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Summary
Neurasthenia, a 19th-century concept for exhaustion, evolved differently globally. While Western psychiatry adopted new terms for fatigue, neurasthenia remains relevant in Russia and Asia, and is recognized in ICD-10.
Area of Science:
- Medical History
- Psychiatry
- Neurology
Background:
- Neurasthenia was a 19th-century concept explaining exhaustion and somatic symptoms due to nervous system overwork.
- The concept was widely adopted, influencing early psychoanalytic thought, notably by Freud.
- In Western psychiatry, neurasthenia declined, replaced by diagnoses like anxiety and affective disorders.
Purpose of the Study:
- To trace the historical trajectory and conceptual evolution of neurasthenia.
- To examine the differing diagnostic landscapes of neurasthenia in Western and Eastern psychiatric contexts.
- To highlight the contemporary relevance and recognition of neurasthenia in international classifications.
Main Methods:
- Historical analysis of psychiatric literature and diagnostic manuals.
- Comparative review of diagnostic trends in Western and Asian psychiatry.
- Examination of the inclusion and significance of neurasthenia in the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM).
Main Results:
- Neurasthenia, initially a mechanistic explanation for fatigue, saw diverse interpretations and eventual decline in Western diagnostics.
- Despite Western shifts, neurasthenia persisted in Russia and Asia due to cultural and ideological factors.
- Contemporary Western psychiatry acknowledges fatigue-related conditions with new terms, while ICD-10 retains neurasthenia.
Conclusions:
- The concept of neurasthenia, though historically debated, reflects enduring clinical realities of fatigue and exhaustion.
- Cultural and regional factors significantly influence the acceptance and classification of psychiatric conditions like neurasthenia.
- International diagnostic systems show divergence, with ICD-10 acknowledging neurasthenia while DSMs do not, necessitating further dialogue on fatigue-related disorders.