What is psychogenic fever caused by stress? Difference between symptoms and cold

What is “psychogenic fever” caused by stress?

When we think of fever, we think of it as something that occurs when we catch a cold, but stress can cause an increase in body temperature, and this symptom is called “psychogenic fever.” Also called functional hyperthermia.

In psychogenic fever, acute or chronic stress can cause a person’s body temperature to rise above normal. If your fever goes down overnight or you have repeated high fevers, psychogenic fever may be the cause.

A rise in body temperature due to stress is a type of stress response, and anyone can develop a psychogenic fever. Causes of psychogenic fever may include:

• Acute stress: working, meeting people, fighting or arguing, being put under extreme stress, going to class, etc.
• Chronic stress……Fatigue from nursing care, troubles in human relationships, worries about one’s own health, continuous overtime at work, etc.

In general, it is often said that a temperature above 37°C is a fever, but there are quite a few people whose normal temperature is in the 37°C range. Body temperature also fluctuates according to time and estrous cycle, and is affected by the measurement equipment and the measurement site.

For this reason, it is difficult to say that “a person has a fever when the temperature rises above ◯℃”.

It affects people of all ages, from children to the elderly

Psychogenic fever is a symptom that can develop in children, adults, and the elderly, regardless of age or gender. In the case of children, it is said that they are more likely to have a high fever because the heat production function is more developed than in adults.

The number of patients with psychogenic fever is not small

The number of patients with psychogenic fever, in which body temperature rises due to stress, is not small. According to a survey conducted in the past, 18% of fevers of unknown origin in children It has been reported that 48% of 40 of the 83 cases in which no specific findings were seen among the patients who visited the hospital for the above reasons had psychogenic fever.

Symptoms of psychogenic fever

Psychogenic fever may cause a strong malaise with an increase in body temperature. Other stress reactions include abdominal pain, headaches, and sleep disturbances.

Mechanism of psychogenic fever

Although it is not fully understood how stress causes body temperature to rise, one of the causes is thought to be that stress disrupts the balance of the autonomic nervous system that regulates body functions.

The autonomic nervous system is a collective term for nerves that have two opposing effects: the sympathetic nerve (activates the state of mind and body) and the parasympathetic nerve (calms the state of the mind and body). By balancing these autonomic nerves, the state of mind and body is adjusted.

Stress is known to stimulate the sympathetic nervous system, which activates the state of mind and body. When you feel stressed, you sweat, your heart beats faster, and you can’t sleep.

It is believed that when the sympathetic nerves become too active, the “brown fat cells” that regulate body temperature are stimulated, resulting in an increase in body temperature.

Two types of psychogenic fever

Psychogenic fever caused by stress can be broadly divided into two types: high fever type and low fever type. From here, we will explain each in detail.

high heat type

The hyperthermia type is a type in which the body temperature rises rapidly when acute stress is applied, and in rare cases, a fever of 40°C or higher may occur.

This high fever type is often seen in children. This is because the school is a stressor (cause of stress), causing an overreaction of stress and raising body temperature.

The high fever type is characterized by quick recovery. However, if you don’t address what is causing the stress, you may experience repeated temperature rises.

Mild fever type

The low-grade fever type is a type that is caused by chronic stress or a combination of several stresses, and is characterized by a continued rise in body temperature to the extent of a low-grade fever. Bad habits also play a role.

This type is often seen in adults in the prime of their lives, such as those who are busy with work and housework and cannot rest both physically and mentally, who are exhausted from nursing care, and who are working overtime. In addition to physical symptoms such as fatigue, headaches, and abdominal pain, insomnia may also occur.

If the stressful situation improves, it may heal naturally, but even after the resolution is resolved, the low-grade fever may continue for a while. Recently, it seems that more and more people have a slight fever due to the stress caused by the corona virus .

In the case of the low-grade fever type, rather than the height of the body temperature itself, there are people who are troubled by the symptoms of psychogenic fever that interfere with their daily lives, such as increased malaise, dizziness, and painful headaches. tend to be many.

Some people have symptoms of both low-grade and high-grade fevers, such as a low-grade fever that usually lasts, and a high fever when exposed to particularly strong stress.

Difference between fever due to stress and fever due to infection

A rise in body temperature caused by stress has a different mechanism from the fever that occurs when you catch a cold. Although it is not correct to call the state in which the body temperature rises due to stress “fever”, it is commonly called fever.

From here, let’s take a closer look at the difference between a fever caused by stress and a fever caused by an infection.

Presence or absence of inflammation

Fever caused by viral infections such as colds is a reaction to fight the virus, triggered by the inflammation caused by the infection.

Substances called “inflammatory cytokines” and “prostaglandin E2 (PGE2)” serve as signals at this time, and the medicines you take when you catch a cold suppress the production of inflammatory cytokines and prostaglandin E2. This gives it an antipyretic effect.

On the other hand, since psychogenic fever is not accompanied by inflammation, it is often said that there is no disease in blood tests and imaging tests such as CT, and that there is no abnormality.

Antipyretic effect

When fever is caused by viral infection, antipyretics act on inflammatory cytokines and prostaglandin E2 to reduce fever.

However, in the case of a stress-induced rise in body temperature, even if the situation is the same, inflammatory cytokines and prostaglandin E2 are not involved. It doesn’t go down.

What department should I see for psychogenic fever?

If you have a high fever or a low-grade fever, it is important to have a thorough examination at the hospital without self-diagnosing that it is because of stress.

If you have symptoms such as “repeated fever at night”, it is not only stress and fatigue, but also the possibility of urinary tract infection, rheumatoid arthritis, and cancer. First of all, let’s thoroughly examine the cause of fever in internal medicine.

If a cause such as illness cannot be found in internal medicine, and psychogenic fever is suspected, it is a good idea to see a psychosomatic medicine or psychiatrist.

Many patients with psychogenic fever are said to have mood disorders such as depression and manic depression, anxiety disorders such as panic disorder and PTSD, and tension-type headache. When treating psychogenic fever, it is important to treat these diseases at the same time.

Treatment for psychogenic fever

Once psychogenic fever is diagnosed, the following methods are used to treat it.

• lifestyle guidance
• drug therapy
• psychotherapy
• Relaxation training (autogenic training method)
• Treatment of other physical and mental illnesses
• Resolving the cause of stress, improving methods of coping with stress, etc.

Antipyretics have little effect on the increase in body temperature due to psychogenic fever, but they may be effective against headache. In addition, anti-stress drugs such as sleeping pills (for insomnia and other inability to get enough sleep), antidepressants, and stabilizers are effective for psychogenic fever.

If you have a fever that is thought to be caused by stress and you think about going to the hospital, record your body temperature. Then, as part of the treatment, they may keep a diary of their temperature.

By keeping a diary, you can understand the effects of antipyretics, the relationship between stress and body temperature, the relationship between housework/work/rest and stress, and the relationship between fatigue and stress, which will be useful for future treatment.

Points to note in daily life when diagnosed with psychogenic fever

If you are diagnosed with psychogenic fever, it is important to spend your daily life. From here, I will explain how to spend your daily life and points to note.

keep stress away

Since psychogenic fevers are caused by stress, it is important to get away from things that are burdening your mind or release stress regularly . regularly .

Physical stress such as overwork and mental stress such as worry and anxiety can lead to brain fatigue and overheating.

Reduce the burden of work and household chores, slow down the pace

Many people have felt tired when they had a fever with a cold.

When hyperthermia persists, the human body consumes more energy than usual to raise the body temperature, so doing things that you normally take for granted can become a burden.

In such a case, if you continue to overdo it, your body temperature will continue to be high. Reduce the burden of work and housework, slow down, and get a good night’s sleep.

Feelings of guilt and self-loathing, such as “I’m sorry that I seem to be skipping” and “I don’t like myself,” lead to stress. It is important to reduce the burden by saying, “This is treatment.”

take frequent breaks before getting tired

For people with fatigue-related body temperature changes, it’s a good idea to take frequent breaks before you get tired, rather than resting when you’re tired.

When taking a break, it is recommended that you lie down rather than standing and sitting. Lying down and closing your eyes relieves not only sympathetic nerve tension but also muscle tension. You don’t need to sleep, just closing your eyes and sitting still can help you relax.

rest the brain

Even if you take time off from work or household chores, if you don’t rest your brain, you won’t be properly rested.

It is important to give your brain a rest by refraining from doing things like surfing the internet on your smartphone or computer, emailing, messaging apps, social media, playing games, making long phone calls, thinking about your worries repeatedly, or blaming yourself.

adjust the rhythm of life

A person’s body temperature is low immediately after waking and then rises, reaching a peak around 4:00 pm. And there is a rhythm of body temperature that the body temperature gradually decreases toward sleep time.

People who have this rhythm out of order may have their life rhythms disrupted, such as going to bed, waking up, and eating. When the rhythm of life is adjusted and the rhythm of body temperature is correct, autonomic nervous system symptoms will improve accordingly.

Psychogenic fever caused by stress is important not to overdo it

An increase in body temperature caused by stress is called “psychogenic fever (functional hyperthermia)”.

Psychogenic fever is divided into high fever type and low fever type, and in the case of low fever type caused by chronic stress, it is important to get enough sleep, slow down your daily life and not overdo it. .

In addition, if the fever continues, there is a possibility that other diseases are hidden instead of psychogenic fever. Don’t make a self-judgment that it’s because of stress, go to a hospital and get tested.

Supervisor profile: Koshiro Fujisawa (general specialist in internal medicine)

Director of Dr. Koshiro’s clinic . General internal medicine specialist certified by the Japanese Society of Internal Medicine. He graduated from Miyazaki University School of Medicine. He is also known as a leading figure in medical education, and his representative works include “Summarize Series”, “Pathophysiology Course”, and “Last Message”. He is also one of the first in Japan to create an original course that incorporates medical English, and is active as an outside lecturer at many university medical schools. To date, about 100,000 medical students and doctors, including those from overseas, have attended the lectures.