Neurasthenia and autonomic imbalance as minor diagnoses: comparison, concept and implications

Abstract

A new term, autonomic imbalance (自律神經失調 or AI), which refers to a wide variety of physical and mental symptoms that are medically unexplained, has recently emerged in Taiwan. Many people compared this condition to neurasthenia, a now obsolete diagnosis. Whether neurasthenia and AI are medically the same or merely similar is a debate that is better left to clinicians; however, this article endeavours to explore the significance of the comparability in terms of socio-cultural theory of health. With Deleuze and Guattari’s notion of minor literature as reference, the objectives of this paper are as follows: to address how and why neurasthenia and AI should be treated as ‘minor diagnoses’ and consequently expose the limitations of current clinical medicine; to provide and discuss reasons why AI can be seen as a reincarnated form of neurasthenia; and to further elaborate how this approach may elevate inquiries on the varieties of medically unexplained symptoms to highlight the bodies that suffer without a legitimate name.

Cultural adaptations of group CBT for depressed clients from diverse backgrounds: A systematic review

“…A more recent example comes from Taiwan, where Chen (2021) reported on the emergence and increasing prevalence of 'Zilushenjin shitiao' (自律神經失調 or autonomic imbalance). Autonomic imbalance is not a formal diagnosis but refers to a wide range of physical and mental symptoms that are medically unexplained (Chen, 2022) In terms of pathways to care, there is variation due to patterns of help-seeking behaviour ranging from traditional to informal, or semi-formal routes. This leads to variation between seeking help from religious leaders, family members and even internet forums (Markova et al, 2020).…”