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The spectra of neurasthenia and depression: course, stability and transitions

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Abstract

Background

Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well understood.

Methods

In a stratified community sample (n = 591), representative of 2600 persons of the canton of Zurich, Switzerland, neurasthenia and depression were assessed in six structured interviews between ages 20 and 41. Course, stability and comorbidity were examined. A severity spectrum of neurasthenia and depression from symptoms to diagnosis was taken into account.

Results

The annual prevalence of a neurasthenia diagnosis increased from 0.7% to 3.8% from age 22–41, while mere symptoms became less prevalent. Intraindividual courses improved in 40% and deteriorated in about 30% of symptomatic cases. The most frequent symptoms overall, besides criterial exhaustion, were increased need for sleep, over-sensitivity, nervousness and difficulty concentrating. Cross-sectional associations and overlap with depression were strong. Longitudinal stability of ICD-neurasthenia was low.

Conclusions

Neurasthenia is intermittent, overlaps significantly with depression, and shows improvement and deterioration over time to roughly equal measures.

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Acknowledgement

This work was supported by Grant 3200–050881.97/1 of the Swiss National Science Foundation.

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Authors and Affiliations

  1. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland

    Alex Gamma, Jules Angst, Vladeta Ajdacic, Dominique Eich & Wulf Rössler

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  1. Alex Gamma

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  2. Jules Angst

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  3. Vladeta Ajdacic

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  4. Dominique Eich

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  5. Wulf Rössler

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Correspondence toAlex Gamma.

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Gamma, A., Angst, J., Ajdacic, V.et al. The spectra of neurasthenia and depression: course, stability and transitions.Eur Arch Psychiatry Clin Neurosci257, 120–127 (2007). https://doi.org/10.1007/s00406-006-0699-6

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