title: The phenomenon of 'chronic Lyme'; an observational study.
abstract: OBJECTIVE
  To chart clinical, laboratory, and psychometric profiles in patients who attribute their complaints to chronic Lyme disease.
  
  
  METHODS
  We assessed the patients by clinical examination, laboratory tests, and questionnaires measuring fatigue, depression, anxiety, health-related quality of life, hypochondriasis, and illness perceptions.
  
  
  RESULTS
  We found no evidence of ongoing Borrelia burgdorferi (Bb) infection in any of the 29 included patients using current diagnostic guidelines and an extended array of tests. Eight (28%) had other well-defined illnesses. Twenty-one (72%) had symptoms of unknown cause, of those six met the suggested criteria for post-Lyme disease syndrome. Fourteen (48%) had presence of anti-Bb antibodies. The patients had more fatigue and poorer health-related quality of life as compared to normative data, but were not more depressed, anxious, or hypochondriacal. Their beliefs about the illness were characterized by negative expectations.
  
  
  CONCLUSIONS
  Our patients, who all attributed their symptoms to chronic Lyme disease, were heterogeneous. None had evidences of persistent Bb infection, but whether current diagnostic criteria are functional in patients with longstanding complaints is controversial. Other well-defined illnesses or sequelae from earlier Lyme disease were probable as main explanatory factor in some cases. The patients were not more depressed, anxious, or hypochondriacal than the normal population, but they had poorer health-related quality of life, more fatigue, and negative expectations about their illness.
authors.affiliation: Department of Neurology, Sørlandet Hospital, Kristiansand, Norway. unn.ljostad@sshf.no
authors.forename: U
authors.initials: U
authors.lastname: Ljøstad
authors.forename: Å
authors.initials: Å
authors.lastname: Mygland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015151:Immunoblotting; D008193:Lyme Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial