Aggressiveness, violence, homicidality, homicide, and Lyme disease

Abstract

Background

No study has previously analyzed aggressiveness, homicide, and Lyme disease (LD).

Materials and methods

Retrospective LD chart reviews analyzed aggressiveness, compared 50 homicidal with 50 non-homicidal patients, and analyzed homicides.

Results

Most aggression with LD was impulsive, sometimes provoked by intrusive symptoms, sensory stimulation or frustration and was invariably bizarre and senseless. About 9.6% of LD patients were homicidal with the average diagnosis delay of 9 years. Postinfection findings associated with homicidality that separated from the non-homicidal group within the 95% confidence interval included suicidality, sudden abrupt mood swings, explosive anger, paranoia, anhedonia, hypervigilance, exaggerated startle, disinhibition, nightmares, depersonalization, intrusive aggressive images, dissociative episodes, derealization, intrusive sexual images, marital/family problems, legal problems, substance abuse, depression, panic disorder, memory impairments, neuropathy, cranial nerve symptoms, and decreased libido. Seven LD homicides included predatory aggression, poor impulse control, and psychosis. Some patients have selective hyperacusis to mouth sounds, which I propose may be the result of brain dysfunction causing a disinhibition of a primitive fear of oral predation.

Conclusion

LD and the immune, biochemical, neurotransmitter, and the neural circuit reactions to it can cause impairments associated with violence. Many LD patients have no aggressiveness tendencies or only mild degrees of low frustration tolerance and irritability and pose no danger; however, a lesser number experience explosive anger, a lesser number experience homicidal thoughts and impulses, and much lesser number commit homicides. Since such large numbers are affected by LD, this small percent can be highly significant. Much of the violence associated with LD can be avoided with better prevention, diagnosis, and treatment of LD.

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Keywords:

• Borrelia burgdorferi
• impulsive
• tick-borne
• rage
• suicide
• immune

This article is referred to by:

Aggressiveness, violence, homicidality, homicide, and Lyme disease

Acknowledgments

Thanks to Michael J Cook for statistical assistance and Rhiannon Woolwich-Holzman, VMD; Ed Breitschwerdt, DVM, DACVIM; Barbara Rosenthal; Courtney Bransfield; Douglas Bransfield; Phillis Chrampanis and Willison Reed for assistance.

Disclosure

The author has treated, evaluated, and been an expert witness in cases involving homicide and other violent behaviors over a span of 45 years. The author has worked in correctional systems. The author has worked with patients with LD over a span of 30 years and has been an expert witness in cases involving LD and in cases involving LD and homicide, multiple homicides, violent behavior, and other legal cases. The author reports no conflicts of interest in this work.