I recently applied to the World Health Organization Family of International Classifications (WHO-FIC) to consider a new and deadly ICD9 (1) diagnosis, LOD 479.0 (Lyme Obsession Disorder) which has reached epidemic levels in some groups of healthcare providers and the general public.

It is characterized by two primary fixed delusions:
1) that the Lyme spirochete is the cause of all diseases and symptoms and
2) that no other cause of chronic medical or psychiatric disorders is remotely possible.

Those afflicted with LOD are usually incapable of considering the other 965,000 causes of Lyme symptoms (e.g., fatigue, various neurological symptoms, arthritis and dermatological symptoms). Furthermore when confronted with the fact that a laboratory abnormality often correlated to Lyme could have nothing whatsoever to do with symptom complexes or that such a finding could suggest that a patient’s immune system is responding rather well to Lyme and possibly 13,000 other opportunistic infections, those diagnosed with LOD will react defensively.

The diagnosis is further broken down by coding the 4th digit as follows.

* LOD with BO features (babesiosis obsessions) – 479.1
* LOD with EIEIO features (ehrlichiosis infections everywhere in others) – 479.2
* LOD with RBBO features (really bad BO or really bad bartenella obsessions) – 479.3
* LOD with AAD features (alien abduction delusions) – 479.4
* LOD with ACD features (anti-communist delusions) – 479.5 (often difficult to differentiate from AAD 479.4)

LOD is often preceded by similar disorders which have historically fallen out of vogue such as HMCAI (2), SVCAI (3), ESCAI (4), FACAI (5), HICAI (6) and CCAI (7). The prognosis is very poor unless a colleague forces themselves upon the clinician suffering from LOD, grabs them by the lapels, shakes them and screams in their face at least once a day for 20 consecutive days, that virtually all chronic diseases (including Lyme) have a multiplicity of PsychoImmunoNeuroEndocrine (PINE) causes and that it is never as simple as treating one or a few germs.

Treatment of the LOD-stricken clinician should also include writing the following sentence on a blackboard 1000 times a day for one month: “Antibiotics and herbals for the treatment of any chronic infection only shift the balance of power 10% (at best) to the immune system, and the PINE system is still responsible (at worst) for 90% of successful clinical outcomes.”

In our outcome series we have found that this treatment achieves 87% positive outcome rates for LOD, but that relapses are common and will require more treatment such as that described here.
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Footnotes:
1- International Statistical Classification of Diseases and Related Health Problems Association (most commonly known by the abbreviation ICD)
2- heavy metals cause all illnesses
3- stealth viruses cause all illnesses
4- environmental sensitivities cause all illnesses
5- food allergies cause all illnesses
6- hormone imbalances cause all illnesses
7- candida causes all illnesses

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