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The British Journal of Psychiatry (2002) 181: 56-61
© 2002 The Royal College of Psychiatrists

Neurasthenia: prevalence, disability and health care characteristics in the Australian community

IAN HICKIE, FRANZCP

School of Psychiatry, University of New South Wales, Sydney, Australia; and Chief Executive Officer, ‘beyondblue: the national depression initiative’, Melbourne, Australia

TRACEY DAVENPORT, BA (Hons)

School of Psychiatry, University of New South Wales at St George Hospital, Sydney, Australia

CATHY ISSAKIDIS, BA (Hons)

World Health Organization Collaborating Centre for Evidence for Mental Health Policy; and, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia

GAVIN ANDREWS, FRCPsych

World Health organization Collaborating Centre for Evidence for Mental Health Policy; and, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia

Correspondence: Professor Ian Hickie, Academic Department of Psychiatry, 7 Chapel Street, Kogarah, NSW 2217, Australia. Tel: +61293502035; fax: +61293502098; e-mail: ian.hickie{at}beyondblue.org.au

Declaration of interest None.

Background Neurasthenia imposes a high burden on primary medical health care systems in all societies.

Aims To determine the prevalence of ICD—10 neurasthenia and associated comorbidity, disability and health care utilisation.

Method Utilisation of a national sample of Australian households previously surveyed using the Composite International Diagnostic Interview and other measures.

Results Prolonged and excessive fatigue was reported by 1465 people (13.29% of the sample). Of these, one in nine people meet current ICD-10 criteria for neurasthenia. Comorbidity was associated with affective, anxiety and physical disorders. People with neurasthenia alone (<0.5% of the population) were less disabled and used less services than those with comorbid disorders.

Conclusions Fatigue is frequent in the Australian community and is common in people attending general practice. Neurasthenia is disabling and demanding of services largely because of its comorbidity with other mental and physical disorders. Until a remedy for persistent fatigue is provided, doctors should take an active psychological approach to treatment.


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