DSM-IV

Translates to "neurasthenia"

In China, a condition characterized by physical and mental fatigue, dizziness, headaches, other pains, concentration difficulties, sleep disturbance, and memory loss. Other symptoms include gastrointestinal problems, sexual dysfunction, irritability, excitability, and various signs suggesting disturbance of the autonomic nervous system. In many cases, the symptoms would meet the criteria for a DSM-IV Mood or Anxiety Disorder. This diagnosis is included in the Chinese Classification of Mental Disorders, Second Edition (CCMD-2).

DSM-5

Shenjing shuairuo ("weakness of the nervous system" in Mandarin Chinese) is a cultural syndrome that integrates conceptual categories of tradition Chinese medicine with the Western diagnosis of neurasthenia. In the second, revised edition of the Chinese Classification of Mental Disorders (CCMD-2-R), shenjing shuairuo is defined as a syndrome composed of three out of five nonhierarchial symptom clusters: weakness (e.g., mental fatigue), emotions (e.g., feeling vexes), excitement (e.g., increased recollections), nervous pain (e.g., headache), and sleep (e.g., insomnia). Fan nao (feeling vexed) is a form of irritability mixed with worry and distress over conflicting thoughts and unfulfilled desires. The third edition of the CCMD retains shenjing shuairuo as a somatoform diagnosis of exclusion. Salient precipitants of shenjing shuairuo include work- or family-related stressors, loss of face (mianzi, lianzi), and an acute sense of failure (e.g., in academic performance). Shenjing shuairuo is related to traditional concepts of weakness (xu) and health imbalances related to deficiencies of a vital essence (e.g., the depletion of qi [vital energy] following overstraining or stagnation of qi due to excessive worry). In the traditional interpretation, shenjing shuairuo results when bodily channels (jing) conveying vital forces (shen) become dysregulated as a result of various social and interpersonal stressors, such as the inability to change a chronically frustrating and distressing situation. Various psychiatric disorders are associated with shenjing shuairuo, notably mood, anxiety, and somatic symptom disorders. In medical clinics in China, however, up to 45% of patients with shenjing shuairuo do not meet criteria for any DSM-IV disorder.

Related conditions in other cultural contexts

Neurasthenia-spectrum idioms and syndromes are present in India (ashaktapanna) and Japan (shinkei-suijaku), among other settings. Other conditions, such as brain fag syndrome, burnout syndrome, and chronic fatigue syndrome, are also closely related.

Related conditions in DSM-5

Major depressive disorder, persistent depressive disorder (dysthymia), generalized anxiety disorder, somatic symptom disorder, social anxiety disorder, specific phobia, posttraumatic stress disorder.

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