Cultural epidemiology of neurasthenia spectrum disorders in four general hospital outpatient clinics of urban Pune, India

Disorders emphasizing symptoms of fatigue and/or weakness, collectively termed Neurasthenia Spectrum Disorders (NSDs), typically emphasize a biological basis in the West and social origins in East Asia. In India, explanatory concepts are diverse. To clarify, 352 outpatients in Psychiatry, Medicine, Dermatology, and Ayurved clinics of an urban hospital were interviewed with a version of the Explanatory Model Interview Catalogue. Comparisons of categories and narratives of illness experience and meaning across clinics indicated both shared and distinctive features. Explanatory models of NSDs highlighted social distress, ‘‘tensions,’’ and both general and clinic-specific physical, psychological, and cultural ideas. Findings indicate the importance of social contexts and cultural meaning in explanatory models of neurasthenia, as well as the potential clinical relevance of the construct of Neurasthenia Spectrum Disorder.