronic fatigue and pain."

"Many times," Dr. Young added, "the neuropsychiatric complications associated with CLD are the most problematic for individuals. My research indicates that individuals with CLD should be evaluated for ADHD. It is unclear if treating ADHD will help these individuals' symptoms of pain and fatigue."

Interpret With Caution

Commenting on the study for Medscape Medical News, Brian Fallon, MD, MPH, director of the Lyme and Tick-Borne Diseases Research Center, Columbia University, New York City, cautioned against drawing any firm conclusions from this survey. Surveys are "notorious for elevating psychiatric complaints," he said.

"Most carefully conducted neurocognitive studies have identified problems with memory, processing speed, and verbal fluency in Lyme patients — and not attention problems. Attention problems are primarily seen in depression," added Dr. Fallon, who was not involved in the study.

Dr. Young is the author of the book ADHD Grown Up: A Guide to Adolescent and Adult ADHD (W.W. Norton, 2009). He has disclosed relationships with Cyberonics Inc, Eli Lily, Novartis, Otsuka, Pfizer, Shire, Forest, Merck, Bristol Myers Squibb Co, and Shionogi Inc. Dr. Fallon has disclosed no relevant financial relationships.

The American Psychiatric Association's 2012 Annual Meeting. Abstract NR8-30. Presented May 8, 2012.


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