Am J Psychiatry 1991; 148:1638-1646
Copyright © 1991 by American Psychiatric Association
Neurasthenia and chronic fatigue syndrome: the role of culture in the making of a diagnosis
SE Abbey and PE Garfinkel
Department of Psychiatry, Toronto Hospital, Ont., Canada.
Chronic fatigue syndrome is an increasingly popular diagnosis consisting of
multiple psychiatric and somatic symptoms. It bears a striking resemblance
to the nineteenth-century diagnosis of neurasthenia. Both disorders arose
during periods characterized by a preoccupation with commerce and material
success and major changes in the role of women. They illustrate the role of
culture in the development of a new diagnosis that emphasizes a "medical"
rather than "psychiatric" etiology. The authors argue that chronic fatigue
syndrome will meet the same fate as neurasthenia--a decline in social value
as it is demonstrated that the majority of its sufferers are experiencing
primary psychiatric disorders or psychophysiological reactions and that the
disorder is often a culturally sanctioned form of illness behavior.
