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Anxiety and somatoform disorders
Published in Laeth Sari Nasir, Arwa K Abdul-Haq, Caring for Arab Patients, 2018
Brigitte Khoury, Michel R Khoury, Laeth S Nasir
The main feature of this disorder is one or more physical complaints which have persisted for six months or longer. Some of these symptoms can be fatigue, loss of appetite, gastrointestinal or urinary complaints. These symptoms cannot be explained by any medical condition or the effect of any substance and cause significant distress and interference in the patient’s daily life. These symptoms may be used as “idioms of distress” to express personal and social problems, which the person is unable either to face or to express verbally. It is mostly seen in women from low socioeconomic backgrounds with limited education, and who resort to this means of communication to express their mental distress. This disorder has been called “neurasthenia” in different parts of the world.
Other symptoms and the psyche
Published in Ad (Sandy) Macleod, Ian Maddocks, The Psychiatry of Palliative Medicine, 2018
Ad (Sandy) Macleod, Ian Maddocks
Fatigue may be caused directly by the disease and indeed many patients attribute their fatigue to the cancer ‘stealing’ their energy. Damage to the nervous system results in profound fatigue, for the system is required to function at maximal capacity to cope with routine life tasks. Therapeutic ‘poisons’ such as chemotherapy and radiotherapy are potent causes of fatigue as are the array of medications with sedating side effects. Tiredness is a sign of depression, a consequence of insomnia and a symptom of anxiety and worry. Clinically differentiating depression and fatigue is difficult.11 The affective and cognitive symptoms differentiate them, but the physiological symptoms do not. There is overlap of symptoms between depression and fatigue. Neurasthenia is being reconsidered as a psychiatric syndrome for this reason. Fatigue is a cardinal symptom of anaemia and a clinical indicator of the need for blood transfusion. Physical disuse reinforces fatigue, and fatigue discourages activity. This vicious cycle not only undermines physical functioning, it erodes emotional well-being, and immobility encourages psychological regression (seeChapter 3).
Neurological Disease in Herpes Simplex Virus Type 2 (HSV-2) Infection
Published in Marie Studahl, Paola Cinque, Tomas Bergström, Herpes Simplex Viruses, 2017
Clinical symptoms of HSV-2-induced meningitis are mainly the same as those found in asentic meningitides caused by other viruses Headache, usually described as intense, develops during 2–3 days (10), together with varying degrees of other signs and symptoms of meningeal irritation such as neck stiffness, photophobia, nausea, and vomiting. Fever is common but not an obligatory finding [present in 63% of 71 patients in one study (14)]. In most cases, the acute symptoms of primary meningitis resolve spontaneously within a week, although sometimes only after a protracted illness (8,7,10,19,25). Neurasthenic symptoms such as mild headache, lability, concentration disabilities, and fatigue may, however, last for several weeks (8,22). One case of chronic meningitis with predominantly headache and meningism lasting for 4 weeks has been reported (35).
Neurasthenia: tracing the journey of a protean malady
Published in International Review of Psychiatry, 2020
Poornima Bhola, Santosh K. Chaturvedi
Although the neurasthenia label has all but disappeared from contemporary nosological frameworks, there is a proliferation of other disorders, e.g. chronic fatigue syndrome, fibromyalgia, that try to capture the experience of fatigue, pain, weakness, and distress even in the absence of clear-cut medical aetiologies. These diagnostic categories have also been challenged and may not stand the test of time, but this does not necessarily mean that they are irrelevant. Perhaps, we need to return to such broad understandings of distress/suffering that are not situated primarily in biomedical spaces but accommodate the social, cultural and personal. All experiences of distress may not neatly translate into diagnostic categories. Pietikainen and Turunen (2017) suggest that viewing modern ‘neuroses’ within the framework of distress rather than disease opens the possibility for a broader range of interventions with the aim of alleviating subjective distress.
Railway spine: The advent of compensation for concussive symptoms
Published in Journal of the History of the Neurosciences, 2020
Page contended that signs and symptoms following concussive incidents in which the patient sustained no validating physical injury reflected “universal nervous shock, rather than … special injury to the spinal cord” (1883, 101). Universal nervous shock was “synonymous” (Page 1891, 46) with neurasthenia, implying nervous exhaustion triggered by generalized fright from a railway collision in a predisposed individual. Signs and symptoms of neurasthenia, in order of observed frequency, included sleeplessness, disturbances of circulation, headache (the idiosyncrasy of the pain response being acknowledged), nervousness (including irritability and symptoms now associated with depression), excessive sweating, visual impairment (e.g., photophobia), and loss of memory (primarily an impairment of attention).
Characterological depression in patients with narcissistic personality disorder
Published in Nordic Journal of Psychiatry, 2019
Jane Fjermestad-Noll, Elsa Ronningstam, Bo Bach, Bent Rosenbaum, Erik Simonsen
The above-mentioned descriptions of different types of depression, draws ties back to previous discussions of whether depression should be understood as a unitarian diagnostic entity, or as binary entity [3,20]. Currently DSM-5 and ICD-10 consider MD as a unitary category. The recognition of distinct forms of affective illnesses has been known since Beard introduced the concept of “neurasthenia” and “melancholia” in 1869 [2]. Neurasthenia was described as a phenomenon dominated by anxiety, pain, fatigue and hypochondria, showing a chronic course. Melancholia was predominated by motor and intellectual slowing, sadness and feelings of powerlessness. The course of melancholia was episodic [2]. Kraepelin is thought to be the one who conceptualized the idea of a unitary understanding of depression, when he introduced the structure of Massive Depressive Illness (MDI) in 1883 [2]. This construct included all forms of melancholia, psychotic depression and serious depressive and manic illness. This construct did however not include psychogenic depression. Psychogenic depression was described as being precipitated by stressful life-events, unlike MDI which usually manifested unrelated to changes in the patient’s social situation [2].