Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.

Abstract

Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia. Key words: aporology, chronic Lyme disease, Lyme disease, medically unexplained symptoms, misdiagnosis, psychological, psychopathogenesis.

Implications of Gender in Chronic Lyme Disease

“…4,26,27 Chronic Lyme disease is clearly different from what has been referred to as ''post-Lyme disease syndrome,'' although some patients with post-Lyme disease syndrome may carry a diagnosis of chronic Lyme disease. 4 Evidence indicates that the majority of patients with chronic Lyme disease have never been infected with B. burgdorferi and, instead, suffer from a number of other diseases or symptom complexes that are often associated with a predominance of females.…”

The emergence of Lyme disease

“…A counterculture has emerged regarding chronic Lyme disease (84). In contrast with the findings of evidence-based medicine, some people believe that the tests for Lyme disease are often inaccurately negative, and that antibiotic therapy is necessary for months or years to suppress the symptoms of this often incurable illness.…”

Lyme borreliosis in 2005, 30 years after initial observations in Lyme Connecticut

“…In 2002, the first licensed vaccine for Lyme disease in the US was removed from the market. Moreover, in both the United States and Europe, a Lyme disease counterculture has emerged with an opposing ideology [4]. However, there is general agreement that much still needs to be learned to achieve optimal control of this complex spirochetal infection.…”