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They are often triggered by things like illness or infection, going without food for a long time, and, in some cases, heavy exercise

JAMA Psychiatry 78:481

doi: 10.1016/j.bbrc.2012.03.109

[DOI] [PMC free article] [PubMed] [Google Scholar] 349.Hartmann B., Heine G., Babina M., Steinmeyer A., Zgel U., Radbruch A., Worm M