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PubMed1997

Chronic fatigue syndrome/myalgic encephalomyelitis as a twentieth-century disease: analytic challenges.

The challenges of chronic fatigue syndrome (often called myalgic encephalomyelitis, especially in the UK) (CFS/ME) to analytical and medical approaches are connected with our inability to understand its distressing somatic symptoms in terms of a single identifiable and understandable disease entity. The evidence for the roles of viral aetiologies remains inconclusive, as does our understanding of the involvement of the immune system. The history and social context of CFS/ME, and its relation to neurasthenia and psychasthenia are sketched. A symbolic attitude to the condition may need to be rooted in an awareness of psychoid levels of operation, and the expression and spread of CFS/ME may sometimes be aided by the ravages of projective identification. Psychic denial, sometimes violent, in sufferers (especially children and adolescents) and their families may be important in the aetiology of CFS/ME. We draw out common threads from psychodynamic work with five cases, four showing some symptomatic improvement, analytic discussions of three cases being presented elsewhere in this issue of JAP.

Adolescent↗

PubMed1983

Neuropsychiatric symptoms in workers occupationally exposed to jet fuel--a combined epidemiological and casuistic study.

Some aircraft personel and airline industry workers are exposed to jet fuel, a mixture of aliphatic hydrocarbons (petroleum 80%) and some organic solvents (petroleum 80%) and some organic solvents (aromatic hydrocarbons 20%). In order to evaluate the possible neuropsychiatric sequeale of such long-term occupational exposure, we examined 30 workers exposed at about 250 mg/m3 for 4-32 years at a jet motor factory. They were compared with two control groups (2 x 30) of matched non-exposed workers. The medical history was first assessed by standardized interviews and examination of medical records kept by the factory physician. The exposed subjects had, after their employment, much more often sought medical advice because of emotional dysfunctions, such as depression and anxiety, than had the control groups (P less than 0.005). When the prevalent mental symptoms, indicative of brain lesion, later were rated by psychiatrists, the exposed workers scored higher than did the controls (P less than 0.001). 14 subjects showing most symptoms were then selected for a thorough neuropsychiatric clinical investigation comprising psychosocial inquiries, psychological testing, personality assessment and neurological/neurophysiological examination. Seven were judged to suffer from mild organic brain syndrome (i.e. "organic neurasthenia") of which one subject was a severe case. The subjects had all undergone a slow but steady personality change over the years--starting from an ordinary strength without neurotic traits and moving towards an asthenic state with fatigue, anxiety and vegetative hyperreactivity. No other cause for this change could be identified as an alternative to the occupational exposure to jet fuel. It is concluded that personality changes and emotional dysfunctions are the foremost effects of such long-term exposure to petroleum products.

Adult↗

PubMed1985

Patterns of psychiatric consultation in a Chinese general hospital.

The authors conducted a study of psychiatric consultation in a Chinese general hospital. Seventy-five inpatients (0.74% of the patients in the hospital) were referred by different services over a 1-year period. Internal medicine referred the most patients, and organic brain syndromes were the most common diagnoses. Depression was not a frequent diagnosis, but neurasthenia was a fairly common one. None of the referred patients had a diagnosis of alcoholism, drug abuse, or personality disorder. The authors compare these data with those of Western studies and discuss the possible factors influencing psychiatric consultation in China.

Adolescent↗

PubMed1986

Diagnostic pattern for neuroses in China, Japan, and the United States.

To investigate the diagnostic patterns for neuroses in China, Japan, and the United States, the authors showed videotapes and brief written case histories of six Chinese patients to psychiatrists and psychiatrists-in-training in Beijing, Tokyo, and Honolulu. In cases with a well-distinguished clinical picture the diagnoses were congruent in the three countries. Diagnostic disagreement occurred in cases with symptoms of decline in mental function, which were overwhelmingly diagnosed as neurasthenia by the Chinese clinicians, and cases with situational stress, which were diagnosed as adjustment reaction by the Americans. This illustrates that different professional concepts and classification systems are used in different countries.

Adjustment Disorders↗

PubMed2001

Depression in the planet's largest ethnic group: the Chinese.

OBJECTIVE: The authors reviewed the evidence for the claim that the Chinese tend to deny depression or express it somatically, examined the possible determinants of those characteristics, and explored implications of the findings for the diagnosis and management of depression in China and for psychiatry in the WEST: METHOD: This paper reviews and interprets original studies and literature reviews considering emotional distress, depression, neurasthenia, and somatization in Chinese subjects. RESULTS: Interpretation of the literature is complicated by the considerable heterogeneity among people described as "the Chinese" and by numerous factors affecting collection of data, including issues of illness definition, sampling, and case finding; differences in help-seeking behavior; idiomatic expression of emotional distress; and the stigma of mental illness. Despite difficulties in interpreting the literature, the available data suggest that the Chinese do tend to deny depression or express it somatically. CONCLUSIONS: The existing evidence supports the hypothesis that the Chinese tend to deny depression or express it somatically. However, Western influences on Chinese society and on the detection and identification of depression are likely to have modified the expression of depressive illness quite sharply since the early 1980s. Analyzing these changes may provide useful insight into the evolution of the diagnosis of depression in Western and other cultures.

Acculturation↗

PubMed2003

Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalized anxiety.

OBJECTIVE: The authors investigated whether narrow definitions of unexplained fatigue syndromes that require additional minor somatic symptoms are more strongly associated with psychiatric morbidity than wider ones. METHOD: This was a secondary analysis of the World Health Organization Collaborative Project on Psychological Problems in General Health Care. A total of 5,438 primary care patients from 14 countries were assessed with the Composite International Diagnostic Interview. RESULTS: The prevalence of fatigue syndromes fell from 7.99 to 1.69 as somatic criteria were added. Patients with depression or anxiety were more likely to report unexplained fatigue, but this association was stronger for definitions of unexplained fatigue with more somatic criteria. CONCLUSIONS: Definitions of unexplained fatigue syndromes that require more somatic criteria selected more patients with psychiatric disorders in this culturally diverse sample. These findings might have implications for the revision of existing international diagnostic criteria for neurasthenia or chronic fatigue syndrome.

Anxiety Disorders↗

PubMed2001

Anthropophobia: its meaning and concomitant experiences.

This study investigated the essential feature and concomitant experiences of anthropophobia, a culturally specific phobic disorder in China and Japan. One hundred and fifty subjects, including 50 anthropophobic, 50 neurasthenic and 50 normal subjects, were recruited from hospitals and downtown residential areas in Beijing. Measures of anthropophobic symptoms and DSM-III-R depressive and anxiety symptoms were administered to all subjects. Nonparametric analysis of variance, analysis of variance (ANOVA and MANOVA) and Fisher's exact test were performed to examine group differences on each symptomatic item of the three measures. Results indicate that the core anthropophobic symptoms include a fear of making eye contact with others and a fear of being watched by others, which essentially express fears of others' judgement or opinion of oneself. Anxiety and depression are associated features of anthropophobia. However, these concomitants are experienced more cognitively and less somatically in the case of anthropophobia than neurasthenia.

Adult↗

PubMed1999

Mental, physical and functional status in primary care attenders.

OBJECTIVE: The purpose of the present study was to analyze the association, in primary care attenders, between psychiatric disorders, medical comorbidity, and impairment in mental and physical function status. METHODS: The study had a two-stage design. The GHQ-12 was used to screen 1647 patients, and 323 of them were then interviewed using the CIDI-PHC to obtain ICD-10 diagnoses. Severity of mental illness was assessed using the Hamilton scales for anxiety and depression. The DUSOI was used to evaluate the severity of physical illness. The MOS SF-36 was used to assess health related quality of life. RESULTS: The estimated prevalence of ICD-10 psychiatric disorders and subthreshold disorders was 12.4 percent and 18 percent respectively. The most common psychiatric disorders were generalized anxiety, major depression, and neurasthenia. The severity of physical illness did not vary across diagnostic status categories. Significant impairment, both in physical and mental functioning was seen in patients suffering from ICD-10 full-fledged and subthreshold disorders. Severity of impairment increased from sub-threshold cases to full-fledged cases, and among the latter according to the severity of depressive and anxious symptoms, assessed using Hamilton scales. The most frequent psychiatric disorders were associated with significant worsening in health related quality of life, with relevant differences between psychiatric diagnoses regarding the domains affected. Impairment associated with mental disorders was greater than that associated with physical illness. CONCLUSIONS: The results of the present study confirm that ICD-10 psychiatric disorders are common in general practice and are associated with relevant impairment in physical and mental functional status. Psychiatric morbidity is not related to severity of physical illness rated by general practitioner.

Adult↗

PubMedDate not supplied

Association between patient report of symptoms after mild head injury and neurobehavioural performance.

Patients with closed-head injuries may have physical, affective, behavioural and memory problems that persist for weeks, months or years. Even patients with minor head trauma have been found to exhibit deficits in neurobehavioural performance. However, very little research has been done to examine the association between patient symptoms after minor head injury and neurobehavioural performance. The associations between five sets of symptoms (memory problems, neurological problems, confusion, neurasthenia and co-ordination) and five neurobehavioural areas (simple motor speed, response speed and attention, complex perceptual motor performance, visual memory, and learning) were examined in a group of 32 adults who had suffered mild to moderate head injury. Patients reported their symptoms with a four-point rating scale. Neurobehavioural functioning was assessed using computerized tests. Memory difficulties were the problems most frequently experienced by the patients and most closely associated with performance deficits.

Adolescent↗

PubMed1976

[Characteristics of psycho-traumatic situations in the clinical picture of psychogenic reactions].

On the basis of a clinico-psychopathological study of 90 patients with the most frequently encountered forms of reactive conditions, the author eliminates the predilective clinical types of psychotraumatizing situations. The appearance of reactive depressions and neurasthenia is connected with stress situations and exhaustions. Obsessional neurotic states are connected with situations of disturbed habitual stereotypes while as hysteric states--with situations of infringement of egocentrism. Paranoical reactions appear in situations of a denial incompromissity.

Adjustment Disorders↗

PubMed1998

[Observations of changes in neurobehavioral functions in workers exposed to high-frequency radiation].

OBJECTIVE: To study the effects of exposure to high-frequency radiation on neurobehavioral function of the exposed workers and its measurement in evaluating occupational hazards caused by it. METHODS: Four neurobehavioral functions were tested for the workers exposed to high-frequency radiation with Neurobehavioral Core Tests Battery recommended by WHO. RESULTS: Scores for various indicators in exposed workers were significantly lower than those in controls, and correlated to the detection of neurasthenia in the exposed workers, to certain extent. CONCLUSION: Changes in neurobehavioral function in workers exposed to high-frequency radiation can reflect its important adverse effects.

Adult↗

PubMed2000

[Complaints as reflection of psychic status in patients with duodenal ulcer exacerbation].

AIM: Study of relationship between leading complaints of patients with duodenal ulcer (DU) exacerbation and their psychic status, attitude to the disease and quality of life. MATERIALS AND METHODS: Psychological questionnaire surgery enrolled 94 males with endoscopically revified uncomplicated recurrence of DU. RESULTS: Patients complaining of dull epigastric pains only demonstrated minimal psychological changes. Their attitude to the disease is primarily ergopathic, sensitive and anosognosic. Nausea and vomiting complains come along with neurotization, maladaptation (anxiety, neurasthenia, egocentric attitude) and deterioration of quality of life. CONCLUSION: Patients with nausea and vomiting complaints need correction of psychic status to achieve psychological compensation in remission of DU.

Adult↗

PubMed2000

[Nociceptive system response to repetitive painful stimuli during chronic psychoemotional stress in humans].

Repeated nocigenic stimuli applied to the skin evoked a hyperalgesia in healthy subjects while in patients with neurasthenia which is a natural model of a chronic psychoemotional stress, they evoked a hyperalgesia accompanied by sensitization. The differences in the nociceptive system responses show particularities in reactivity (plasticity) of a wide dynamic range of the spinal neurons under chronic psychoemotional stress that is due to disorders in supraspinal descending modulation system of plasticity in the spinal nociceptive neurons.

Adult↗

PubMedDate not supplied

[Tumor necrosis factor alpha (TNF-alpha) in patients with ischemic stroke].

Tumour necrosis factor alpha (TNF-alpha) is a proinflammatory cytokine. Stroke induces a rapid increase in TNF-alpha levels within and around the focus of damaged brain. The aim of our study was to evaluate, whether patients with stroke differ from control patients in the concentrations of TNF-alpha in cerebrospinal fluid and serum. We studied TNF-alpha levels in cerebrospinal fluid and serum in 30 patients with stroke within 24 h after onset of neurological signs and in 15 patients of control group with the diagnosis of tension headache and neurasthenia. In patients with stroke the levels of TNF-alpha in the cerebrospinal fluid and serum were significantly higher in comparison with control group. The results of our study may suggest the overproduction of TNF-alpha during first twenty-four hours of stroke.

Aged↗

PubMed1999

[Not Available].

The essay delineates the professional evolution of the German surgeon Heinrich Helferich (1851-1945). Being of a learned family, Helferich embraced a medical career. He succeeded with strong scientific ambition and outstanding laboriusness and became professor in ordinary at Greifswald University in 1885, at Kiel University in 1899. In 1907, his career came to a sudden end, when he was discharged because of severe deficiencies and personal lapses in his administration. They were considered as consequences of nervous exhaustion. Helferich's life - looked upon as a case report - reveals both tendencies within the social group called "Bildungsburgertum" and characteristics of the contemporary illness "Neurasthenia".

Fatigue↗

PubMed2001

[Treatment of asthenic disorders with tanakan].

AIM: To evaluate efficacy and safety of tanakan in different asthenic disorders. MATERIAL AND METHODS: Tanakan in a dose 240 mg/day was used in 60 patients with various asthenic disorders arising in neurasthenia and late after craniocerebral trauma. The response was assessed by the scale of general clinical impression, side effects and by changes in psychic and somatic status. RESULTS: The response was achieved in 90% of the patients. 78% had significant improvement regardless nosological entity of asthenia. CONCLUSION: Tanakan is safe and effective in therapy of asthenic disorders. Moreover, with tanakan asthenia can be treated without polypragmasia.

Antioxidants↗

PubMedDate not supplied

[Brain activation levels and the significance of the stage B(I) indices in neuroses].

Two forms of neuroses--neurasthenia and hysteria--show statistically definitive differences in the EEG patterns. In the initial EEGs of neurasthenic patients, as a rule, more or less marked alpha-rhythm is preserved, whereas the EEG in hysteria in most cases consists of low amplitude fast frequencies ("flat" EEG) and only in 30-35% cases short episodes of alpha-waves can be recorded. In the course of medical treatment the index alpha often increases and the EEG gradually obtains normal features. One of the most favourable signs of convalescence is the renewal of the ability to develop the phase of drowsiness with the stage B in the EEG, during which the outburst of alpha-waves is recorded as a reaction to stimulation.

Acoustic Stimulation↗

PubMed1992

[Clinical variants of neuropsychological disorders during remission in chronic alcoholism].

To study the psychopathological characteristics of remissions in alcoholism, 142 patients aged 32 to 45 years were examined. The anxious hypochondriac, neurasthenia-like, asthenic-depressive, anxious suspicious, anxious depressive, excitable, euphoric, apathetic, dysphoric syndromal variants are described. Correlation of the indicated syndromal variants with the other clinical characteristics of alcoholism made it possible to distinguish a favourable and relatively unfavourable type of remission, providing a possibility of differentiating between the treatment and rehabilitation measures in patients suffering from alcoholism.

Adult↗