Dissertations / Theses on the topic 'Neurasthenia'

This thesis is a first biographical account of the German/Austrian psychiatrist Richard von Krafft-Ebing (1840 - 1902). It seeks to paint a more accurate picture than is so far available by bringing together new biographical data including background information on the institutional settings in which he worked. Above all, it explores the full range of Krafft-Ebing's written work and ideas over the whole period of his life. This shows Krafft-Ebing as a man of many interests and is intended to counteract our present, limited understanding of his work. Although Krafft-Ebing is, in fact, known to many, this knowledge is mainly based on the cursory reading of one book, the Psychopathia sexualis, 1886. This has led to a seriously one-sided view of Krafft-Ebing, particularly in Englishs-peaking countries. Part one is about Krafft-Ebing's outer life: a brief summary of known biographical data, followed by several chapters on those places where he lived and worked. Different points are highlighted according to their relevance for Krafft-Ebing's ideas: for example, chapter 2 emphasises the general atmosphere of the Illenau (one of the leading asylums at the time), which shaped his approach to psychiatry lastingly; the chapter on Graz centres around the very varied patients he treated during that period. Part two represents an intellectual biography. Exploiting the full range of published work (see appendix), chapter 5 gives an overview over the topics Krafft-Ebing wrote on, followed by more detailed analyses of specific areas: sexuality (including its important forensic aspect), hypnotism and neurology. Part three - the appendix - consists of a new and complete list of Krafft-Ebing's published works containing about 550 items; the few letters by Krafft-Ebing found so far have also been transcribed and reprinted here.

This thesis studies some of the most popular alternative treatments for neurasthenia in Japan in the period of 1890 to 1945, including breathing exercise, quiet-sitting, hypnotism-derived mental therapy and Morita therapy. Neurasthenia, with its supposed relation to modern civilization, was a widely used and preferred disease label in Japan. As the official Western medicine failed to provide satisfactory solutions to this obstinate and debilitating disease, a variety of alternative treatments were invented or reinvented and some of them became very popular. Concerning the popularity and effectiveness of these treatments, this thesis argues that they provided contemporary Japanese, who had been experiencing rapid and dramatic change to lifestyle, culture and society, with models by which they could perceive, conceive and strengthen their neurological, circulatory and psychological systems by their analogy to ki. Known as a nervous disorder, neurasthenia was also perceived and understood as a disorder of ki, with insufficiency, stagnation, obstruction and turbulence still thought to be the major faults. Through undergoing and practicing these treatments, Japanese neurasthenic patients could control and invigorate the flow of nervous currents, blood and ideas as they previously cultivated ki. This thesis also investigates these treatments in the context of Japanese nationalism. Their advocates often claimed that they were embedded in traditional Japanese culture and hence particularly effective for Japanese patients. Returning to traditional lifestyle and culture was regarded by them as a cure for neurasthenia, which they thought was a disease of ‘de-Japanization’. Furthermore, they founded a large number of groups and organizations for the practice and promotion of these treatments, which were in many ways like traditional extended families and provided patients with a much-needed sense of security and belonging. These treatments were endowed with social and cultural significance, which was also crucial to their therapeutic effectiveness for neurasthenia.

Orientador: Benito Pereira Damasceno<br>Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação<br>Made available in DSpace on 2018-08-12T23:55:42Z (GMT). No. of bitstreams: 1 Martinelli_JoseEduardo_D.pdf: 1621179 bytes, checksum: 1c984f95e30d98f7e2b8bd7a1e61a4c2 (MD5) Previous issue date: 2008<br>Resumo: A Síndrome Astenoemocional (SAE) é uma das seis síndromes básicas da Psiquiatria Orgânica e a mais freqüente na prática clínica. É pouco conhecida no meio clínico pelo fato de ser oriunda do trabalho de dois pesquisadores escandinavos (Lindqvist & Malmgrem, 1993), que tomaram como base antigos conceitos da psiquiatria alemã e, baseados na experiência clínica, criaram um sistema classificatório para a Psiquiatria Orgânica. É importante divulgar no meio médico o que representa a SAE em termos de diagnóstico, mostrar que essa entidade não é tão incomum em termos de freqüência e salientar que o conjunto sintomatológico que a define é comum a várias doenças que ainda não se manifestaram plenamente. O presente estudo é uma continuidade da dissertação de Mestrado "Diagnósticos Diferenciais da Síndrome Astenoemocional em Idosos".O objetivo principal foi de detectar parâmetros diagnósticos relacionados a cada etiologia da SAE. Foram examinados 129 pacientes sendo identificados como suspeitos clínicos 72 indivíduos (52 homens, 77 mulheres, idade entre 60 e 93 anos, média 77.61). Após anamnese detalhada enfatizando os sintomas, todos os casos suspeitos foram submetidos a investigação laboratorial incluindo hemograma, glicemia, dosagem de eletrólitos, perfil hepático, renal, dosagens hormonais e outros exames que se fizessem necessários de acordo com a suspeita clínica de cada paciente; de neuroimagem incluindo tomografia comoutadorizada, ressonância magnética e outros exames que se fizessem necessários de acordo com a suspeita clínica de cada paciente; e neuropsiquiátrica que incluiu o mini exame do Estado Mental (FOLSTEIN et. al., 1975), o CAMDEX (The Cambridge Mental Disorders of the Eldery Examination) (Roth et. al., 1986), seu teste cognitivo (Cognitive Section of the CAMDEX-CAMCOG) e o teste de desenho do relógio (TDR). Foram identificados os diagnósticos de: Hipotiroidismo 29,2%; doença de Alzheimer 23,6%; Hipertiroidismo 13,9%; Hidrocefalia de pressão normal 11,1%; Hiperdensidade da substância branca 9,7%; Declínio Cognitivo Leve (DCL) 8,3%; câncer de pâncreas 1,4%; Hematoma subdermal 1,4% e Hepatite C 1,4%. Observamos que a dosagem do hormônio tireoestimulante (TSH) foi a única de valor no esclarecimento diagnóstico (MW p=0.014). Entre os testes neuropsiquiátricos, os casos de DCL e de Hipertiroidismo apresentaram desempenho superior à Hidrocefalia de Pressão Normal na memória total (KW p=0.032). Nos subtestes avaliatórios da memória recente e de evocação, os casos de DCL apresentaram pontuação maior que os de Hidrocefalia de Pressão Normal (KW p=0.045). Os pacientes com Hipertiroidismo mostraram melhor desempenho em relação à doença de Alzheimer, hiperdensidade da substância branca e Hidrocefalia de Pressão Normal (KW; p=0.001). Em conclusão, constatou-se que a SAE afeta o desempenho social e pode ser diagnosticada com alta confiabilidade através do quadro sintomatológico. A dosagem de TSH e os testes neuropsicológicos podem auxiliar em alguns diagnósticos etiológicos específicos.<br>Abstract: The Asthenoemotional Syndrome (AES) is one of the six basic syndromes described in Organic Psichiatry and the most frequent in clinical pratice. It is relatively unknown as it was described by two scandinavian researchers (Lindqvist & Malmgrem, 1993), who, based on old german psichiatry concepts and clinical experience, created a classificatory scheme for Organic Psichiatry. It is important to disseminate in the clinical environment what AES represents in terms of diagnosis, demonstrate that the disorder is not uncommon and that the sintomatologic ensemble that defines the syndrome is common to several diseases that are not entirely developed. The main objective of the present study was to identify the factors related to AES etiology. This study is a sequence of the master thesis "Diferential Diagnosis of the Asthenoemotional Syndrome of the eldery". We examined 129 Seventy two individuals (52 men, 72 women, age between 60 and 93 years, 77.61 ± years) were identified as possible SAE cases. All patients suspected of SAE identified by a thorough anamnesis emphasizing symptoms, were submitted to a laboratory investigation including blood counts, glucose, basic metabolic panel, hormones, hepatic and renal profiles and other specific exams depending on each patient evaluation; neuroimages investigation including computed tomography, magnetic ressonace exam and other specific exams depending on each patient evaluation; a neuropsichiatric exam including the mini-mental state test (MMSE) (FOLSTEIN et. al., 1975), the CAMDEX test (The Cambridge Mental Disorders of the Eldery Examination) (Roth et al., 1986) and its cognitive test (Cognitive Section of the CAMDEX-CAMCOG), and the clock drawing test (CDT). We observed: Hypothyroidism 29.2%; Alzheimer's disease 23.6%; Hyperthyroidism 13.9%; normal pressure hidrocephalia 11.1%; hyperdensity on cerebral white matter 9.7%; mild cognitive impairment (MCI) 8.3%; pancreatic cancer 1.4%; subdermal hematoma 1.4% and type C Hepatitis 1.4%. The thyrotrophic hormone (TSH) was the only one of diagnostic utility. MCI and Hyperthyroidism patients had a better performance on total memory tests than normal pressure hydrocephalus (MW p=0.032). Concerning recent memory and evocative memory tests, the MCI patients had higher scores compared to normal pressure hydrocephalia patients (KW p=0.045). The Hyperthyroidism patients displayed better performance than Alzheimer's disease patients (KW p=0.001), hiperdensity on cerebral white matter (KW p=0.001) and normal pressure hydrocephalia patients (KW p=0.001), whereas MCI patients had higher scores when compared to hiperdensity on cerebral white matter (KW p=0.032) and normal pressure hydrocephalia patients (KW p=0.045). We conclude that AES afects social performance and can be diagnosed accurately based on its symptoms. TSH measurement and neuropsychologic tests may help identify specific causes of AES.<br>Doutorado<br>Psicologia Educacional<br>Doutor em Educação

A la fi de segle XIX, va sorgir una nova categoria de malaltia: la neurastènia. Aquesta es va concebre com una condició que afectava tant a el cos com a la ment, i era producte de la civilització moderna. Els historiadors han assenyalat el valor que té aquesta malaltia com a objecte a través del qual comprendre els desenvolupaments de les idees mèdiques i psiquiàtriques, així com la construcció d’identitats nacionals. Aquesta tesi analitza com es va conceptualitzar la neurastènia a Espanya en relació a aquestes qüestions entre la dècada de 1890 i principis de la de 1920. Aplicant un enfocament d’història cultural, analitza la forma en què es va construir d’acord amb les idees espanyoles contemporànies sobre la medicina, la modernitat i la masculinitat. En general, la tesi ofereix dos nivells d’anàlisi. El primer tracta qüestions tradicionals de la història de la medicina; és a dir, l’apropiació del concepte, la seva definició clínica i conceptualització patològica, i els diferents tractaments que se li van presentar. Els metges espanyols van apropiar la malaltia de l’context francès, i van debatre diferents formes d’entendre-la. La pluralitat dels tractaments que van oferir va contribuir a definir-la com una condició general de l’subjecte, més que com una malaltia local o específica. No obstant això, la tesi mostra que la neurastènia també es va conceptualitzar en altres espais i per altres subjectes: el mercat de medicaments i dispositius; els balnearis i sanatoris; pels autors dels manuals per a la formació de la voluntat; i pels propis pacients. Aquests altres actors van ampliar els límits de la malaltia, de manera que va acabar perdent la seva especificitat i es va interpretar de manera més general com “debilitat” en el sentit ampli de la paraula. Un segon nivell d’anàlisi s’ocupa dels significats culturals atribuïts a la malaltia i com aquests van donar forma a les idees de modernitat i masculinitat durant el període que s’analitza. La tesi mostra que la neurastènia va estar estretament lligada a l’discurs de l’regeneracionisme que va caracteritzar a la fi de segle espanyol i que es va articular en termes d’una crisi de masculinitat. Les elits espanyoles van qüestionar l’estatus d’Espanya en la jerarquia de la civilització i van afirmar que la regeneració de país depenia de la regeneració moral dels seus homes. Els metges van afirmar que la neurastènia era conseqüència de la moderna “lluita per l’existència”, caracteritzada per la competició entre individus i entre nacions en la recerca de la civilització. Va ser principalment una malaltia de la burgesia, aquella classe social encarregada de garantir el futur de la nació a través de la seva tasca intel·lectual. Els metges van utilitzar la malaltia per definir els límits del que constituïa formes adequades i inadequades de masculinitat burgesa: la recerca desinteressada del progrés i el bé comú, d’una banda; i l’egoisme i la passivitat de l’altra. Com a tal, els metges van articular una narrativa ambigua sobre la neurastènia que podria validar o destruir la masculinitat de l’pacient. A el mateix temps, la neurastènia va servir per articular un subjecte modern ideal, definit com un participant actiu en la lluita per l’existència. La tesi sosté que la neurastènia va servir per presentar la competició individual i internacional com una condició natural de la modernitat i per establir els límits normatius del que es considerava com el comportament burgès masculí apropiat entre 1890 i principis de la dècada de 1920. A el fer-ho, demostra el valor que tenen les malalties com a objectes històrics a través del qual explorar la història de la medicina, la identitat nacional i el gènere en el passat.<br>A finales del siglo XIX, surgió una nueva categoría de enfermedad que proliferó en Estados Unidos, Europa y Asia: la neurastenia. Esta se concibió como una condición que afectaba tanto al cuerpo como a la mente, y era producto de la civilización moderna. Los historiadores han señalado el valor que tiene esta enfermedad como objeto a través del cual comprender los desarrollos de las ideas médicas y psiquiátricas, así como la construcción de identidades nacionales. Esta tesis analiza cómo se conceptualizó la neurastenia en España en relación a estas cuestiones entre la década de 1890 y principios de la de 1920. Aplicando un enfoque de historia cultural, analiza la forma en que se construyó de acuerdo con las ideas españolas contemporáneas sobre la medicina, la modernidad y la masculinidad. La tesis ofrece dos niveles de análisis. El primero trata cuestiones tradicionales de la historia de la medicina; a saber, la apropiación del concepto, su definición clínica y conceptualización patológica, y los diferentes tratamientos que se le prescribieron. Los médicos españoles se apropiaron del concepto de la enfermedad procedente del contexto francés, y debatieron diferentes formas de entenderla. La pluralidad de los tratamientos que ofrecieron contribuyó a definirla como una condición general del sujeto, más que como una enfermedad local o específica. Sin embargo, la tesis muestra que la neurastenia también se conceptualizó desde otros espacios y por otros sujetos: el mercado de medicamentos y dispositivos; los balnearios y sanatorios; por los autores de los manuales para la formación de la voluntad; y por los propios pacientes. Estos actores ampliaron los límites de la enfermedad, de modo que terminó perdiendo su especificidad y se interpretó de manera más general como “debilidad” en el sentido amplio de la palabra. Un segundo nivel de análisis se ocupa de los significados culturales atribuidos a la enfermedad y cómo estos dieron forma a las ideas de modernidad y masculinidad durante el periodo que se analiza. La tesis muestra que la neurastenia estuvo estrechamente ligada al discurso del regeneracionismo que caracterizó al fin de siglo español y que se articuló en términos de una crisis de masculinidad. Las élites españolas cuestionaron el estatus de España en la jerarquía de la civilización y afirmaron que la regeneración del país dependía de la regeneración moral de sus hombres. Los médicos españoles afirmaron que la neurastenia era consecuencia de la moderna “”lucha por la existencia””, caracterizada por la competición entre individuos y entre naciones en la búsqueda de la civilización. Fue principalmente una enfermedad de la burguesía, aquella clase social encargada de garantizar el futuro de la nación a través de su labor intelectual. Los médicos utilizaron la enfermedad para definir los límites de lo que constituía formas adecuadas e inadecuadas de masculinidad burguesa: la búsqueda desinteresada del progreso y el bien común, por un lado; y el egoísmo y la pasividad por el otro. Como tal, los médicos articularon una narrativa ambigua sobre la neurastenia que podría validar o destruir la masculinidad del paciente. Al mismo tiempo, la neurastenia sirvió para articular un sujeto moderno ideal, definido como un participante activo en la lucha por la existencia. En general, la tesis sostiene que la neurastenia sirvió para presentar la competición individual e internacional como una condición natural de la modernidad y para establecer los límites normativos de lo que se consideraba como el comportamiento burgués masculino apropiado entre 1890 y principios de la década de 1920. Al hacerlo, demuestra el valor que tienen el estudio de las enfermedades como objetos históricos a través del cual explorar la historia de la medicina, la identidad nacional y el género en el pasado.<br>“In the late nineteenth century, a new disease category emerged and proliferated around the USA, Europe, and Asia. “Neurasthenia”, or nervous exhaustion, referred to a condition that affected both the body and the mind, and was the product of modern civilisation. Historians have pointed out the usefulness of neurasthenia as a lens through which to understand developments in medical and psychiatric ideas as well as the construction of national identities. This thesis analyses how neurasthenia was conceptualised in Spain in relation to these issues between the 1890s and early 1920s. It takes a cultural history of medicine approach to analyse the way in which neurasthenia was constructed according to contemporary Spanish ideas about medicine, modernity, and masculinity. The thesis offers two levels of analysis. The first deals with traditional questions in the history of medicine; namely, the appropriation of the concept, its clinical definition and pathological conceptualisation, and the different treatments that were presented for it. Spanish physicians critically appropriated the disease from the French context and debated different ways in which to understand the condition. They defined neurasthenia as a condition that primarily affected bourgeois men. The plurality of treatments they offered also contributed to defining it as a condition rather than a local or specific disease. However, although physicians played an important part in defining the disease, neurasthenia was also conceptualised in other spaces: namely, the market for medicines and devices; manuals for training the will; spas and sanatoria; and by patients themselves. These other sites broadened the boundaries of the disease, so that it ended up losing its specificity and becoming more generally construed as “weakness” in a broad sense of the word. A second level of analysis deals with the cultural meanings ascribed to the disease and how these shaped ideas of modernity and masculinity. The thesis shows that neurasthenia was tightly linked to the discourse of regenerationism, a discourse of crisis and change that characterised the Spanish fin de siècle and that was articulated in terms of a problem of vilirity and a crisis of masculinity. Spanish elites questioned Spain’s status on the hierarchy of civilisation and claimed that the regeneration of the country depended on the moral regeneration of its men. This thesis shows that neurasthenia was framed by this discourse. Physicians claimed that the disease was the consequence of the modern “struggle for survival”, characterised by competition between individuals and among nations in the quest for civilisation. It was primarily a disease of the bourgeoisie, who were responsible for guaranteeing the future of the nation through their intellectual labour. Physicians used the disease to define the boundaries of what constituted proper and improper forms of bourgeois masculinity: the selfless pursuit of progress and the common good, on the one hand; and egotism and passivity on the other. As such, physicians articulated an ambiguous narrative about neurasthenia that could be either validating or destructive to the patient’s masculinity. At the same time, neurasthenia served to articulate an ideal modern subject, one who was an active participant in the struggle for survival. Overall, the thesis argues that neurasthenia served to present individual and international competition as a natural condition of modernity, and to establish the normative boundaries of what constituted proper masculine bourgeois behaviour between 1890 and the early 1920s. In doing so, it demonstrates the value that diseases have as historical objects through which to explore the history of medicine, national identity, and gender in the past. It concludes that the historians should return to the history of diseases to explore how the self has been constructed in the past.