Study: Bedbugs can drive some people crazy

Crain's New York Business
Wednesday, May 18, 2011

Bedbugs are enough to give anyone the whim whams. But for New Yorkers already struggling with mental illness, bedbug infestations-and even just the possibility of them-are sending some patients over the edge, a team of NYU Langone Medical Center doctors reports.

In an abstract of an unpublished study presented at a recent meeting of the American Psychiatric Association in Honolulu, the doctors told of patients whose conditions worsened because of the creepy critters. "We are not saying bedbugs cause psychosis," said Dr. Evan Rieder, a psychiatry resident at the medical center, but the bedbug is increasingly being seen as "a psycho-social stressor," just like losing a job, going through a divorce or having a death in the family. That can bring out latent illness or worsen existing mental conditions.

At Stern Environmental Group in Secaucus, N.J., a large bedbug-exterminating firm whose clients include several New York City hospitals, managing partner Douglas Stern said the report did not surprise him. "We've known for years that even normal people have a psychological response to bed bugs," Mr. Stern said. "Society's more concerned about people with medical problems and maybe people don't put the same value on bedbugs causing this kind of mental suffering so it's good they did this study."

Intense media interest in the infestations is also contributing to patients' fears, said Dr. Gareen Hamalian, also a psychiatric resident at NYU. The abstract charted a dramatic spike in the number of media reports on bedbugs.

Dr. Rieder said he found the patients by talking to colleagues in clinics, private doctors' offices and in hospital emergency departments. The problem is widespread, he said: "When we presented this at the APA meeting, which is attended by people from all over the world, it resonated with a lot of them."

New York patients described anonymously in the study included a 22-year-old woman diagnosed with bipolar disorder whose illness was under control until she found bedbugs in her apartment. According to the study, she hired an exterminator but the resulting fees and anxiety led to depression, hopelessness and "significant social isolation," including a forced leave from her work. Things got better three weeks after the exterminator left, but then she found another bug-and all her symptoms returned.

The patients' stories point to an unmet need, the authors suggest. "The psychiatric implications of bedbugs are important to consider and treat when attempting to control and contain infestations. [In extreme cases,] impairment may be significant enough to cause suicidality and warrant inpatient hospitalization."

In another case, a 49-year-old woman living in a housing project was dealing with chronic paranoid schizophrenia when a bedbug infestation added to her problems. According to the study, "her boyfriend stopped visiting and her church asked her not to return after bedbugs were found in pews." Social service agencies came to her rescue. A case manager saw that workers were hired to clean the apartment, discard her belongings and then exterminate. But the patient had to be hospitalized for a month, both because her mental state was worsened and because she had anemia apparently due to blood loss from bedbug bites. With help she was able to return to the apartment, only to inadvertently re-infest it. "She transferred bedbugs from her mother's apartment," the study said. The patient was re-admitted to a hospital.

Though those patients' problems involved real bugs, the study also cited a case of a 35-year-old man with was convinced bedbugs were biting him-despite negative findings by several dermatologists and an exterminator who went to his apartment. Though the man had never been treated for mental illness, psychiatrists diagnosed him with a delusional disorder, one he may still have. "He voiced conviction that daily scrubbing with household bleaches was the only reason for [improvement] of his symptoms," the doctors wrote.

Infestation may even have played a role in another patient's suicide attempt, though alcohol abuse was involved, the study found.

In addition to making their profession more aware of the phenomenon, the study's authors hope their findings, which they expect to be published in a journal, will lead to a public education campaign addressing the need to contain infestations.

Mr. Stern said the bedbug problem shows no signs of going away. "It's seasonal," he explained. "They'll come out in the warm weather. It's quiet now but everything I hear says this summer's going to be worse than last."