Masturbation as a Cause of "Sexual Neurasthenia": Anton Chekhov's Medical Report (1883).

ABSTRACT: In the 18th and 19th centuries, in Europe and the United States, masturbation was seen not only as a deviant form of sexual activity but also as a cause of nervous diseases. Masturbation was originally thought to cause insanity, but with the introduction of George Miller Beard's concept of neurasthenia, it came to be considered a form of nervous exhaustion. In the current article, we analyzed the almost forgotten medical report of a "sexual neurasthenic," written by the famous Russian writer and physician Anton Chekhov (1860-1904). This report gives us detailed information about the treatment of a patient allegedly experiencing the effects of masturbation, and thus reflects the medical discourse on masturbation in Russia in the early 1880s. It shows that although the international debate on the causes of neurasthenia had just begun, the concept of neurasthenia toward masturbation had already been put into practice at the Moscow University Clinic in 1883.

STATE OF COGNITIVE FUNCTIONS IN CHILDREN WITH PATHOLOGY OF DIGESTIVE ORGANS, WHO LIVE AT RADIOACTIVE CONTAMINATED TERRITORIES OF UKRAINE. / STAN KOGNITYVNYKh FUNKTsIY̆ U DITEY̆ Z PATOLOGIIeIu ORGANIV TRAVLENNIa, IaKI PROZhYVAIuT' NA RADIOAKTYVNO ZABRUDNENYKh TERYTORIIaKh UKRAÏNY.

OBJECTIVE: to study the state of cognitive functions in children who were born and permanently live at radioactive contaminated territories (RCT) with pathology of the upper digestive tract, using pathopsychological testing; to increase the effectiveness of treatment and prophylactic measures aimed at preserving and restoring the health of RCT residents. DESIGN, PATIENTS AND METHODS: A randomized blind controlled clinical trial was conducted. There were examined, a total of 90 persons aged 6 to 17 years (35 boys and 55 girls) who were divided into two groups: the control group (I) included 30 persons of the conventional «clean¼ territories, and the main group (II) - 60 patients with patho- logy of the digestive organs who were born and live at the RCT. The study program included: the collection of anam- nesis, complaints; clinical and instrumental examinations. The following tests were applied by us: «What things are hidden in the drawings¼, Toulouse-Pieron, Raven, and Luria testing. For detecting the anxiety level, and the subjec- tive signs of autonomic dysfunctions were used the Spilberg-Hanin self-diagnosis and the Wein questionnaire, respectively. RESULTS: It was shown that in children aged 6-11 years, according to the results of the Toulouse-Pieron test, speed of cognitive information-processing was significantly decreased by 7.17 conventional units, while on the back- ground of the etiopathogenetic treatment of the digestive tract - by 10.24 conventional units relative to the va- lues of the control group. The long-term memory was statistically significantly decreased in the examined children of senior school age (from 12 to 17 years). A significant increase in reactive anxiety and a reverse correlation between the personal anxiety (PA) and speed of cognitive information-processing (r = -0.331) were recorded in patients aged 6-11 years. In older patients, PA was increased.Сonclusions. The obtained results indicate that the state of cognitive functions was characterized by a decrease in speed of cognitive information-processing, long-term memory and a high level of anxiety in children aged from 6 to 17 years residents of RСT with pathology of digestive organs, according to the used testing.

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.

Is Today's 21st Century Burnout 19th Century's Neurasthenia?

This essay addresses the relevance of the concept of "burnout" to concerns about the mental and physical health of today's physicians and those training to join the medical profession. Comparisons are made with the diagnosis of neurasthenia in the 19th century. Social contributors to and the influence of stress on the phenomena in each instance are presented.

Traumatic Hystero-Neurasthenia in Professor Charcot's Leçons du Mardi.

At the end of the 19th century, several authors became interested in the physical and psychological symptoms resulting from traumatic life events. Oppenheim presented 42 detailed clinical observations. He suggested the term "traumatic neurosis." Charcot, who was interested in male hysteria, published over 20 cases of traumatic hysteria between 1878 and 1893. The symptoms were considered to have a dynamic or functional origin. The role of horror and terror during the trauma was emphasized. However, Charcot opposed the idea of traumatic neuroses as specific syndromes as he considered them to be only an etiological form of hystero-neurasthenia. In The Tuesday Lessons (Les Leçons du Mardi), he presents several observations. They are surprising when compared with the current criteria for posttraumatic stress disorder (PTSD). Although he had rejected this new entity, a hundred years before the appearance of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Charcot described most of the symptoms mentioned for a diagnosis of PTSD such as intrusion (reliving the trauma, nightmares, and severe emotional distress), avoidance, negative changes in thinking and mood (negative thoughts, lack of interest, etc.), arousal, and reactivity (trouble sleeping, trouble concentrating, being easily startled or frightened, irritability, etc.).

[The complex of neurological symptoms of substance abuse].

Standard neurological examination was performed in 85 patients of military service age (the average age was 32,6±5,3 years - from 19 to 44 years) with a confirmed diagnosis of substance abuse, caused by the use of narcotic drugs and psychotropic substances: cocaine and amphetamine in 12 patients, opioids - in 73 patienls. Some symptoms of nervous system damage had statistically characteristic peculiarities for different forms of substance abuse. Mydriasis, signs a bilateral pyramidal insufficiency, hyperkinetic disorder are often characteristic for cocaine and amphetamine abuse. Opioid abuse is characterised by more severe symptoms of nervous system damage, disseminated neurologic symptomatic and polyneurotic disorders. Symptoms of neurasthenia and vegetative-vascular dystonia, which are usually accompanied by the; symptoms of organic lesions of the central and peripheral nervous system, were observed in all patients with substance abuse. In order to detect the symptoms of nervous system damage in patients, which are supposed to be conscribe, it is necessary to take medical history.

Characterization of fatigue states in medicine and psychiatry by structured interview.

CONTEXT: Unexplained fatigue states are prevalent, with uncertain diagnostic boundaries. OBJECTIVE: Patients with fatigue-related illnesses were investigated by questionnaire and a novel semistructured interview to identify discriminatory features. METHODS: Cross-sectional samples of women from specialist practices with chronic fatigue syndrome (n = 20), postcancer fatigue (PCF; n = 20), or major depression (n = 16) were recruited. Additionally, two longitudinal samples were studied: women with fatigue associated with acute infection who subsequently developed postinfective fatigue syndrome (n = 20) or recovered uneventfully (n = 21), and women undergoing adjuvant therapy for breast cancer experiencing treatment-related fatigue who subsequently developed PCF (n = 16) or recovered uneventfully (n = 16). Patients completed self-report questionnaires, and trained interviewers applied the Semi-structured Clinical Interview for Neurasthenia. The receiver operating characteristics curves of the interview were measured against clinician-designated diagnoses. Cluster analyses were performed to empirically partition participants by symptom characteristics. RESULTS: The interview had good internal consistency (Cronbach alpha "fatigue" = .83), and diagnostic sensitivity and specificity for chronic fatigue syndrome (100% and 83%) and major depression (100% and 72%), with reasonable parameters for PCF (72% and 58%). Empirical clustering by "fatigue" or "neurocognitive difficulties" items allocated most patients to one group, whereas "mood disturbance" items correctly classified patients with depression only. CONCLUSIONS: The Semi-structured Clinical Interview for Neurasthenia offers reliable diagnostic use in assessing fatigue-related conditions. The symptom domains of fatigue and neurocognitive difficulties are shared across medical and psychiatric boundaries, whereas symptoms of depression such as anhedonia are distinguishing.

[Treatment of asthenic syndrome in patients with chronic brain ischemia: results of the non-interventional observational program TRIUMPH].

OBJECTIVE: To assess the severity of asthenic syndrome (AS) in chronic brain ischemia (CBI) in primary health care settings. MATERIAL AND METHODS: The study included 1170 patients with brain ischemia, aged 45-65 years, treated with phenotropil in dose 100 mg during 2 and 3 months. Clinical examination and MFI-20 subscales were administered. RESULTS AND СONCLUSION: The high incidence of asthenic syndrome was observed across all MFI-20 subscales. The decrease in asthenic syndrome severity was significant already in the end of the first month of treatment with phenotropil. Such dynamics maintained to the end of the second and third month of treatment. More than 2-fold decrease in the severity of asthenia symptoms was achieved in all subgroups 3 months after treatment. More rapid and apparent decrease in asthenic syndrome was observed in younger patients.

[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.

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.

Neurastenia / Neurasthenia

Apresenta a categoria médica da neurastenia, criada em solo estadunidense no fim do século XIX pelo neurologista George Beard. São apresentadas as características gerais do quadro clínico, bem como as principais hipóteses explicativas para os sintomas, e as proposições terapêuticas sugeridas nas obras do referido autor. Além disso, é discutida a recepção do diagnóstico fora dos EUA, tanto no que se refere ao seu uso na Europa quanto ao caso específico do Brasil.

The article addresses the medical category of neurasthenia, developed in the United States by neurologist George Beard at the close of the nineteenth century. Points of discussion include the principle features of the category's clinical presentation, the main hypotheses advanced to account for symptoms, and the treatment alternatives suggested in Beard's works. The article also looks at how the diagnosis was received outside the United States, both in Europe and, more specifically, in Brazil.

[Subclinical hypothyroidism and quality of life of women aged 50 or more with hypercholesterolemia: results of the HYOGA study]. / Hypothyroïdie fruste et qualité de vie chez des femmes hypercholestérolémiques de plus de 50 ans: résultats de l'étude HYOGA.

AIM: Subclinical hypothyroidism (SCHT) is defined by the combination of an increased TSH level and a normal free thyroxin concentration. The aim of this survey is the description of the prevalence, the symptoms and the quality of life in SCHT diagnosed in a group of hypercholesterolemic women. METHODS: A total of 1610 female patients aged 50 or more with hypercholesterolemia (total cholesterol between 240 and 400mg/dl, receiving or not a lipid-lowering treatment) were enrolled by 347 general practitioners (GPs). A clinical form including symptoms, clinical history, and treatments was completed by GPs while a SF-36 QOL form was filled up by the patients. Further GPs' prescriptions for tests and treatments were also recorded. RESULTS: Full data leading to subclinical hypothyroidism are available in 721 patients (44.8%) who were selected into the study. Among these patients, the prevalence of SCHT (SCHT+) is 16.6% (120 patients) and 76.3% of the patients have at least one symptom. Most frequent symptoms are physical and intellectual asthenia, muscular weakness, and sensitivity to cold but those symptoms are present in patients without SCHT (SCHT-) too and there is no significant difference between the two groups. TSH level was 4 to 10 mUI/l in 90% of SCHT+ patients. 38.6% of hypercholesterolemic SCHT+ patients never had any TSH measurement. QOL is affected in SCHT+ compared to SCHT- patients with a significantly decreased mental summary score of 36.21+/-9.4 versus 39.4+/-12.18 (p<0.006). QOL (mental health score) is significantly lower when TSH value raised from a 2.4-4 range up to a 4-10 mUI/L range. CONCLUSIONS: SCHT is frequent in a population of hypercholesterolemic female patients aged 50 or more. In the presence of suggestive symptoms, screening is important especially as QOL is affected even when TSH is < 10 mUI/L. It remains to show with controlled prospective studies whether thyroxin supplementation can improve symptoms and QOL.

Symptoms of neurasthenia following earthquake trauma: re-examination of a discarded syndrome.

The authors examined symptoms of neurasthenia in the context of trauma through a survey conducted 10 months post-earthquake, among a sample of earthquake survivors in rural Taiwan. An algorithm closely resembling neurasthenia as defined in ICD-10 was designed a priori. Three diagnostic groups were identified, including those with "pure" neurasthenia (n=27) who did not exhibit any Axis I disorder, those with an Axis I disorder but without neurasthenia (n=46) and controls who were without neurasthenia or an Axis I disorder (n=152). Those with neurasthenia were demographically similar to non-psychiatrically disordered controls and did not differ with respect to impact of trauma. Greater severity of intrusive and avoidant/numbing posttraumatic stress disorder (PTSD) symptoms and less resilience characterized neurasthenia relative to controls. Morbidity was similar for neurasthenia and Axis I disorders, except for the presence of less resilience in the neurasthenia group. Thus, "pure" neurasthenia appears to be independent from other psychopathology in a significant number of earthquake survivors, and was not closely related to the impact of earthquake trauma. The meaningful number of subjects meeting criteria for our algorithm of neurasthenia suggests that further study of this syndrome employing exact ICD-10 diagnostic criteria is warranted.

Unloading the trunk: neurasthenia, CFS and race.

The aetiologies of both chronic fatigue syndrome (CFS) and its predecessor neurasthenia, have been linked to technological advances in 'developed' countries. This paper discusses how this has led to a form of race thinking within discussions about fatigue which has persisted for more than a century. We review the historical development of this race thinking from neurasthenia to CFS and describe how it is manifested in both the lay- and medical literature. We also review the epidemiological literature on CFS and ethnicity to better understand the relatively low percentage of non-white patients seen in tertiary referral clinics for CFS. The aim of this paper is to act as a starting point for a debate on race and CFS.