What is Neurasthenia?

Neurasthenia is one of the diagnoses of neurosis in China. It is due to long-term stress and stress, and the phenomenon of mental excitement and mental fatigue is often accompanied by emotional distress, irritability, sleep disorders, muscle tension pain, etc .; these symptoms cannot be attributed to brain, physical and other mental illnesses . Symptoms are mild and severe, fluctuations are related to psychosocial factors, and the course of the disease is often prolonged. In the recent century, the concept of neurasthenia has undergone a series of changes. With the changes in doctors' understanding of neurasthenia and the classification of various special syndromes and subtypes, the diagnosis has been discontinued in the United States and Western Europe. Field tests have proven that the diagnosis of neurasthenia is also significantly reduced in China.

Basic Information

English name

neurasthenia

Visiting department

Department of Neurology, Psychiatry, Counseling

Common causes

Mental factors, social work stress, bad personality, etc.

Common symptoms

Fatigue, fatigue, inattention, insomnia, etc.

Causes of Neurasthenia

Many patients have poor personality traits before they fall ill: inferiority, sensitivity, suspiciousness, lack of self-confidence, or bias of subjectivity, irritability, and eagerness, which can easily lead to relaxation regulation disorders of life events, leaving the brain in a persistently stressed state Onset.

At present, most scholars believe that mental factors are the main cause of neurasthenia. All factors that can cause persistent tension and long-term inner contradictions make the nervous activity process intense and lasting in a state of tension that exceeds the tolerance limit of the nervous system's tension, and can cause disease. Such as excessive fatigue without getting rest is excessive tension in the excitement process; dissatisfaction with the current situation is excessive tension in the suppression process; often changing the living environment without adaptation, putting the central nervous system in excessive tension and fatigue. Nerve cells in the cerebral cortex are highly tolerant. Although fatigue occurs after intense mental work, it can be restored after a short rest or sleep. However, once long-term intense nervous activity exceeds the tolerance, At the limit, neurasthenia may occur.

Clinical manifestations of neurasthenia

Common symptoms are fatigue and fatigue. Difficulty in concentration, insomnia, poor memory, and often forgetting things, whether mental or physical activity, feeling tired for a long time. Excessive sensitivity to stimuli such as sound, light stimulation or minor physical discomfort.

Neurasthenia test

In order to rule out possible organic lesions, ECG, EEG, EEG topography, transcranial Doppler ultrasound, and skull CT are required.

Neurasthenia diagnosis

According to the third edition of the Chinese Mental Disorder Classification and Diagnostic Standard (CCMD_-3), the diagnostic criteria are as follows:

(I) Symptom Criteria

1. Meet the diagnostic criteria for neurosis;

2. The main symptoms of weak brain and physical function are characterized by persistent and distressing mental fatigue (such as feeling of lack of spirit, self-conscious mental retardation, inattention or non-persistence, poor memory, and decreased thinking efficiency) and Physical fatigue is susceptible to fatigue, which cannot be recovered after rest or entertainment, and there are at least the following 2 items:

(1) Emotional symptoms, such as annoyance, nervousness, and irritability, are often related to various contradictions in real life, and it is difficult and difficult to deal with. May have anxiety or depression, but do not predominate;

(2) Symptoms of excitement, such as feeling mentally excited (such as increased memories and associations, mainly due to the effort of directional thinking, but non-directional thinking is very active, pain and unhappiness due to difficult control, but increased speechless movement Sometimes sensitive to sound and light.

(3) muscle tension pain (such as tension headache, limb muscle soreness) or dizziness;

(4) Sleep disorders, such as difficulty falling asleep, having more dreams, feeling uncomfortable after waking, loss of sleep, and disturbance of sleep awakening rhythm;

(5) Other psychophysiological disorders, such as dizziness, tinnitus, palpitation, chest tightness, bloating, indigestion, frequent urination, sweating, impotence, premature ejaculation, or menstrual disorders.

(Two) serious standards

Patients felt pain or actively seek treatment because they obviously felt that their brain and body functions were weakened, affecting their social functions.

(Three) disease course standards

Has met the criteria for symptoms for at least 3 months.

(IV) Exclusion criteria

1. Exclude any of the above neurosis subtypes;

2. Exclude schizophrenia and depression.

Differential diagnosis of neurasthenia

Many cases that were previously diagnosed with neurasthenia meet current criteria for depression or anxiety. However, in some cases, the description of neurasthenia is more appropriate than any other neurotic syndrome. In the diagnosis of neurasthenia, depression and anxiety disorders should be ruled out first. Patients with schizophrenia may have symptoms similar to neurasthenia in the early stage, but the pain is not obvious, and the heart is not strong. With the development of the disease course and the emergence of mental symptoms, it is not difficult to identify.

Schizophrenia

Neurasthenia symptoms may appear in the early and remission stages of schizophrenia, but patients have indifferent attitudes to their disease, no urgent treatment requirements, and corresponding psychiatric symptoms can be identified;

2. Depression

Differential diagnosis is often difficult, especially in patients with mild depression, which is often misdiagnosed as neurasthenia. Because depression patients often suffer from insomnia, fatigue, lack of concentration, lack of energy, and various physical discomforts. The two types of symptoms are similar, and physical examinations have no corresponding positive signs. Depression in patients who ignore the examination often leads to misdiagnosis. Therefore, depression must be ruled out in the clinical diagnosis of neurasthenia. Depression patients show low mood, loss of happiness, loss of interest in daily life, self-blame, self-sin, and often negative suicide ideas. The patient's symptoms can show rhythmic fluctuations in the morning and night. Early awakening is a feature of sleep disorders in depression. The course of depression can be relieved periodically.

3. Chronic fatigue syndrome

It is a group of obstacles whose main performance is fatigue and cannot be solved by rest. Syndrome that lasts for more than six months and no medical or psychiatric diseases causing fatigue are found, often accompanied by low fever, sore throat, lymph node pain, muscle weakness, muscle pain, joint pain, bloating pain, psychosocial symptoms of persistent fatigue (such as Irritability, forgetfulness, lack of concentration, difficulty thinking, depression, etc.), sleep disorders (expressed as excessive sleep or insomnia). Physical examination revealed low fever (37.6 ° C-38.6 ° C), non-exudative pharyngitis, and enlarged and tender lymph nodes in the front and back of the neck or pharyngeal isthmus. Objective signs such as low fever, sore throat, enlarged lymph nodes, and tenderness are helpful in distinguishing from neurasthenia.

Neurasthenia Treatment

The treatment principle of this disease is that after detailed examination and elimination of organic diseases, the application of psychological therapy, behavioral therapy, combined with drugs and physical therapy can achieve better results. Anti-anxiety and anti-depression drugs can improve anxiety and depression in patients, relax muscles and eliminate some physical discomfort. Other treatments include physical exercise, travel recuperation, adjustment of unreasonable learning and working methods, etc. It may be a good way to get rid of the troubled situation, improve tension, and relieve mental stress. Supportive and interpretive psychotherapy can help patients understand the nature of the disease and eliminate secondary anxiety.