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ARTICLE

Building Bridges Between Infectious Disease Physicians and Psychiatrists

NOV 30, 2017 | ROBERT C BRANSFIELD, MD, DLFAPA
A newer, scientifically-based approach methodically analyzes how infections and complex interactive infections in the body can have immune and metabolic effects on the brain that, in turn, alter the neural chemistry and neural circuitry resulting in mental illnesses. This approach is replacing the outdated belief still held by some individuals in the field: that psychiatric illness has no physiological basis and is responsible for causing so-called "subjective and non-specific symptoms," medically unexplained symptoms, and "bodily distress syndrome."

There are thousands of articles in the medical literature demonstrating an association between infections, the associated immune reactions, and mental illnesses. Infections most commonly associated with mental illnesses include venereal, viral, and vector-borne diseases. Similar to AIDS, many of these infections are complex interactive infections. Tick-borne infections are one example of complex interactive infections, and there are several hundred articles demonstrating a causal association with a spectrum of psychiatric symptoms and illnesses, including anxiety, apathy, cognitive impairments, depression, autism, psychosis, dementia, and violence.

This leaves us with a challenge. How can infectious disease physicians and psychiatrists overcome the current communication and knowledge gap, embrace and further develop the current science and more effective work together for the benefit of our patients?

Possible options may include any of the following:
  • Peer Exchange programs that include infectious disease physicians, psychiatrists, and psychoimmunologists
  • Medical conferences that include these three specialties
  • Internet-based educational programs
  • Cooperative efforts between the Infectious Disease Society of America and the American Psychiatric Association
  • A journal specializing in the field
  • The development of a program devoted to this area at the National Institute of Health
  • Psychoimmunology program development in medical schools
  • Program development in residency training
  • Developing foundation support for research grants in this area
  • Other ideas from the readership

Through these efforts, infectious disease physicians and psychiatrists can actively work towards closing the gap between the two disciplines in order to provide the best care possible for their patients.
 
References
  1. O'Connor SM, Taylor CE, Hughes JM. Emerging infectious determinants of chronic diseases. Emerg Infect Dis. 2006; 12(7):1051-1057.
  2. Ewald PW. Evolution of Infectious disease. Oxford: Oxford University Press; 1994.
  3. Nesse RM. How is Darwinian medicine useful? West J Med. 2001;174(5):358-360.
  4. NIH HMP Working Group, Peterson J, Garges S, et al. The NIH human microbiome project. Genome Res. 2009;19(12):2317-2323. doi: 10.1101/gr.096651.109.
  5. Bransfield RC. The psychoimmunology of Lyme/tick-borne diseases and its association with neuropsychiatric symptoms. Open Neurol J. 2012;6:88-93. doi: 10.2174/1874205X01206010088.
  6. Bransfield RC. List of 700 articles citing chronic infection associated with tick-borne disease compiled by Dr Robert Bransfield. International Lyme and Associated Diseases Society. http://www.ilads.org/ilads_news/2017/list-of-700-articles-citing-chronic-infection-associated-with-tick-borne-disease-compiled-by-dr-robert-bransfield/. Published February 9, 2017. Accessed November 26, 2017.
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