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Neurasthenia Disorder

Neurasthenia is characterized by general lassitude, irritability, lack of concentration, worry, and hypochondria. The term was introduced into psychiatry in 1869 by G. M. Beard, an American neurologist. Neurasthenia covers a wide spectrum of symptoms, including painful sensations or numbness in parts of the body, chronic fatigue, anxiety, and fainting. Some medical historians believe that neurasthenia may actually be the same as the modern day disorder of chronic fatigue syndrome.

Also known as: Primary Neurasthenia, Cardiac Neurosis, Chronic Asthenia, Da Costa's Syndrome, Effort Syndrome, Functional Cardiovascular Disease, Soldier's Heart and Subacute Asthenia.

Diagnostic criteria for neurasthenia include:

Persistent and distressing symptoms of exhaustion after minor mental or physical effort including general feeling of malaise, combined with a mixed state of excitement and depression.

Accompanied by one or more of these symptoms: muscular aches and pains, dizziness, tension headache, sleep disturbance, inability to relax and irritability.

Inability to recover through rest, relaxation or enjoyment.

Disturbed and restless, unrefreshing sleep, often troubled with dreams.

Duration of over three months.

Does not occur in the presence of organic mental disorders, affective disorder, panic or generalized anxiety disorder.

Sub Types:

Cerebral. - Headaches are the prominent symptom. Insomnia is quite characteristic, and the patient arises unrefreshed; there is more or less despondency; the patient is anxious, worried, and fearful, anxious of some impending danger. A continued tired feeling is generally present.

Spinal. - . Backache, with tenderness along the spine, is characteristic. Other manifestations may include tingling, crawling, or burning sensation, or certain parts will feel hot or cold.

Gastro-Intestinal - Gastric disturbances are the chief characteristics of this form. Hyperacidity, waterbrash, nausea, retching, and vomiting. The patient sleeps poorly, has unpleasant dreams, and develops an irritable disposition. There is flatulency, rumbling of the bowels, constipation may alternated with diarrhea, and a sense of weight or soreness over the abdomen.

Cardiac - While there is no organic reason, the person may experience palpitations and sometimes sharp pain similar to angina.

Urinary - The quantity of urine expelled is usually small. The patient becomes irritable, and experience dull headaches.

Sexual - A fear of becoming impotent preys upon the mind, the patient is depressed, sleeps poorly, has nocturnal emissions, complains of pain or crawling sensations in the testicles, has perverted sexual desires, and frequently masturbates.

Associated Features:

May experience rapid intense heartbeat that may be irregular (palpitations, tachycardia).
Cold extremities, clammy hands and feet.
Abnormally rapid breathing (hyperventilating).
Dizziness or faintness.
Periodic sighing
Sweating for no apparent reason.
Be restless fidgeting.

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.Many medical disorders can cause fatigue therefore a through medical examination and review of medical history is necessary.

Generalized Anxiety Disorder.
Somatic Complaints.
Other psychosomatic conditions.


The cause of Neurasthenia remain unknown however like most disorders, certain predisposing factors may play an important part, chief of which may be mentioned heredity factors, occupation (high stress occupations), age (tends to occurs between 20 and 55 years of age), and sex (predominantly see in males).


No physical treatment has been established. If other mental or physical disorders are present, these may require treatment.

Counseling and Psychotherapy [ See Therapy Section ]:

Until a remedy for persistent fatigue is provided, doctors should take an active psychological approach to treatment.

Pharmacotherapy [ See Psychopharmacology Section ] :

Amitriptyline (for pain and sleep regularization).


DSM Code


F48.8 Neurasthenia

Disorder Sheets

Mind (UK)
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London E15 4BQ
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Recommended Book

Cultures of Neurasthenia:
From Beard to the First World War - Click Here to View


Neurasthenia Disorder

Misc Information


Chronic Fatigue Syndrome