Elton Mayo and Thomas Henry Reeve Mathewson: the forgotten Australian pioneers of the treatment of patients with shell shock, neurasthenia and nervous breakdown.

The contributions of Australians on shell shock are absent from the literature. However, two Australians were pioneers in the treatment of shell shock: George Elton Mayo (1880-1949) and Dr Thomas Henry Reeve Mathewson (1881-1975). They used psychoanalytic approaches to treat psychiatric patients and introduced the psychoanalytic treatment of people who suffered from shell shock. Their 'talking cure' was highly successful and challenged the view that shell shock only occurred in men who were malingering and/or lacking in fortitude. Their work demonstrated that people experiencing mental illness could be treated in the community at a time when they were routinely treated as inpatients. It also exemplified the substantial benefits of combining science with clinical knowledge and skill in psychology and psychiatry.

Managing Chineseness: neurasthenia and psychiatry in Taiwan in the second half of the twentieth century.

The present study investigates the role of Taiwanese psychiatrists in turning neurasthenia into a culture-specific disease in the late twentieth century. It first delineates the shift in both explanatory models of psychoneuroses and patient population in post-World War II Taiwan. Neurasthenia became a focus of international attention in the 1970s and 1980s with the advance of cultural psychiatry, and, as China was closed to the outside world, Taiwanese psychiatrists were influential in framing the cultural meaning of neurasthenia. With the rise of post-socialist China, Taiwan lost its status as a key laboratory of Chinese studies. This paper argues that the history of neurasthenia during the period was closely associated with the professional development and national identity of Taiwanese psychiatrists.

Soldier's heart: the forgotten circulatory neurasthenia - a systematic review.

Soldier's Heart (SH) is a former medical diagnosis, rarely mentioned nowadays, presented under several other names. Considering the controversy regarding the removal of Soldier's Heart diagnosis from DSM-5, this study aimed to conduct a systematic review to evaluate its usage in the clinical practice. Information on diagnosis, military stress, heart rate variability, treatment, and prognosis were collected from 19 studies included after a systematic literature search. Considering the lack of adequate use of Soldier's Heart diagnosis and the diagnostic overlapping with other conditions, the present systematic review supports the inclusion of Soldier's Heart under the umbrella of posttraumatic stress disorders (PTSDs). This proposal is also in line with the conception that physical symptoms are relevant features often associated with generalized anxiety disorder and PTSD. Also, it will be described the higher prevalence of cardiological comorbidities in SH and possible cardiological consequences. Pharmacotherapy based on benzodiazepines and beta-blockers, as well as biofeedback and mindfulness techniques are considered to be useful treatment options. Further studies are needed to better define psychopathological domains of this syndrome and possible novel treatment targets.

Neurasthenia: Modern Malady or Historical Relic?

Neurasthenia was a popular diagnosis from 1869 through 1930. Despite being discarded, the core symptoms of neurasthenia can still be found throughout modern society. The present article reviews the symptoms, common course, proposed causes, and common treatments for neurasthenia. Similarities are seen in several familiar diagnoses, including depression, chronic fatigue syndrome, and fibromyalgia. Through reviewing the trends of neurasthenia, modern doctors may learn more about the subtleties of the diagnostic process, as well as the patient-physician relationship. The goal is to learn from the past as it relates to current problems that may be related to the stress of modern living. The history of neurasthenia is presented as it relates to problems that may remain today.

Neurasthenia, psy sciences and the 'great leap forward' in Maoist China.

The present study looks into the much-neglected history of neurasthenia in Maoist China in relation to the development of psy sciences. It begins with an examination of the various factors that transformed neurasthenia into a major health issue from the late 1950s to mid-1960s. It then investigates a distinctive culture of therapeutic experiment of neurasthenia during this period, with emphasis on the ways in which psy scientists and medical practitioners manoeuvred in a highly politicized environment. The study concludes with a discussion of the legacy of these neurasthenia studies - in particular, the experiment with the famous 'speedy and synthetic therapy' - and of the implications the present study may have for future historical study of psychiatry and science.

Neurasthenia, Generalized Anxiety Disorder, and the Medicalization of Worry in a Vietnamese Psychiatric Hospital.

This article examines two forms of the medicalization of worry in an outpatient psychiatric clinic in Ho Chi Minh City, Vietnam. Biomedical psychiatrists understand patients' symptoms as manifestations of the excessive worry associated with generalized anxiety disorder (GAD). Drawing on an ethnopsychology of emotion that reflects increasingly popular models of neoliberal selfhood, these psychiatrists encourage patients to frame psychic distress in terms of private feelings to address the conditions in their lives that lead to chronic anxiety. However, most patients attribute their symptoms to neurasthenia instead of GAD. Differences between doctors' and patients' explanatory models are not just rooted in their understandings of illness but also in their respective conceptualizations of worry in terms of emotion and sentiment. Patients with neurasthenia reject doctors' attempts to psychologize distress and maintain a model of worry that supports a sense of moral selfhood based on notions of obligation and sacrifice.

Straighten the Back to Sit: Belly-Cultivation Techniques as "Modern Health Methods" in Japan, 1900-1945.

In Japan, the first half of the twentieth century saw a remarkable revival of concern with the cultivation of the belly, with a variety of belly-cultivation techniques, particularly breathing exercise and meditative sitting, widely practiced for improving health and treating diseases. This article carefully examines some practitioners' experiences of belly-cultivation practice in attempting to understand its healing effects for them within their life histories and contemporary intellectual, social and cultural contexts. It shows that belly-cultivation practice served as a medium for some practitioners to reflect on and retell their life stories, and that the personal charisma of certain masters and the communities developing around them provided practitioners with a valuable sense of belonging in an increasingly industrialized and urbanized society. Moreover, these belly-cultivation techniques provided an embodied way for some to explore and affirm their sense of self and develop individual identity. While they were increasingly promoted as cultural traditions capable of cultivating national character, they also served as healing practices by inspiring practitioners with a sense of collective identity and purpose. With these analyses, this article sheds light on the complicated meanings of belly-cultivation for practitioners, and provides illustrative examples of the multitude of meanings of the body, bodily cultivation and healing.

A Disorder of Qi: Breathing Exercise as a Cure for Neurasthenia in Japan, 1900-1945.

Neurasthenia became a common disease and caused widespread concern in Japan at the turn of the twentieth century, whereas only a couple of decades earlier the term "nerve" had been unfamiliar, if not unknown, to many Japanese. By exploring the theories and practices of breathing exercise-one of the most popular treatments for neurasthenia at the time-this paper attempts to understand how people who practiced breathing exercises for their nervous ills perceived, conceived, and accordingly cared for their nerves. It argues that they understood "nerve" based on their existing conceptions of qi Neurasthenia was for them a disorder of qi, although the qi had assumed modern appearances as blood and nervous current. The paper hopes to contribute to the understanding of how the concept of nerves has been accepted and assimilated in East Asia. It also points out the need to understand the varied cultures of nerves not only at the level of concept and metaphor, but also at the level of perception and experience.

Treating emotion-related disorders in Japanese traditional medicine: language, patients and doctors.

This paper analyses how the conceptual and therapeutic formation of Japanese traditional medicine (Kampo) has been socially constructed through interactions with popular interpretations of illness. Taking the example of emotion-related disorders, this paper focuses on the changing meaning of constraint (utsu) in Kampo medicine. Utsu was once a name for one of the most frequently cited emotion-related disorders and pathological concerns during the Edo period. With the spread of Western medicine in the Meiji period, neurasthenia replaced utsu as the dominant emotion-related disorder in Japanese society. As a result, post-Meiji doctors developed other conceptual tools and strategies to respond to these new disease categories, innovations that continue to influence contemporary practitioners. I begin this history by focusing on Wada Tokaku, a Japanese doctor of the Edo period who developed a unique theory and treatment strategy for utsu. Secondly, I examine. Yomuto Kyushin and Mori Dohaku, Kampo doctors of the early twentieth century, who privileged neurasthenia over utsu in their medical practice. The paper concludes with a discussion of the flexibility and complexity of Kampo medicine, how its theory and practices have been influenced by cross-cultural changes in medicine and society, while incorporating the popular experience of illness as well.

[Neurasthenia in Norway 1880-1920]. / Nevrasteni i Norge 1880-1920.

Neurasthenia was introduced as a diagnostic category in America in 1869, and rapidly spread to Europe. Many have drawn parallels between the historical disease entity of neurasthenia and contemporary conditions such as chronic fatigue syndrome/myalgic encephalopathy and burn-out, but we have little knowledge about the early history of neurasthenia in Norway. On the basis of Norwegian medical journals from the period 1880-1920, we have sought to study the introduction, understanding and application of the concept of neurasthenia in Norwegian medical practice, with particular emphasis on symptoms, causes, treatment, prognosis and prevalence. Results show that the term was probably used in a Norwegian medical journal for the first time in 1876, and during the 1880s there followed an increasing number of reports of people who had been diagnosed with neurasthenia. The condition was defined as a weakness of the nervous system. The symptom picture was extensive, with exhaustion as the main symptom. The causes of the symptoms could not be objectively verified or located, and theories abounded. Overexertion was a common explanation, although traumas, infections, malnutrition, heredity and sexual excesses were also assumed to be causes. The recommended treatment focused on strengthening the nervous system, for example through rest and electrotherapy. The condition was described as typical of its time, as a response to the «Zeitgeist¼ and modern life.

[Acupuncture in the treatment of neurasthenia].

Neurasthenia--is the exhaustion of the nervous system, mental disorder that belongs to a group of neuroses. Doctors sometimes briefly describing him "irritable weakness" or "irritable fatigue." This term is justified: a person who suffers asthenic-neurotic syndrome, while experiencing fatigue and increased nervous excitability. Reasons neurasthenia quite a lot. Unfortunately, the lifestyle of modern man gives many reasons for the emergence of asthenic-neurotic syndrome.

The role of neurasthenia in the formation of the physiotherapy profession.

Background: Neurasthenia was one of the most commonly diagnosed disorders in the later years of the 19th century. Its most widely used treatment, known as the Rest Cure, relied heavily on physical therapies, but little is known about the practitioners who administered the treatment. In this paper, I argue that the nurse-masseuses who delivered the massage and electricity so vital to the success of the Rest Cure, used the opportunity to develop approaches to treatment that would form the backbone of the physiotherapy profession in England after 1894. Methods: Extensive primary and secondary texts were drawn from a wide range of sources and critically reviewed. Findings: This study argues that the management of neurasthenic cases in the 1880s and 90s created the conditions necessary for the development of the profession's relationship with medicine and the establishment of new practice roles for women, and that these would play an important role in shaping the physiotherapy profession in Britain after 1894. Read through the critical sociological writings of Magali Sarfatti Larson and Anne Witz, I argue that the work of the nurse-masseuses can be seen as a complex gendered negotiation between the need to be deferential to the dominant male medical profession; distinct from emerging notions of the angelic, motherly nurse; obedient, technically competent and safe. The creation of a space in the clinic room for a third practitioner who could deliver a different form of care to the doctor or the nurse, established an approach to practice that physiotherapists would later adopt almost without amendment. Discussion: I argue that this approach owes much to the work done by nurse-massueses who established and tested its principles in treating cases of neurasthenia.

Subjective distress predicts treatment seeking for depression, bipolar, anxiety, panic, neurasthenia and insomnia severity spectra.

OBJECTIVE: To examine correlates of mental health treatment seeking such as gender, diagnosis, impairment, distress and mastery. METHOD: Longitudinal epidemiological data from the Zurich Study of common psychiatric syndromes, including unipolar and bipolar depression, panic, anxiety, neurasthenia and insomnia, were utilized. In longitudinal Generalized Estimating Equations, treatment seeking was regressed on measures of subjective distress and impairment, childhood family problems, mastery and number of comorbid diagnoses. RESULTS: Approximately half of all treated participants across all six syndromes suffered from subthreshold disorders. Meeting full or subthreshold diagnostic criteria was associated with treatment seeking for insomnia. Being female was associated with treatment seeking for depression. The only variable highly and consistently associated with treatment seeking, across all syndromes, was subjective distress. Treated participants reported high levels of distress, work and social impairment in both diagnostic and subthreshold groups. CONCLUSION: Subjective distress may be a better indicator of treatment seeking than symptom count.

[Urology goes electric-electrotherapy : Modern therapies in the treatment of modern diseases-examples from urology]. / Die Urologie wird elektrisch ­ Elektrotherapie : Moderne Therapien zur Behandlung moderner Erkrankungen ­ Beispiele aus der Urologie.

The significance of electricity for medicine in the modern industrial age should not be underestimated. Particularly in connection with neurasthenia, electrotherapeutic approaches also experienced a boom for domestic use. Thus, electrotherapy reached urology just as it was becoming established as a medical specialty. We analyzed urological manuals and textbooks and objects in the W. P. Didusch Center for Urologic History and the Museum zur Geschichte der Urologie in Berlin to present the wide range of indications for electrotherapy in the emerging field of urology from impotence to urethral strictures and try to highlight the variability of their importance over time.

Psychosocial and immunological factors in neurasthenia.

BACKGROUND: Neurasthenia is a disorder whose pathogenesis is still unknown. OBJECTIVE: The authors sought to examine the relationships between neurasthenia and possible psychosocial and immunological correlates. METHOD: A sample of 30 Chinese neurasthenic patients was compared with a matched sample of 30 control subjects for 1) the level of serum Epstein-Barr virus (EBV) gamma G immunoglobulin (IgG) and gamma M immunoglobulin (IgM); 2) scores on the Eysenck Personality Questionnaire (EPQ); 3) the Symptom Checklist-90; and 4) the Life Event Scale (LES); 27 of the 30 neurasthenia patients were treated with medication and psychotherapy for a 4-month period, with measures taken pre- and posttreatment. RESULTS: As compared with the control group, neurasthenic patients exhibited higher EPQ scores for neuroticism, higher levels of introversion, and a higher number of negative life events. Within the neurasthenia sample, scores for neuroticism and the SCL-90 Global Severity Index were significantly lower at follow-up than at baseline. CONCLUSION: As compared with control subjects, neurasthenia patients were characterized by greater neuroticism and introversion, and they reported a higher rate of negative life events. Moreover, the positive rate of EBV in neurasthenic patients was higher, which may be associated with higher EBV activation under states of stress.

[Chronic fatigue syndrome--a functional somatic syndrome]. / Chronisches Erschöpfungssyndrom--eine funktionelle Störung.

Chronic fatigue can be categorized as a functional somatic syndrome (fss), because there are findings of typical preconditions, trigger mechanisms and maintaining conditions. With relevance for therapy it makes sense to see it as an medical-psychiatric interface-disorder Subsyndromal short episodes of chronic fatigue are many more frequent as three or six month during clearly diagnosed episodes of "neurasthenia" or "chronic fatigue syndrome". Their descriptions are very similar and obvious those means the same matter. For original aetiological assumptions it wasn't any evidence. But there are findings of charcteristical patterns of changed neurhumeral and immunological interactions for the chronic fatigue syndrome, common for fss. Especially changes of HPA-Axis and its interactions with other systems of functional regulation. Another importent fact are increased senzitation in neuronal and neurocognitive regulation. Increased critical appraisal of somatic funtions and dysfunctional coping strategies are maintaining factors at least. Patterns of dysfuntional coping are not a problem of patients alone. There are also experiences, that some doctors shows the same dysfunctional somatizing management of fss in general and especially for chronic fatigue. In fact, a single and specific cause of chronic fatigue doesn't exist. But the above-mentioned facts allows a starting point for a more successful treatment. There are reviews that shows a good evidence for therapeutic procedures wich are calling for acticvity by patients, such cognitive behavioral therapy and graduated activation. Antidepressants, especialy SSRI, are helpful with a small evidence. They can be used to increase treatment effects. There is no evidence for therapies without patients activation.

[Masked depression--history and present days]. / Depresja maskowana--historia i wspólczesnosc.

Masked depression is a special form of an atypical depression. In the 70's and 80's years it was often identified at patients who complained on somatic diseases, without any distinguishable organic disorder. Depression symptoms were of secondary importance, with lesser intensification, some of them didn't appear at all. The psychiatrists of the time created a lot of terms to describe them, i.e.: a depression equivalent, a vegetative equivalent, a depression without a depression, a hidden depression. Current classifications: ICD-10 (International Classification of Diseases, 10th Revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, published by the American Psychiatric Association) do not contain the term masked depression. It doesn't mean that have disappeared the problem of atypical depression syndrome with a picture significantly different from the commonly known. The american scientists claim that such group contains 6-7% of depression disorders. The lack of proper diagnosis and disease entity qualification leads to serious somatic and psychological consequences for patients. Improper diagnosis and treatment of a patient limits his or her social and professional life, forms suicide rate and makes high costs of diagnosis and treatment.