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Characteristics of neurasthenia: examination and cross-cultural applicability of ICD-10 Diagnostic Criteria for Research

Published online by Cambridge University Press:  16 April 2020

V Starčević ,
K Kelin  and
M Munjiza
V Starčević
Affiliation:
Institude of Mental Health,Palmotićeva 37,1100 Belgrade Belgrade University School of Medicine,Department of Psychiatry, Belgrade, Yugoslavia
K Kelin
Affiliation:
Institude of Mental Health,Palmotićeva 37,1100 Belgrade
M Munjiza
Affiliation:
Institude of Mental Health,Palmotićeva 37,1100 Belgrade Belgrade University School of Medicine,Department of Psychiatry, Belgrade, Yugoslavia
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Summary

The purpose of this study was to examine characteristics of Yugoslav patients with neurasthenia diagnosed according to the ICD-10 Diagnostic Criteria for Research (ICD-10-DCR), and to examine the ICD-10-DCR symptoms of neurasthenia and applicability of the corresponding diagnostic criteria to Yugoslav patients with this condition. Thirty-four patients with the ICD-10-DCR neurasthenia and 31 patients with mixed anxiety and depressive disorder were compared in terms of demographic variables, results of several questionnaires, symptom profiles and comorbidity with other mental disorders. Patients with neurasthenia were less educated and more often held jobs as unskilled and semiskilled workers; they had a more chronic course of illness, tended to report more symptoms, manifested more hostility, somatization and hypochondriacal tendencies and received a comorbid diagnosis of hypochondriasis more frequently. In addition to exhaustion and weakness, the most prominent features of neurasthenia were irritability, anger, nervousness, various somatic symptoms and tension. An ICD-10-DCR diagnosis of neurasthenia could not be made in slightly over one-third of patients who would have otherwise met criteria for this diagnosis because of the imposed diagnostic hierarchy, ie, due to current comorbidity with affective disorders and generalized anxiety disorder in such patients. It is concluded that the ICD-10-DCR concept of neurasthenia is generally suitable for Yugoslav patients, except for the diagnostic hierarchy requirement. The diagnostic criteria therefore require revision in order to reflect more accurately the variability in clinical presentation of neurasthenia in different countries.

Keywords

neurastheniacross-cultural psychiatryICD-10 DCRdiagnosisirritabilitysomatization
Type
Original article
Information
European Psychiatry , Volume 11 , Issue 6 , 1996 , pp. 289 - 297
Copyright
Copyright © Elsevier, Paris 1996

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References

Abbey, SE, Garfinkel, PENeurasthenia and chronic fatigue syndrome: the role of culture in the making of a diagnosis Am J Psychiatry 1991 148 1638–1646Google ScholarPubMed
American Psychiatric Association, DSM-IV Options Book: Work in Progress Washington, DCAPA 1991Google Scholar
Bech, P, Malt, UF, Dencker, SJ, et al.Scales for assessment of diagnosis and severity of mental disorders Acta Psychiatr Scand 1993 87suppl 372Google Scholar
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, JAn inventory for measuring depression Arch Gen Psychiatry 1961 4 561–571CrossRefGoogle ScholarPubMed
Beck, AT, Epstein, N, Brown, G, Steer, RAAn inventory for measuring clinical anxiety: psychometric properties J Consult Clin Psychol 1988 56 893–897CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA, Garbin, MGPsychometric properties of the Beck Depression Inventory: twenty-five years later Clin Psychol Rev 1988 8 77–100CrossRefGoogle Scholar
Fava, GA, Grandi, S, Michelacci, L, et al.Hypochondriacal fears and beliefs in pregnancy Acta Psychiatr Scand 1990 82 70–72CrossRefGoogle ScholarPubMed
Frighi, L, Coppi, R, Pichini, FThe extensive and graphic treatment of sociopsychiatric data relative to a population of university students Riv Psichi 1972 7 299–339Google Scholar
Katanec, NInfluence of social factors on the development of neurasthenic picture of neurosis Soc Psihi 1976 4 19–26Google Scholar
Kellner, RSomatization and Hypochondriasis New YorkPraeger 1986Google Scholar
Kellner, RAbridged Manual of the Illness Altitudes Scales (IAS) AlbuquerqueUniv of New Mexico School of Medicine Dept Psychiatry, 1987Google Scholar
Kellner, R, Abbott, P, Winslow, WW, Pathak, DFears, beliefs, and attitudes in DSM-III hypochondriasis J Nerv Ment Dis 1987a 175 20–25CrossRefGoogle Scholar
Kellner, R, Samet, JM, Pathak, DHypochondriacal concerns and somatic symptoms in patients with chronic airflow obstruction J Psychosom Res 1987 31 575–582CrossRefGoogle ScholarPubMed
Kleinman, ANeurasthenia and depression: a study of somatization and culture in China Culture Med and Psychiatry 1982 6 117–190CrossRefGoogle ScholarPubMed
Lee, SThe vicissitudes of neurasthenia in Chinese societies: where will it go from the ICD-10? Transcultural Psychiatr Res Rev 1994 31 153–172CrossRefGoogle Scholar
Lin, TYNeurasthenia revisited: its place in modern psychiatry Culture Med Psychiatry 1989 13 105–129CrossRefGoogle ScholarPubMed
Lipman, RS, Covi, L, Shapiro, AKThe Hopkins Symptom Checklist (HSCL): factors derived from the HSCL-90 J Affective Disord 1979 1 9–24CrossRefGoogle ScholarPubMed
Liu, ZH, Yang, Q, Huang, MS, et al. Clinical research on neurosis: a summary report Clinical Research on Neurosis 1992 West China Univ Med Sci: Dep Psychiatry 3–4 (in Chinese)Google Scholar
Merikangas, K, Angst, JNeurasthenia in a longitudinal cohort study of young adults Psychol Med 1994 24 1013–1024CrossRefGoogle Scholar
Otto, MW, Pollack, MH, Sachs, GS, Rosenbaum, JFHypochondriacal concerns, anxiety sensitivity, and panic disorder J Anxiety Disord 1992 6 93–104CrossRefGoogle Scholar
Rin, H, Huang, MGNeurasthenia as nosological dilemma Culture Med Psychiatry 1989 13 215–226CrossRefGoogle ScholarPubMed
Rogler, LHThe meaning of culturally sensitive research in mental health Am J Psychiatry 1989 146 296–303Google ScholarPubMed
Simon, G, Von Korff, MSomatization and psychiatric disorders in the NIMH Epidemiological Catchment Area study Am J Psychiatry 1991 148 1494–1500Google Scholar
Starčević, VNeurasthenia: a paradigm of social psychopathology in a transitional society Am J Psychother 1991 45 544–553CrossRefGoogle Scholar
Starčević, V, Fallon, S, Uhlenhuth, EH, Pathak, DGeneralized anxiety disorder, worries about illness, and hypochondriacal fears and beliefs Psychother Psychosom 1994 61 93–99CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JBW, Gibbon, M, First, MBStructured Clinical Interview for DSM-III-R Washington DCAmerican Psychiatric Press 1990Google Scholar
Timotijevic, I, Paunovic, VRInstrumenti klinicke procene u psihijatriji (Instruments for Clinical Assessment in Psychiatry.) BelgradeNaucna Knjiga 1992Google Scholar
Ware, NC, Kleinman, ACulture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome Psychosom Med 1992 54 546–560CrossRefGoogle ScholarPubMed
Ware, NC, Weiss, MGNeurasthenia and the social construction of psychiatric knowledge Transcultural Psychiatr Res Rev 1994 31 101–124CrossRefGoogle Scholar
Wessely, SOld wine in new bottles: neurasthenia and ‘ME’ Psychol Med 1990 20 35–53CrossRefGoogle Scholar
World Health Organization The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines GenevaWHO 1992Google Scholar
World Health Organization The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research GenevaWHO 1993Google Scholar
Zar, JHBiostatistical Analysis 2nd ed. Englewood CliffsPrentice-Hall 1984Google Scholar
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