Disabling symptoms associated with increased axillary temperature in patients with functional hyperthermia

Table 1 Patient demographics and clinical characteristics

Age, mean ± SD, years	31.2 ± 10.9
Sex, male:female, n (%)	7 (35):13 (65)
Maximal axillary temperature, ℃
Mean ± SD	38.0 ± 0.4
Range	37.5 – 39.0
Fever duration
Mode	2 years
Range	2 months – 7 years
Fever subtype, n
1) Usually a normal temperature, but suddenly develops a high fever of 38 °C or higher	0
2) A low-grade fever in the 37 °C range persists for more than several weeks	8
3) A low-grade fever in the 37 °C range intermittently	4
4) A continuous low-grade fever in the 37 °C range and sometimes a high fever of 38 °C or higher	8
Visited psychiatrists, n (%)	13 (65%)
Final diagnosis of comorbid psychiatric disorders (includes duplicate diagnoses), n
None except for functional hyperthermia	4
Depressive disorders	4
Adjustment disorders	3
Anxiety disorders	3
Somatic symptom and related disorders	2
Neurodevelopmental disorders	1
Post-traumatic stress disorder	1
Presence of physical disease, n (%)	8 (40%)
Comorbid physical diseases (includes duplicate diagnoses), n
Premenstrual syndrome	5
Irritable bowel syndrome	3
Orthostatic dysregulation	2
Tension-type headache	2
Functional dyspepsia	1
Sleep apnea syndrome	1
Overactive bladder	1
Hypertension	1
Background factors, n
Stressful events within the past six months before the onset of symptoms	18
Inflammatory events, such as viral infection, just before symptom onset	8
Both stressful events and inflammatory events before the onset of symptoms	7
Adverse childhood experiences	5

Background factors were determined from the patient's pre-examination form and medical interview at the first visit. Eighteen patients reported that they had high stress within the past 6 months before the onset of symptoms and that it might be associated with their low-grade fever. Two patients denied the involvement of psychosocial stress. One female patient was a doctor who developed symptoms while busy with her job, raising 2 young children, and doing housework. However, she did not find it stressful. One male patient who had a psychologically traumatic experience as a child was worried about interpersonal relationships at work and in his family, but he did not feel that this was stressful. In other words, these 2 patients exhibited characteristics of alexisomia, or difficulty in the awareness and expression of physical conditions [3]. Therefore, in the author’s opinion, all patients with FH in this study could be diagnosed with psychosocial stress-related psychogenic fever

ISSN: 1751-0759