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07-SEPTEMBER-2008 03:17:44 - Neurasthenia Neurasthenia Classification and external resources ICD-10 F48.0 ICD-9 300.5 Neurasthenia is a psycho-pathological term first used by George Miller Beard in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, impotence, neuralgia and depressed mood.1 It is currently a diagnosis in the World Health Organisation's International Classification of Diseases, and in the Chinese Classification of Mental Disorders under the translation 'shenjing shuairuo'. Americans were supposed to be particularly prone to neurasthenia, which resulted in the nickname Americanitis popularized by William James. However, it is no longer included as a diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders although there is a category of Undifferentiated Somatoform Disorders. Contents 1 Symptoms 2 Treatment 3 Diagnosis 4 Skepticism 5 Today 6 Notes 7 See also 8 References Symptoms It was explained as being a result of exhaustion of the central nervous system's energy reserves, which Beard attributed to civilization. Physicians in the Beard school of thought associated neurasthenia with the stresses of urbanization and the pressures placed on the intellectual class by the increasingly competitive business environment. Typically, it was associated with upper class individuals in sedentary employment. Treatment Beard, with his partner A.D. Rockwell, advocated first electrotherapy and then increasingly experimental treatments for people with neurasthenia, a position that was controversial. An 1868 review posited that Beard's and Rockwell's grasp of the scientific method was suspect and did not believe their claims to be warranted. William James was diagnosed with neurasthenia, and was quoted as saying, I take it that no man is educated who has never dallied with the thought of suicide. Townsend, 1996. Diagnosis In the late 1800s, neurasthenia became a popular diagnosis, expanding to include such symptoms as weakness, dizziness and fainting, and a common treatment was the rest cure, especially for women, who were the gender primarily diagnosed with this condition at that time. Virginia Woolf was known to have been forced to undergo rest cures, which she describes in her book On Being Ill. Charlotte Perkins Gilman's protagonist in The Yellow Wallpaper also suffers under the auspices of rest cure doctors, much like Gilman herself. Marcel Proust was said to suffer from neurasthenia. To capitalize on this epidemic, the Rexall drug company introduced a medication called 'Americanitis Elixir' which claimed to be a soother for any bouts related to Neurasthenia. Skepticism In 1895, Sigmund Freud reviewed electrotherapy and declared it a pretense treatment. He highlighted the example of Elizabeth von R's note that the stronger these were the more they seemed to push her own pains into the background,. See also placebo effect. Nevertheless, neurasthenia was a common diagnosis in World War I - for example, every one of the c.1700 officers processed through the Craiglockhart War Hospital was diagnosed with neurasthenia - but its use declined a decade later. Today The modern view holds that the main problem with the neurasthenia diagnosis was that it attempted to group together a wide variety of cases. In recent years, Richard M. Fogoros has posited that perhaps neurasthenia was a word that could include some psychiatric conditions, but more importantly, many physiological conditions marginally more understood by the medical community, such as fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome, that according to Fogoros have one factor in common: dysautonomia. He emphasizes that the majority of patients who would have once been diagnosed with neurasthenia have conditions that are real, honest-to-goodness physiologic as opposed to psychologic disorders... and while they can make anybody crazy, they are not caused by craziness. see reference, below The diagnosis of Neurasthenia became popular in China, although it has been increasingly subsumed under the DSM construct of Major depressive disorder. It has been a less stigmatizing diagnosis than depression, being conceptually distinct from psychiatric labels. It was also said to fit well with a tendency to express emotional issues in somatic terms, and with the traditional Chinese epistemology of disease causation on the basis of disharmony of vital organs and imbalance of qi. Notes ^ The term had been used at least as early as 1829 to label an actual mechanical weakness of the actual nerves, rather than the more metaphorical nerves referred to, by Beard, in 1869. See also Combat stress reaction References Beard, G. 1869, April 28. Neurasthenia, or nervous exhaustion. The Boston Medical and Surgical Journal. pp. 217-221 Weir Mitchell, S. 1884. Fat and Blood: an essay on the treatment of certain types of Neurasthenia and hysteria. Philadelphia: J. D. Lippincott Co. Marcus, G. 1998, January 26. Where are the elixers of yesteryear when we hurt? The New York Times. Ross, D. 1991. William James: Spoiled child of American psychology. In G. A. Kimble, M. Wertheimer, C. White Eds. Portraits of pioneers in psychology pp. 13-25. Washington, DC: American Psychological Association. Schultz, D. P., Schultz, E. S. 2004. A history of modern psychology. pp. 178-179. California: Thomson Wadsworth. Townsend, K. 1996. Manhood at Harvard: William James and others. pp. 32-33. New York: W. W. Norman Gijswijt-Hofstra, M. Porter, R. eds, Cultures of Neurasthenia: From Beard to the First World War, Rodopi, Amsterdam, 2001; ISBN 90-420-0931-4. A family of misunderstood disorders, by Richard N. Fogoros An American Treatment for the 'American Nervousness' Neuraesthenia revisited: ICD-10 and DSM-III-R psychiatric syndromes in chronic fatigue patients and comparison subjects v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Elopement, Sundowning, Wandering · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering Retrieved from http://en..org/wiki/Neurasthenia Categories: Anxiety disorders | Neurological disorders | Military psychiatry Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages ÄŒesky Español Esperanto Nederlands Polski СрпÑ?ки / Srpski This page was last modified on 26 August 2008, at 10:16
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