Bhola, Poornima, Chaturvedi, Santosh K · International review of psychiatry (Abingdon, England) · 2020 · DOI
This article traces the history of 'neurasthenia,' an old medical diagnosis meaning nervous exhaustion that was popular in the past but has largely disappeared from modern medicine. The authors explain how this diagnosis reflected the culture, biases, and social beliefs of its time, and how similar conditions today—like ME/CFS and fibromyalgia—are trying to describe the same patient experience of fatigue, pain, and weakness without clear medical causes.
This historical perspective helps ME/CFS patients and researchers understand how diagnosis frameworks evolve and how cultural factors shape medical recognition of conditions. It highlights that ME/CFS exists within a broader historical context of fatigue-related diagnoses, and recognizes that societal biases can influence whether conditions are taken seriously or medicalized.
This review does not establish the biological validity or pathophysiology of neurasthenia, ME/CFS, or fibromyalgia. It does not prove whether these conditions share a common underlying mechanism or whether current diagnostic approaches are adequate. It is a historical and conceptual analysis, not an empirical study of disease mechanisms or patient outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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