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

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

In: European Archives of Psychiatry and Clinical Neuroscience, 2007, vol. 257, no. 2, p. 120-127

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    Titre
    • The spectra of neurasthenia and depression: course, stability and transitions
    Auteur
    • Gamma, Alex. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland
    • Angst, Jules. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland
    • Ajdacic, Vladeta. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland
    • Eich, Dominique. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland
    • Rössler, Wulf. Research Department, Zurich University Psychiatric Hospital, Lenggstr. 31, 8032, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Archives of Psychiatry and Clinical Neuroscience, 2007, vol. 257, no. 2, p. 120-127. Steinkopff-Verlag; www.steinkopff.springer.de
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321668
    Summary
    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