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Wulf Rössler - One of the best experts on this subject based on the ideXlab platform.
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The spectra of Neurasthenia and depression: course, stability and transitions
European Archives of Psychiatry and Clinical Neuroscience, 2007Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood. Methods In a stratified community sample ( n = 591), representative of 2600 persons of the canton of Zurich, Switzerland, Neurasthenia and depression were assessed in six structured interviews between ages 20 and 41. Course, stability and comorbidity were examined. A severity spectrum of Neurasthenia and depression from symptoms to diagnosis was taken into account. Results The annual prevalence of a Neurasthenia diagnosis increased from 0.7% to 3.8% from age 22–41, while mere symptoms became less prevalent. Intraindividual courses improved in 40% and deteriorated in about 30% of symptomatic cases. The most frequent symptoms overall, besides criterial exhaustion, were increased need for sleep, over-sensitivity, nervousness and difficulty concentrating. Cross-sectional associations and overlap with depression were strong. Longitudinal stability of ICD-Neurasthenia was low. Conclusions Neurasthenia is intermittent, overlaps significantly with depression, and shows improvement and deterioration over time to roughly equal measures.
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The spectra of Neurasthenia and depression: course, stability and transitions.
European archives of psychiatry and clinical neuroscience, 2006Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood.
Vladan Starcevic - One of the best experts on this subject based on the ideXlab platform.
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Neurasthenia in European Psychiatric Literature
2016Co-Authors: Vladan StarcevicAbstract:Neurasthenia has been a frequent diagnosis in Europe, particularly in some Eastern European countries. This article reviews European contributions to Neurasthenia over the past 20 years. The review shows that there are considerable cross-national differences in the way Neurasthenia is conceptualized, understood etiologically, and treated. These differences can to a certain extent be attributed to different social and political forces that operate in different settings. The implications of such a diversity of views are discussed, with respect to diagnosis, nosology and cross-cultural utility of the concept of Neurasthenia. In Europe, the diagnostic label of Neurasthenia is still used officially, because this diagnosis has been retained by the World Health Organization and its International Classification of Diseases (ICD). However, there is no &dquo;unified&dquo; European concept of Neurasthenia. It appears that Neurasthenia has been following local traditions in various countries, not unlike some other diagnostic concepts (e.g., paraphrenia and &dquo;psychogenic psychoses&dquo;). Accordingly, the status of Neurasthenia has varied from one European country to another. In comparison with other mental disorders, there is a relative paucity of articles on Neurasthenia in modern psychiatric literature, especially in countries of Western Europe. This can be attributed to a possible decrease in prevalence of Neurasthenia in these countries or to a loss of interest in this disorder. Furthermore, the influence of the American psychiatry and its recent classification systems (DSM-III, DSM-III-R and DSM-IV), which have excluded neuras-thenia from the official nomenclature, may also account for this neglect of Neurasthenia. In Eastern Europe, the diagnostic label of Neurasthenia has, by all accounts, been used frequently. However, in the world psychiatric literature there are relatively few studies and reports from Eastern at PENNSYLVANIA STATE UNIV on May 17, 2016tps.sagepub.comDownloaded from 126 European countries on the psychopathology, clinical features, epidemiology, etiology, and treatment of Neurasthenia. This review covers all articles on Neurasthenia from Europe, published from 1972 ’ through the end of 1993. The articles were searched for through th
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Neurasthenia: cross-cultural and conceptual issues in relation to chronic fatigue syndrome.
General hospital psychiatry, 1999Co-Authors: Vladan StarcevicAbstract:The purpose of this study was to examine several conceptual and cross-cultural issues in Neurasthenia, particularly in terms of their relationship to chronic fatigue syndrome. A review of this relationship led to the conclusion that these conditions are much more alike in Western countries than in countries such as China, where Neurasthenia could almost be regarded as a "culture-bound syndrome." This may be a consequence of factors such as the heterogeneous nature of Neurasthenia and different diagnostic practices in different countries, despite the ICD-10 definition of Neurasthenia, intended for worldwide use. Likewise, there is no consensus on what the "core" characteristics of Neurasthenia are, because its clinical presentation and key features in different countries are very different. Despite the finding of relatively low comorbidity rates between Neurasthenia and other mental disorders, clinical experience suggests that features of Neurasthenia frequently overlap with those of depression, chronic anxiety, and somatoform disorders. There is no convincing evidence that in cases of overlap or comorbidity, other diagnoses should automatically have "primacy" over Neurasthenia nor should the diagnosis of Neurasthenia thereby be excluded. Although some aspects of its validity have improved recently, especially its descriptive validity, the overall validity of the diagnosis of Neurasthenia is still not satisfactory. Suggestions for further research, aimed at improving the diagnostic validity of Neurasthenia, are offered in this paper.
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Neurasthenia in European Psychiatric Literature
Transcultural Psychiatric Research Review, 1994Co-Authors: Vladan StarcevicAbstract:Neurasthenia has been a frequent diagnosis in Europe, particularly in some Eastern European countries. This article reviews European contributions to Neurasthenia over the past 20 years. The review shows that there are considerable cross-national differences in the way Neurasthenia is conceptualized, understood etiologically, and treated. These differences can to a certain extent be attributed to different social and political forces that operate in different settings. The implications of such a diversity of views are discussed, with respect to diagnosis, nosology and cross-cultural utility of the concept of Neurasthenia.
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Neurasthenia: a paradigm of social psychopathology in a transitional society.
American journal of psychotherapy, 1991Co-Authors: Vladan StarcevicAbstract:A particular social aspect of an illness is reflected in an emphasis on those symptoms that the society considers socially detrimental and/or destabilizing. Thus, in the work- and production-oriented society, chronic fatigue, which affects one's productivity and ability to work, becomes a hallmark of Neurasthenia or Neurasthenia-like syndrome. In a society based on rigid social structures and severely limited possibilities for social change, excessive irritability and outbursts of anger are perceived as a greater threat to the stability of the existing social order, and therefore they come to dominate the concept of Neurasthenia. In Yugoslavia, Neurasthenia has been primarily conceived of as a manifestation of an accumulated social frustration and anger; Neurasthenia has then been constructed as a mental disorder because anger was expressed in a way that the society considered inappropriate, maladaptive, and pathological. A far-reaching, underlying purpose of this conceptualization of Neurasthenia has been a preservation of the social status quo. While Neurasthenia as a distinct mental disorder remains controversial, its dependence on the social context cannot be denied. Although the designation of Neurasthenia so often seems provisional, because it symbolizes limitations and failures of our diagnostic and nosological systems, it serves a definite social purpose, which varies from time to time, and from one culture to another.
Jules Angst - One of the best experts on this subject based on the ideXlab platform.
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The spectra of Neurasthenia and depression: course, stability and transitions
European Archives of Psychiatry and Clinical Neuroscience, 2007Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood. Methods In a stratified community sample ( n = 591), representative of 2600 persons of the canton of Zurich, Switzerland, Neurasthenia and depression were assessed in six structured interviews between ages 20 and 41. Course, stability and comorbidity were examined. A severity spectrum of Neurasthenia and depression from symptoms to diagnosis was taken into account. Results The annual prevalence of a Neurasthenia diagnosis increased from 0.7% to 3.8% from age 22–41, while mere symptoms became less prevalent. Intraindividual courses improved in 40% and deteriorated in about 30% of symptomatic cases. The most frequent symptoms overall, besides criterial exhaustion, were increased need for sleep, over-sensitivity, nervousness and difficulty concentrating. Cross-sectional associations and overlap with depression were strong. Longitudinal stability of ICD-Neurasthenia was low. Conclusions Neurasthenia is intermittent, overlaps significantly with depression, and shows improvement and deterioration over time to roughly equal measures.
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The spectra of Neurasthenia and depression: course, stability and transitions.
European archives of psychiatry and clinical neuroscience, 2006Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood.
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Neurasthenia in a longitudinal cohort study of young adults
Psychological medicine, 1994Co-Authors: Kathleen R. Merikangas, Jules AngstAbstract:This study examines the concept of Neurasthenia in a longitudinal cohort of young adults selected from a community sample of the canton of Zurich, Switzerland. The major focus is on the validity of the case definition of Neurasthenia. Close approximations of the proposed descriptive and research definitions of the ICD-10 are employed as well as the concept of 'irritable weakness' as described in 1831 by Kraus (1926-1932). The prevalence of Neurasthenia defined according to the ICD-10 criteria was: 1% across 10 years and 0.9% in 1988 for a duration criterion of > or = 3 months; and 8.1% across 10 years and 12% in 1988 for a duration criterion of > or = 1 month. The duration criterion of > or = 3 months appeared to be excessively restrictive to represent individuals with Neurasthenia in the community. Subjects with 1 month episodes of Neurasthenia exhibited sufficient differences from controls and similarities to subjects with anxiety or depressive disorders to justify a 1 month duration criterion for Neurasthenia in community samples. The clinical significance of Neurasthenia was indicated by the magnitude of subjective distress, and occupational and social impairment reported by the majority of the cases. Prospective assessment of the longitudinal course of Neurasthenia revealed that approximately 50% of the cases continued to exhibit this disorder at follow-up. Our findings suggest that Neurasthenia is equally likely to represent an early manifestation of affective illness as it is a consequence in those neurasthenic subjects who exhibited comorbid affective disorders. The magnitude, chronicity, impairment, longitudinal stability and distinction from anxiety and depression associated with this condition in the general population, suggest that Neurasthenia is an important diagnostic entity for which additional validation studies should be undertaken.
Alex Gamma - One of the best experts on this subject based on the ideXlab platform.
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The spectra of Neurasthenia and depression: course, stability and transitions
European Archives of Psychiatry and Clinical Neuroscience, 2007Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood. Methods In a stratified community sample ( n = 591), representative of 2600 persons of the canton of Zurich, Switzerland, Neurasthenia and depression were assessed in six structured interviews between ages 20 and 41. Course, stability and comorbidity were examined. A severity spectrum of Neurasthenia and depression from symptoms to diagnosis was taken into account. Results The annual prevalence of a Neurasthenia diagnosis increased from 0.7% to 3.8% from age 22–41, while mere symptoms became less prevalent. Intraindividual courses improved in 40% and deteriorated in about 30% of symptomatic cases. The most frequent symptoms overall, besides criterial exhaustion, were increased need for sleep, over-sensitivity, nervousness and difficulty concentrating. Cross-sectional associations and overlap with depression were strong. Longitudinal stability of ICD-Neurasthenia was low. Conclusions Neurasthenia is intermittent, overlaps significantly with depression, and shows improvement and deterioration over time to roughly equal measures.
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The spectra of Neurasthenia and depression: course, stability and transitions.
European archives of psychiatry and clinical neuroscience, 2006Co-Authors: Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich, Wulf RösslerAbstract:Background Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood.
Mitchell G Weiss - One of the best experts on this subject based on the ideXlab platform.
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cultural epidemiology of Neurasthenia spectrum disorders in four general hospital outpatient clinics of urban pune india
Transcultural Psychiatry, 2011Co-Authors: Vasudeo Paralikar, Mohan Agashe, Sanjeev Sarmukaddam, Sharmishtha S Deshpande, Vejaya Goyal, Mitchell G WeissAbstract:Disorders emphasizing symptoms of fatigue and/or weakness, collectively termed Neurasthenia Spectrum Disorders (NSDs), typically emphasize a biological basis in the West and social origins in East Asia. In India, explanatory concepts are diverse. To clarify, 352 outpatients in Psychiatry, Medicine, Dermatology, and Ayurved clinics of an urban hospital were interviewed with a version of the Explanatory Model Interview Catalogue. Comparisons of categories and narratives of illness experience and meaning across clinics indicated both shared and distinctive features. Explanatory models of NSDs highlighted social distress, ‘‘tensions,’’ and both general and clinic-specific physical, psychological, and cultural ideas. Findings indicate the importance of social contexts and cultural meaning in explanatory models of Neurasthenia, as well as the potential clinical relevance of the construct of Neurasthenia Spectrum Disorder.
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Neurasthenia and the Social Construction of Psychiatric Knowledge
Transcultural Psychiatric Research Review, 1994Co-Authors: Norma C Ware, Mitchell G WeissAbstract:The diagnostic category of Neurasthenia is examined as a cultural construct with social uses and implications for psychiatric nosologies. The legitimation of otherwise stigmatized symptoms through a diagnosis of neuras thenia is discussed. The re-thinking and re-definition of the category in Chinese psychiatry in the 1980s is reviewed to illustrate the social construction of knowl edge and DSM's influence abroad. The proposal to include Neurasthenia in DSM-IV is considered as part of the initiative to increase the cultural validity of the DSM system. Implications for research are suggested, and questions raised about the ability of DSM to resist change and re-produce itself.