[Neurasthenia and thymasthenia]

The term of depression applies to two syndromes at least; one is associated with a reduction in interests, activities and with a withdrawal; the other consists of a moral pain, a pessimism, a guilty feeling, an irritability. In each case the depressive mood corresponds to the subjective state. A first survey concerning 3,000 outpatients in general practice allowed us to identify 16.5 of depressed subjects, with 3% showing a pure painful syndrome, 7% showing a syndrome that we described as thymasthenia, and 6% showing the two syndromes (this last group consists probably of major depressive states). This new study, organized by the WHO and concerning 2,000 consecutive patients in primary care, permitted to precise the definition of thymasthenic subjects. The prevalence of current major depressive states is 13.7% and that of dysthymic disorders is 3.6%. Thymasthenia is observed in 9.2% of patients (mean age: 38 years; 60% of women). Among them, 62% show major depressive states, 18% dysthymic disorders, 16% panic disorders, and 11% pure thymasthenia, corresponding to a prevalence of 1%. It should be noted that the prevalence of neurasthenia (according to the definition given by IDC-10) is of 2.9% and that 36% of thymasthenic subjects show also neurasthenia (according to IDC-10). The qualitative content of these two syndromes will be compared.