Crowd-sourced investigation of a potential relationship between Bartonella-associated cutaneous lesions and neuropsychiatric symptoms

INTRODUCTION: Preliminary studies suggest that infection with Bartonella bacteria can not only cause a characteristic rash, headache, fever, and fatigue but also neuropsychiatric symptoms. To date, this association has only been reported in case studies, and it remains unclear if this association generalizes to larger samples. METHODS: We used Amazon's Mechanical Turk (MTurk) to crowdsource a large sample (N = 996) of individuals to ascertain the extent to which the presence of participant-identified Bartonella-associated cutaneous lesions (BACL) was associated with self-reported measures of anxiety, depression, and schizotypy. Participants were asked to select images of cutaneous lesions they had seen on their own bodies and complete a battery of self-report questionnaires to assess psychiatric symptoms. Participants were not informed that the focus of the study was on potential dermatological lesions associated with Bartonella. Point-biserial correlations were used to determine the potential relationship between selecting a BACL image and the severity of self-reported psychiatric symptoms. RESULTS: Scores of anxiety, depression, and schizotypy were positively and significantly correlated with selecting a BACL image. Furthermore, self-report scores of 10 or higher on the GAD-7 and PHQ-9, which represent the suggested clinical cutoffs for meeting criteria for a depressive or anxiety-related disorder, were also significantly associated with selecting a BACL image. Non-Bartonella-associated cutaneous legions were also significantly associated with self-reported measures of psychiatric symptoms. DISCUSSION: The current study broadens the link between the presence of BACL and the presence of psychiatric symptoms of anxiety, depression, and schizotypy and extends a potential relationship beyond the small sample sizes of previous case studies and case series. Further investigation is recommended to address limitations and expand on these findings.