Pyrexiophobia: symptoms, causes and treatment

Extreme fear of hallucinations caused by fever, or pyrexiophobia, can be very harmful.

We know that phobias exist for any stimulus we can imagine. Many of them are considered "rare" phobias, because of their low frequency of occurrence and/or because of the characteristics of the phobic stimulus.

This is the case of pyrexiophobia, which is an intense, irrational and disproportionate fear of fever hallucinations.. In this article we will know what this peculiar phobia consists of, and we will review what fever is and what hallucinations are. Finally, we will know the symptoms, causes and treatments of pyrexiophobia.

Pyrexiophobia: what is it?

Pyrexiophobia is the phobia of fever hallucinations. That is to say, it appears an intense fear to suffer hallucinations in febrile states.. This is a specific phobia (anxiety disorder), classified as "other phobia" according to the DSM-5 (Diagnostic Manual of Mental Disorders).

When suffering from a very high fever, sometimes one of the symptoms that may arise is hallucinations. Hallucinations are "objectless perceptions", i.e. it involves for example seeing something that does not really exist, or hearing it, noticing it, feeling it, etc.

Thus, hallucinations can be of different types: auditory, visual, tactile...... They are usually associated with delusions (in psychotic disorders), although in the case of fever this is not the case.

Hallucinations

Hallucinations also appear in other pathologies, this time more serious, since they are mental disorders and not a simple fever. Thus, hallucinations appear especially in psychotic disorders (e.g. schizophrenia). They can also appear in mood disorders (bipolar disorder and depressive disorder) or in a cognitive impairment disorder (dementias).

In the population without mental pathology, although less common, hallucinations can also appear under highly stressful situations. Normally it is a more "physiological" type of hallucination; specifically, we are talking about hypnagogic and hypnopompic hallucinations. The former appear when we are entering a state of sleep, and the latter, when we wake up.

However, in pyrexiophobia, fear appears only in the face of hallucinations produced by fever.

Fever

Fever consists of an increase in body temperature. This increase is usually temporary, and responds to an illness, infection or specific discomfort. In most cases, fever is a response to infections.

What causes fever is a group of substances (endogenous and exogenous) called "pyrogens". But how exactly does fever occur? As we said, pyrogens are the agents that cause fever. These substances act on centers of the hypothalamus (specifically, on centers called "thermoregulatory"), increasing its temperature.

When can we say that we have a fever? In the case of children, a fever is considered to exist when the temperature is equal to (or higher than):

38 degrees Celsius (38 ºC): if measured in the buttocks. 37.5 ºC (37.5 ºC): if measured in the mouth 37.2 ºC: if measured under the arm (axilla).

In the case of adults, a fever is considered to be present when the body temperature is between 37.2°C and 37.5°C.

Very high fevers: hallucinations.

As we were saying, hallucinations appear when fevers are very high. We are talking about temperatures that can exceed 41ºC. This type of fever is usually not caused by an infection, but by an alteration of the central nervous system (CNS).

When the body temperature is so high, the body can be damaged.. In addition to hallucinations, other symptoms such as confusion and drowsiness appear. The hallucinations that appear can be of different types and intensity.

On the other hand, if the body temperature continues to rise, the damage to the body becomes irreversible; in these cases, the proteins eventually lose their structure. Finally, when a temperature of 42 ºC is reached, the patient falls into a coma, and at 43 ºC death occurs.

Differential diagnosis

We know that high fever can cause hallucinations. However, there are other medical conditions that can cause high fever and hallucinations.and that we must take into account in order not to confuse the symptoms:

Encephalitis

Encephalitis consists of an inflammation of the brain, which can cause irritation and swelling.. It is usually caused by a virus. Among the symptoms of encephalitis are hallucinations and high fever. However, we insist that in pyrexiophobia, the phobia is given only to hallucinations caused by fever.

Symptoms

The symptoms of pyrexiophobia, as a specific phobia, consist mainly of an intense, persistent and disproportionate fear of suffering hallucinations caused by high fever..

Another symptom of pyrexiophobia is the avoidance of the phobic stimulus; in this case, the person would avoid at all costs suffering from high fever, the person would avoid at all costs suffering from a fever (although this is a difficult situation to control). This avoidance of fever would logically imply the avoidance of hallucinations.

In addition, as in all phobias, there is discomfort associated with the symptoms, which has an impact on the overall functioning of the person. This distress is clinically significant and interferes in the daily life of the individual with pyrexiophobia.

Causes

The causes of pyrexiophobia are related to previous lived experiences, related to hallucinations caused by the fever itself. That is, it is likely that the person has experienced these hallucinations in a situation of very high fever, and has experienced the situation as very unpleasant.

The hallucinations probably caused fear, anguish, anxiety, or such a degree of bewilderment. or such a degree of perplexity that the experience became traumatic and led to pyrexiophobia.

Other possible causes of pyrexiophobia are related to more temperamental or personality aspects; there is a type of people more predisposed to suffer anxiety disorders. These are people with a more insecure, unstable or "fragile" temperament. If, in addition, the person already suffers from another previous anxiety disorder, the risk may also increase..

Treatment

Pyrexiophobia is treated as a specific phobia. The main (and most effective) psychological treatment indicated for specific phobias is exposure therapy.. Through it, we can expose the patient to situations increasingly more anxiogenic and closer to the phobic stimulus.

In the case of pyrexiophobia, as it would be unethical to induce a state of fever or induce hallucinations through drugs, we can choose to expose the patient to symptoms similar to these states. It can also be done through virtual reality exposure or symbolic exposure (through videos).

The objective is that the patient, as far as possible in this case, experiences/feels the symptoms that cause so much anxiety (hallucinations) and that the intense fear associated with them disappears.

Cognitive techniques can also be used that allow the patient to have a more realistic vision of the stimuli that he/she fears so much, understanding that these do not have to cause him/her harm. It is important that he/she understands that high fevers only appear in extreme and rare cases, that many times this cannot be controlled or predicted, and that in the case of appearing, the hallucinations he/she may experience will not cause him/her any harm either.

In the end, fever is an adaptive response of the body that is warning us that "something is wrong" (together with hallucinations, which can hardly be avoided) and this should be conveyed to the patient, to reduce the catastrophic and pessimistic thoughts associated with pyrexiophobia.