NEUROCIRCULATORY ASTHENIA - A REASSESSMENT USING MODERN PSYCHOSOMATICCRITERIA

The purpose of this study was to assess the prevalence of mental illne ss and to evaluate the quality of life of patients with neurocirculato ry asthenia. A consecutive series of 80 patients who satisfied the dia gnostic criteria developed by Kannel et al. for neurocirculatory asthe nia was included in this study. Patients underwent a psychiatric diagn ostic research interview and extensive psychometric evaluation, with b oth observer and self-rated scales for depression, anxiety, phobic sym ptoms, quality of life and abnormal illness behavior. In 47 patients ( 59%), a psychiatric diagnosis (mainly an anxiety disorder) antedated t he onset of neurocirculatory asthenia, which was thus defined as secon dary, also because cardiorespiratory symptoms were part of the mental symptoms. In the remaining 33 patients (41%) neurocirculatory asthenia was the primary disorder. Patients with secondary neurocirculatory as thenia reported significantly higher levels of anxiety, depression, so cial phobia, abnormal illness behavior and an impaired quality of life compared with patients with primary neurocirculatory asthenia. This l atter did not significantly differ in these variables (except for depr ession) from healthy control subjects matched for sociodemographic var iables. At a 1-year follow-up, patients with primary neurocirculatory asthenia had a much better prognosis than those with secondary neuroci rculatory asthenia. The results indicate the feasibility of the primar y/secondary distinction based on the time of onset of mental and cardi orespiratory symptoms in neurocirculatory asthenia. Since only about o ne quarter of the patients were found to suffer from decreased energy and fatigue according to specified criteria, the terms neurocirculator y asthenia and effort syndrome should probably be discarded.