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The significant impacts of infections, such as Lyme, on mental health

An in-depth review by three leading experts.

A woman speaks to a mental health practitioner in a light room with a plant and a sofa, and there's a pink aura in the room.

Dr. Robert Bransfield, Dr. Charlotte Mao and Dr.Rosalie Greenberg have written a comprehensive and important review that addresses the history, pathophysiology, personal and clinical significance of the interface between microbes and mental health. From the definition of terms and specific mental conditions, to relevant considerations in diagnosis and treatment, this review contains important information for anyone wanting to better understand these issues.

The review summarizes many of the possible causes of psychiatric symptoms including direct effects of the microbes themselves and the effect that microbes have on the immune system. Implications for specific infections are outlined, including relevant clinical information regarding Lyme disease. The authors highlight the psychiatric implications of a delayed diagnosis.  

“Considerable confusion, controversy, and complexity surrounding Lyme disease testing contribute to many missed or late diagnoses of Lyme disease that then can manifest with significant late-stage neuropsychiatric symptomatology…Lab testing cannot be relied on alone to diagnose or exclude Lyme disease and, instead, must always be considered in the context of the whole clinical picture. Clinicians must be familiar with the full array of clinical manifestations of Lyme borreliosis, as, ultimately, Lyme disease must be diagnosed clinically on the basis of clinical history and exam findings, with lab testing regarded as supportive or not of the clinical diagnosis”

This comprehensive review is an excellent reference not only for clinicians, but also for patients and their families. Thank you Dr. Bransfield, Dr. Mao and Dr. Greenberg for writing this review and bringing these critically important issues to the forefront.


Bransfield RC, Mao C, Greenberg R. Microbes and Mental Illness: Past, Present, and Future. Healthcare. 2024; 12(1):83. https://doi.org/10.3390/healthcare12010083

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