Among those who develop episodic or persistent high core body temperature (Tc) without
any inflammatory causes, there are patients whose high Tc is associated with psychological
stress. Some patients develop a high fever (up to 40 °C) when they are exposed to emotional events, whereas others show a persistent low-grade
fever (37–38 °C) during situations of chronic stress. Their high Tc has been called “psychogenic
fever”. Psychogenic fever is a stress-related, psychosomatic disease especially seen
in young adults. The mechanisms underlying how psychological stress causes acute or
persistent increases in Tc in these patients are still poorly understood. However,
studies have demonstrated that psychogenic fever is not attenuated by antipyretic
drugs but by psychotropic drugs that have anxiolytic and sedative properties, relaxation
training or psychotherapy. In this symposium, I would like to give a historical overview
of psychogenic fever first. Then, I would like to discuss the possible mechanisms
of psychogenic fever based on the findings obtained by stress interviews. Some patients
develop high Tc during a stress interview, e.g. 1.0 °C increase within one hour. Increase in Tc is not associated with blood levels of
prostaglandin E2 or pyrogenic cytokines such as IL-1β or IL-6, but with increase in blood catecholamine.
Furthermore, psychogenic fever patients show heightened heart rate response to orthostatic
stress compared with healthy subjects. These findings suggest that psychogenic fever
in humans is induced by different mechanisms from infection/inflammation-associated
fever, where proinflammatory mediators play a pivotal role. Rather, heightened sympathetic
activity may be involved in this phenomenon.
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© 2015 Published by Elsevier Inc.