Feeling feverish? It might be stress


PSYCHOGENIC fever is a stress-related, psychosomatic condition that manifests itself in high body temperature. It is caused by exposure to emotional events or chronic stress. Dr Takakazu Oka, of the Kyushu University Graduate School of Medical Sciences, specializes in psychosomatic medicine and treats patients with psychogenic fevers. In his review article “Psychogenic fever: how psychological stress affects body temperature in the clinical population,” published in the journal Temperature, Dr Oka introduces his recent findings from his research and clinical experience regarding the disease.

“While this condition is known in the literature, only a few doctors in the world study it and treat patients with psychogenic fevers,” says Professor Andrej Romanovsky, of St. Joseph’s Hospital and Medical Center in Arizona, and the Editor-in-Chief of Temperature, “this is why we have invited Dr Oka to share his unique experience.”

According to Dr Oka, there has been no epidemiological study of psychogenic fevers yet. Therefore, the number of affected patients is unknown. However, Dr Oka relays that this condition is relatively widespread — based on the available case reports and his clinical practice. He has seen a high number of patients, especially amongst Japanese students due to academic stress. Dr Oka explains that due to many doctors not fully understanding how stress can affect body temperature, patients with psychogenic fever are being diagnosed with cause unknown for their disabling symptoms.

Dr Oka further describes that the complaints from patients are of the fever itself, along with the symptoms from the high temperature, symptoms from the stress, plus the symptoms from the psychiatric diseases that the patient may suffer from. “High body temperature is just one of the symptoms induced or exacerbated by stress,” Dr Oka says, “Patients ask for the treatment of fever not just their temperature be normalized, but all symptoms to be treated.”

Several treatment options are currently available, but, in general, they are similar to the treatments of other stress-related diseases and not specific to psychogenic fever. However, Dr Oka is convinced that a breakthrough in treatment will occur in the near future, as more research is conducted. He explains, “Because even their doctors did not believe the fever is caused by or related with psychological stress… Recent animal studies enable doctors to be aware of this pathophysiology.”

Instead of using the traditional term “psychogenic fever,” Dr Oka proposes to call this condition “functional hyperthermia.” Using the word “functional” would prevent stigmatizing these patients, and in a clinical setting connotes both stress-related pathology and impaired functioning of the autonomic nervous system.