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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with some "social maladjustments" or disturbed interpersonal relationship under 2 mg pimozide (Orap: a 24 h long-acting neuroleptic) for six to twelve months. Concomitant but complementary medication was kept unchanged. Control was based on: long-term investigation (1/2 - 1 year), quantification, use of two scales. Statistical evaluation of the changes in "cardinal symptoms" showed a significant improvement in tension, disorders of sleep, intellectual disturbances, cardiovascular symptoms and gastrointestinal complaints. More detailed analysis of the other 27-item rating scale revealed a dramatic improvement in anxiety and paranoidism. The overall appreciation shows that: 25 patients responded well or very well to pimozide, eight did moderately, seven poorly. Neurasthenia and related states with predominant asthenia turned out to be no indication for pimozide treatment. Except for some cases of increased fatigue, tolerance was exceptionally good. The trial showed that extra patience is required from the therapist as a clinical onset of one to two months is not uncommon.
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PMID:Pimozide in the treatment of some "social maladjustments" in "personality disorders". 55 47

A differentiation between the normal sensation of tiredness and the symptom "fatigue" is often difficult. Both are influenced by cultural, social, psychological and biological factors, which can lead--interactively--to symptom formation. Psychiatric disorders frequently associated with fatigue are all forms of depression, somatization and anxiety disorders, chronic pain states and drug abuse among many others. In at least 2/3 of patients with the fashionable chronic fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be made, most of them also suffer from many symptoms attributes to the autonomous nervous system. The clinical approach should be cautious avoiding diagnostic and therapeutic overaction and therapy should emerge from a diagnosis properly assessed.
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PMID:[Intense fatigue in humans. Psychosocial and cultural aspects]. 175 73

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.
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PMID:Neurasthenia: a paradigm of social psychopathology in a transitional society. 178 86

In writing a history of any illness there is always a dilemma whether to attempt the story of the condition 'itself', the medical attempts to define its nature, or to glimpse it via our changing reactions. The easiest is a straightforward account of the attempts of scientists to solve a problem--the classic medical detective story. However, this is often more fiction than fact. Medicine rarely moves smoothly from ignorance to knowledge, but often in a more circular fashion. A historical approach is thus not solely a record of who did what, but also contributes to our understanding of the problems under scrutiny in this issue. Terminology is never easy in this subject, but the following conventions will be used: The terms neurasthenia and ME will be used in their actual context (as authors themselves used them), without defining either. Post-infectious fatigue syndrome (PIFS) will cover similar conditions when related to infective episodes. All will be used in a neutral fashion, to refer to changing realities as understood by doctors and historians. This chapter attempts both chronological description and social analysis. The justification for this approach is clear in the case of neurasthenia, since 'as so little was known of its pathological basis physicians' statements regarding the disease were composed more of social and cultural elements than of scientific knowledge'. Although much has changed, a contemporary account still reveals as much about cultural attitudes as the advance of science.
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PMID:History of postviral fatigue syndrome. 179 91

The history of neurasthenia is discussed in the light of current interest in chronic fatigue, and in particular the illness called myalgic encephalomyelitis ('ME'). A comparison is made of the symptoms, presumed aetiologies and treatment of both illnesses, as well as their social setting. It is shown that neurasthenia remained popular as long as it was viewed as a non-psychiatric, neurological illness caused by environmental factors which affected successful people and for which the cure was rest. The decline in neurasthenia was related to the changes which occurred in each of these views. It is argued that similar factors are associated with the current interest in myalgic encephalomyelitis. It is further argued that neither neurasthenia nor 'ME' can be fully understood within a single medical or psychiatric model. Instead both have arisen in the context of contemporary explanations and attitudes involving mental illness. Future understanding, treatment and prevention of these and related illnesses will depend upon both psychosocial and neurobiological explanations of physical and mental fatigability.
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PMID:Old wine in new bottles: neurasthenia and 'ME'. 218 19

In the 1980s, patients suffering from unexplained fatigue and what seemed like a prolonged attack of acute mononucleosis were given the diagnosis of chronic mononucleosis or chronic infection with the Epstein-Barr virus. Although the diagnosis has great appeal, the Epstein-Barr virus does not cause the syndrome (CFS) of chronic fatigue, which has been renamed and redefined chronic fatigue syndrome to remove the inference that the virus is its cause. From a historical perspective, both syndromes represent the 1980s equivalent of neurasthenia, a disease of fatigue that influenced the development of psychiatric nosology. Because patients with depression and anxiety also have chronic fatigue and because most patients with CFS have an affective disorder, the assessment of organic causes of this syndrome requires careful psychiatric diagnosis and treatment. Defining chronic fatigue syndrome as a medical disorder may deprive patients of competent treatment of their affective disorder.
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PMID:Neurasthenia in the 1980s: chronic mononucleosis, chronic fatigue syndrome, and anxiety and depressive disorders. 218 52

The conditions of ten patients with metastatic renal cell carcinoma were serially evaluated by neuropsychiatric examination to determine the nature of the fatigue-asthenia symptoms resulting from human leukocyte interferon alpha therapy. The majority of the patients had moderate to severe behavioral changes and mild to moderate cognitive, affective, and personality changes within the first week of daily intramuscular administration of 3 X 10(6) units of interferon. This descriptive clinical study suggests that the intense fatigue may be a manifestation of a complex neurotoxicity, most suggestive of frontal lobe changes, and resulting in neurasthenia syndrome with reversible impairment of some higher mental functions.
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PMID:Neuropsychiatric manifestations of human leukocyte interferon therapy in patients with cancer. 674 98

Neurasthenia is both a Western disease construct and a popular Chinese illness concept (shenjing shuairuo, SJSR). Using a self-report questionnaire, we examined 148 Hong Kong Chinese undergraduates' concept of its epidemiology, symptomatology, etiology and treatment. Notwithstanding that fatigue is the sine qua non of neurasthenia in Western nosology, subjects believed that SJSR was compatible with a diversity of symptoms which fell, on factor analysis, into the "neurotic," "psychotic," "somatic" and "dysfunctional" subgroups. Contrary to the popular portrayal of SJSR as a physical or chronic fatigue disorder, the most common perceived symptoms were anxiety, insomnia, depression and fright. Logically, psychological etiology and remedy were highly emphasized. The perceived high prevalence, non-aggressive nature and symptomatic diversity of SJSR attested to the notion that it might camouflage and destigmatize psychiatric labels of insanity. The contextual study of neurasthenia illustrates how in its search for legitimacy an originally Western concept adapts, transforms, and acquires distinctive local meanings in a non-Western culture.
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PMID:Rethinking neurasthenia: the illness concepts of shenjing shuairuo among Chinese undergraduates in Hong Kong. 767 22

Neurasthenia was described and explained in very mechanistic terms, at the end of the 19th century, by G.M. Beard to account for physical and mental exhaustion and for varied somatic troubles imputed to failure of too much solicited nervous resources. This concept was then universally adopted and gave rise to diverse interpretations, among which was the Freud's one. Later, in Occident, came a deterioration, the diagnostic of neurasthenia giving way to those of anxious or affective disorders. In the same time, at least for ideological and cultural reasons, the concept remained lively in Russia and in Asia. During the last decade the western psychiatry has been led to accept that there are clinical situations focussed on fatigue and fatigability, even if it coined for them new terminologies (post-infectious fatigue, chronic fatigue syndrome, etc.) and while DSMs keep on ignoring neurasthenia, the ICD 10 gives it an important place.
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PMID:[Neurasthenia, yesterday and today]. 784 49

Fatigue chronic syndrome (SFC) is the heir-at-law of neurasthenia. Both are seen like physical diseases and share certain therapeutic measures, such as sleep; they have the same symbolic function and enable patients as well as doctors reluctant to psychological dimensions of pathology, to get and express sympathy and attention. A strong controversy developed these last years concerning the SFC physiopathology particularly concerning the responsibility of viral infectious agents or psychiatric troubles. The SFC fatigue is unlikely hysterical or neuromuscular but it probably depends on several associated factors; cerebral neurobiochemistry anomalies (possibly induced by an infection or immune reactions), effort perception trouble, affective trouble, lack of physical activity. The handicap seems to be worse on account of unsuitable care and inefficacious treatment. Especially sleep, which is often beneficial in a short term, is source of ulterior chronicisation. Antidepressants are the only justified pharmacological treatment for SFC at the moment. Referring to the existence and the nature of cognitive distortions, the author suggests a cognitivo-behavioural therapy, whose aim is a progressive activity resumption.
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PMID:[Chronic fatigue syndrome. Clinical, social psychological problems and management]. 784 55


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