Oka, Takakazu, Kanemitsu, Yoshio, Sudo, Nobuyuki et al. · BioPsychoSocial medicine · 2013 · DOI
This study followed one ME/CFS patient who noticed her low-grade fevers got worse during stressful work situations. Researchers had her recall stressful memories while measuring her body temperature and stress hormones. Her core temperature rose by about 1°C during stress, but blood markers related to fever-causing inflammation didn't change, suggesting stress hormones (not immune inflammation) triggered the temperature increase.
Low-grade fever affects many ME/CFS patients but remains poorly explained. This case suggests that psychological stress may trigger temperature elevation through sympathetic nervous system activation rather than classic immune inflammation, potentially opening new avenues for understanding and managing this symptom.
This single-case report does not establish that psychological stress causes fever in all or most CFS patients—findings may not generalize beyond this one individual. The study shows correlation between stress and temperature changes, not definitive causation, and cannot rule out other physiological mechanisms operating in different patients. The lack of cytokine changes does not prove they are never involved in CFS fever.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Oka, Takakazu, Kanemitsu, Yoshio, Sudo, Nobuyuki, Hayashi, Haruo, & Oka, Kae (2013). Psychological stress contributed to the development of low-grade fever in a patient with chronic fatigue syndrome: a case report.. BioPsychoSocial medicine. https://doi.org/10.1186/1751-0759-7-7
BibTeX
@article{mecfsatlas-oka-2013-psychological-stress,
author = {Oka, Takakazu and Kanemitsu, Yoshio and Sudo, Nobuyuki and Hayashi, Haruo and Oka, Kae},
title = {Psychological stress contributed to the development of low-grade fever in a patient with chronic fatigue syndrome: a case report.},
journal = {BioPsychoSocial medicine},
year = {2013},
doi = {10.1186/1751-0759-7-7},
note = {PubMed: 23497734},
url = {https://www.mecfsatlas.com/evidence/oka-2013-psychological-stress},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/oka-2013-psychological-stress
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