Neurasthenia as nosological dilemma.

While researching concepts of neurasthenia as described by patients and physicians of various backgrounds, it was found that there is a great discrepancy between the two groups. In this study, questionnaires were administered to 70 psychiatric patients, 6 Chinese medicine men, 44 general physicians and 35 neuropsychiatrists, to inquire into the reasons for positive or negative attitudes toward neurasthenia. Half of the clinical patients believed that they were suffering from neurasthenia. Neurasthenia is a predominate term used for various types of distress arising mainly from psychiatric diseases. Chinese medicine men are aware that this term is a medical diagnosis introduced from the West. Through experience they regard neurasthenia as a kind of deficit of nerve. Apparently, the concept of neurasthenia has been integrated into the Chinese medical system, a fact substantiated by its longstanding, nosological use by the public. Younger generation physicians within both general and neuropsychiatric disciplines on the whole reject neurasthenia as a diagnostic term. However, one-third of neuropsychiatrists and 40% of general physicians use this term in their practice in order to improve the treatment of and to establish good communication and rapport with the patients whom they treat. Most of them, however, do not use the term in their formal diagnosis. The concept of the illness, neurasthenia, is historically rooted and today presents a nosological dilemma. It will eventually be transformed conceptually and disappear from the public mind.