title: Sickness behavior in feverish children is independent of the severity of fever. An observational, multicenter study.
abstract: Behavioral changes in a febrile child are usually considered to stem from the fever. We studied sickness behavior (SB) in terms of its clinical components and its relation to fever.
  
  
  METHODS
  This observational, multicenter study included children aged 6 months to 3 years who were either febrile (fever ≥12 hours, ≥ 39°C and ≥38°C at inclusion) or non-febrile and well. The child had to have been awake for the 2 hours preceding the consultation and cared for by the parent who brought him/her to the doctor. SB was evaluated according to 6 parameters over this 2-hour period: time spent playing, distance covered, time spent seeking comfort, time spent whining or crying, time spent in a state of irritation or of anger, most distorted facial expression. Two parameters were assessed for the 24-hour period preceding the consultation: time spent sleeping and appetite. The parent reported the degree of change in these parameters compared with the usual situation, using rating scales.
  
  
  RESULTS
  200 febrile children (most with nonspecific upper respiratory infections) and 200 non-febrile children were included. The mean values of the 8 parameters differed significantly (p<0.001) between the 2 groups and were independent of the height of fever at inclusion in the febrile children. In the study conditions, paracetamol failed to improve SB when the child was still feverish.
  
  
  CONCLUSIONS
  The 8 parameters suggested that SB and fever are two independent manifestations that are activated simultaneously during an infection. This independence is in harmony with recommendations to treat the discomfort of SB and not the fever.
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.|Association Française de Pédiatrie Ambulatoire, Chambéry, France.
authors.forename: François
authors.initials: F
authors.lastname: Corrard
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Christian
authors.initials: C
authors.lastname: Copin
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Alain
authors.initials: A
authors.lastname: Wollner
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.|Department of Microbiology, CHI Créteil, Créteil, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Elbez
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Derkx
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bechet
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Levy
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.
authors.forename: Michel
authors.initials: M
authors.lastname: Boucherat
authors.affiliation: Association Clinique et Thérapeutique Infantile du Val-de-Marne. Saint-Maur-des-Fossés. France.|Association Française de Pédiatrie Ambulatoire, Chambéry, France.|Department of Microbiology, CHI Créteil, Créteil, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology / Q000523:psychology*; D006801:Humans; D055809:Illness Behavior; D007223:Infant; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal