Okada Ayumi, Shigeyasu Yoshie, Fujii Chikako, Tanaka Chie, Hanzawa Mana, Sugihara Akiko, Horiuchi Makiko, Tsukahara Hirokazu
Department of Pediatrics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Pediatrics, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700- 8558, Japan.
Biopsychosoc Med. 2024 Dec 18;18(1):23. doi: 10.1186/s13030-024-00322-8.
Psychosocial stress can induce various physical symptoms, including fever, which is a commonly seen symptom in pediatric practice. In cases of unexplained fever, psychogenic fever should be considered as a potential cause. Children with neurodevelopmental disorders may be more vulnerable to stress and therefore more prone to developing somatic symptoms than their peers. This study aimed to elucidate the characteristics of children with psychogenic fever and comorbidity.
This study included 21 patients with psychogenic fever who visited the Department of Pediatric Psychosomatic Medicine, Okayama University Hospital. Information on age, sex, disease onset, final estimated diagnosis, comorbidities, treatment course, and outcome was obtained from the patients' medical records.
Of the 21 patients included, 7 were boys and 14 were girls, and their median age was 13.0 (range: 8.6-14.6) years. A total of 19 patients had no attendance at school, and all patients showed signs of maladjustment in school. The comorbidities included orthostatic dysregulation (n = 4) and migraine (n = 3). Neurodevelopmental disorders were observed in nine patients, eight of whom were diagnosed after the initial visit. The mean treatment duration was 37.2 months. The outcomes were complete remission (n = 9), improvement (n = 4), discontinuation (n = 1), and referral to another physician (n = 7).
Various comorbidities were observed in the patients of this study with psychogenic fever, including the coexistence of neurodevelopmental disorders, such as autistic spectrum disorder. Children with neurodevelopmental disorders are prone to psychological stress resulting from difficulties in social adjustment. It is crucial to understand the developmental characteristics and environmental adaptation of patients to facilitate accurate diagnosis and treatment.
心理社会压力可诱发多种身体症状，包括发热，这在儿科临床中是常见症状。在不明原因发热的病例中，应考虑心因性发热为潜在病因。神经发育障碍儿童可能比同龄人更容易受到压力影响，因此更易出现躯体症状。本研究旨在阐明心因性发热儿童及其合并症的特征。
本研究纳入了21例到冈山大学医院儿童身心医学科就诊的心因性发热患儿。从患者病历中获取了年龄、性别、发病情况、最终估计诊断、合并症、治疗过程及结果等信息。
纳入的21例患者中，7例为男孩，14例为女孩，中位年龄为13.0岁（范围：8.6 - 14.6岁）。共有19例患者未上学，所有患者均表现出在学校适应不良的迹象。合并症包括直立性调节障碍（n = 4）和偏头痛（n = 3）。9例患者存在神经发育障碍，其中8例在初次就诊后被诊断。平均治疗时长为37.2个月。结果为完全缓解（n = 9）、改善（n = 4）、停药（n = 1）及转诊至其他医生（n = 7）。
本研究中心因性发热患者存在多种合并症，包括神经发育障碍如自闭症谱系障碍的共存。神经发育障碍儿童容易因社会适应困难而产生心理压力。了解患者的发育特征和环境适应情况对于促进准确诊断和治疗至关重要。
