The Study of 16 Cases of Psychogenic Fever

Abstract

Objective : Psychosocial stress can result in various physical symptoms. Fever is one such symptom ; however, fever can also be an important indicator of a serious disease. Parents of a child with psychogenic fever can be confused about this symptom and worried that the child has a serious illness, a situation that can be difficult to manage. The purpose of this study was to clarify the characteristics and treatment of psychogenic fever.

Methods : This study included 16 pediatric patients (4 boys and 12 girls), with an average age of 12.2±1.8 years (median age, 13 years), whose chief complaint was fever and who attended the child psychological treatment unit of Okayama University Hospital. We investigated the timing of onset of the fever, comorbidity, treatment, and outcome.

Results : Among the 16 patients, 12 had poor attendance at school and 13 experienced difficulties with adapting to school. Three patients had suffered child abuse. Comorbidities included developmental disability and orthostatic dysregulation (OD). The mean treatment period was 28.9 months (median, 22.5 months), after which nine were cured, one improved, two were stable, one discontinued treatment, and three were transferred to the Department of Psychiatry.

Conclusions : These patients with psychogenic fever had experienced various psychosocial problems, and it was important for them and their families to ensure the child’s safety through appropriate physical conditions and environment. When an opportunity to address the psychogenic fever was clear, it was easy to resolve the symptoms ; for example, children with developmental disability often improved through adjustment of the environment. However, if the psychological causes were uncertain, it was difficult to bring about improvement because this needed growth of both the child’s mind and body, taking a long period of time to improve the psychogenic fever and the child’s adjustment disability.