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

  • Alex Gamma
  • Jules Angst
  • Vladeta Ajdacic
  • Dominique Eich
  • Wulf Rössler
ORIGINAL PAPER

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.

Keywords

neurasthenia depression prevalence course comorbidity spectrum 

Notes

Acknowledgement

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

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Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Alex Gamma
    • 1
  • Jules Angst
    • 1
  • Vladeta Ajdacic
    • 1
  • Dominique Eich
    • 1
  • Wulf Rössler
    • 1
  1. 1.Research DepartmentZurich University Psychiatric HospitalZurichSwitzerland

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