Behavioural Disturbances Related with Febrile Illnesses: A Hospital-based Longitudinal Study

Introduction: Various psychiatric symptoms are seen in patients with fever and during the course of treatment of fever. Due to meager understanding and limited knowledge along with poor infrastructure and lack of facility in peripheral healthcare centres, many patients of febrile psychosis are referred to tertiary centres.

Aim: To study the demographic, clinical profile and diagnostic categorisation of various behavioural manifestations in febrile patients.

Materials and Methods: The present hospital-based longitudinal study was conducted at Department of Psychiatry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2021 to August 2021, on 54 patients, who developed psychiatric symptoms during course or after remission of fever. Detailed socio-demographic characteristics, clinical profile, along with psychiatric assessment, were recorded in proforma designed for the study. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 26.0 (IBM Corp. Armonk, NY, USA).

Results: Out of total 54 patients, in the age group of 21 to 30 years, there were 18 (33.3%) patients and in 31 to 40 years, there were 12 (22.2%) patients who developed psychiatric symptoms after remission or during the course of fever. Most of the patients 40 (74.1%) were hailed from rural areas, 26 (48.1%) patients belonged to lower-middle socio-economic status, majority of the subjects (19, 35.2%) were shop owners, clerks and farmers. Overall, 19 (35.1%) patients developed psychosis due to malarial fever followed by enteric fever (13, 24.1%), viral fever (9, 16.7%), tuberculosis (3, 5.6%) and rheumatic fever (1, 1.8%). Drug-induced behavioural disturbance was found in 9 (16.7%) patients.

Conclusion: General conception among peripheral healthcare workers is that behavioural abnormalities associated with fever occur solely due to serious illnesses like meningitis, encephalitis and cerebral malaria, but present study suggests that a fair number of these psychiatric manifestations are either induced or precipitated functional psychosis and resolve on appropriate management.