Evaluation of Prospectively Followed Adult Patients with Erythema Migrans Using the Beck Depression Inventory Second Edition
BACKGROUND: The Beck Depression Inventory (BDI-II) may be used to evaluate individuals for symptoms of depression. METHODS: In a 1-year prospective study, 52 adult Lyme disease patients with erythema migrans and 104 matched control subjects were clinically assessed and completed the BDI-II at study entry and approximately 6 and 12 months later following antibiotic treatment. RESULTS: The mean BDI-II score was significantly higher at the baseline visit among Lyme disease patients compared with controls (P=.002), but no significant differences between the groups were observed at either the 6- or 12-month study visits. Over the course of the study, the mean BDI-II scores decreased an average of approximately 0.22 points per month (P < .0005) for Lyme disease patients, whereas the mean scores changed very little for controls (mean change=-0.02 per month, P=.50). The total number of somatic symptoms, of the 12 symptoms evaluated, strongly and directly correlated with the BDI-II scores at the baseline visit for the Lyme disease patients. CONCLUSIONS: The mean BDI-II scores of patients with early Lyme disease significantly exceeded that of matched controls at study entry, but by 6 months the values did not differ significantly. There was a good-to-excellent direct correlation between the BDI-II score and the total number of symptoms, suggesting that the BDI-II scores were reflecting somatic rather than affective depressive symptoms. When using the BDI-II as an assessment tool of patients with Lyme disease, infection-related somatic symptoms per se need to be considered in the interpretation of the results.
Wormser, G., Park, K., Madison, C., Rozenberg, J., McKenna, D., Scavarda, C., Karmen, C., Dornbush, R., & Visintainer, P. (2019). Evaluation of Prospectively Followed Adult Patients with Erythema Migrans Using the Beck Depression Inventory Second Edition. The American Journal of Medicine, 132 (4), 519-524. https://doi.org/10.1016/j.amjmed.2018.11.039