ORIGINAL RESEARCH article
Front. Child Adolesc. Psychiatry
Sec. Developmental Psychopathology and Mental Health
Volume 4 - 2025 | doi: 10.3389/frcha.2025.1685016
This article is part of the Research TopicSevere Mental Illnesses in Children: Unravelling Developmental Trajectories, Neuropsychiatric Impairments, and Chronic PainView all 3 articles
Investigating the Frequency of Tick-borne Infections in a Case Series of 37 Youth Diagnosed with Pediatric Bipolar Disorder
Provisionally accepted
- Overlook Medical Center, Summit, New Jersey, United States
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Introduction: This retrospective chart review examined 37 youth with pediatric bipolar disorder from a private practice in the Lyme-endemic state of New Jersey, expanding on findings from 27 previously reported cases to explore the potential contribution of tick-borne infections to disease etiology. Methods: Diagnoses were based on DSM-IV-TR and DSM-V criteria using parent and child interviews, questionnaires, and school reports. Initial screening evaluated for possible PANDAS/PANS, with testing for Group A beta-hemolytic streptococcus, Borrelia burgdorferi, Babesia, Bartonella, and Mycoplasma pneumoniae. Lyme disease testing included ELISA, Western Blot (IgM/IgG), and immunoblots, interpreted per CDC guidelines. Other pathogens were assessed via IgM/IgG titers, anti-streptolysin O, anti-DNase B, fluorescent in-situ hybridization, and blood cultures. A positive diagnosis required both laboratory evidence and clinician confirmation. Results: Babesia was detected in 51% (19/37), Bartonella in 49% (18/37), Mycoplasma pneumoniae in 38% (14/37), Borrelia burgdorferi in 22% (8/37), and Group A Streptococcus in 19% (7/37). Overall, 92% (34/37) had evidence of tick-borne exposure, with 81% (30/37) meeting both laboratory and clinical criteria. Discussion: More than three-quarters of the cohort demonstrated confirmed tick-borne infections. Overlaps between bipolar disorder and tick-borne illness—such as immune dysregulation, chronic symptomatology, and responsiveness to treatments like minocycline and anti-inflammatory agents—support further exploration of infectious contributors to pediatric bipolar disorder. While limited by its single-practice retrospective design, these findings suggest that tick-borne pathogens may play a role in the pathogenesis of bipolar symptoms in youth, warranting larger, controlled studies.
Keywords: Pediatric Bipolar Disorder, Tick-borne illness, Lyme Disease, Babbesia, Bartonella
Received: 15 Aug 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Greenberg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rosalie Greenberg, rgmd@verizon.net
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