[A scale to assess psychasthenia]

Area of Science:

• Psychiatry
• Psychology
• Neurology

Context:

• Pierre Janet's concept of psychasthenia is largely unappreciated and not recognized in current diagnostic manuals like the DSM III-R.
• The symptoms of psychasthenia are fragmented across various diagnostic categories, including mood, anxiety, and somatoform disorders.
• This fragmentation leads to underdiagnosis and misdiagnosis of patients experiencing psychasthenia.

Purpose:

• To introduce a novel scale for the global evaluation of psychasthenia.
• To provide a diagnostic aid for clinicians encountering patients with symptoms consistent with psychasthenia.
• To facilitate the recognition and accurate classification of psychasthenia as a distinct clinical entity.

Summary:

• The proposed scale comprises three lists assessing asthenia (fatigue without organic cause), cognitive difficulties (concentration issues, obsessions), and neurasthenic physical symptoms.
• The first list evaluates physical and mental fatigue linked to an inability to act.
• The second list measures difficulties in mental concentration, characterized by doubts and obsessions, while the third list details somatic complaints without identifiable organic pathology.

Impact:

• This scale can assist clinicians in identifying and diagnosing psychasthenia more effectively.
• By offering a structured evaluation, it may lead to better understanding and treatment of patients previously categorized under different diagnoses.
• The scale's inclusion of items referencing the disorder's history (items 2, 3, 5, 25, 26, 29) aids in longitudinal assessment.