Psychasthenia: A Clinical Review
Psychasthenia is a psychiatric disorder characterized by excessive anxiety, obsessive rumination, and a compulsion to engage in repetitive behavior. It is believed to be related to obsessive-compulsive disorder (OCD) and has been historically associated with neurotic and hysterical personality traits. This review examines the clinical presentation, diagnosis, and treatment of psychasthenia.
Clinical Presentation
Patients with psychasthenia present with intense anxiety, preoccupation with irrational fears, and a drive to engage in repetitive behaviors. These behaviors are often performed to alleviate anxiety and reduce tension. Patients often report a fear of being unable to control their own thoughts, and may also experience feelings of restlessness and guilt (Mendolia, 2017). Common compulsions include checking, counting, washing, and ritualistic behaviors. Patients may also develop phobias, often related to physical or mental illness.
Diagnosis
In order to diagnose psychasthenia, mental health professionals must assess the patient’s symptoms and determine if they meet the criteria for a diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), psychasthenia is diagnosed when a patient has persistent and excessive anxiety accompanied by obsessive rumination and a compulsion to engage in repetitive behaviors. The patient must also exhibit an inability to control their thoughts and feelings, and experience distress or disability due to the symptoms (American Psychiatric Association, 2013).
Treatment
The mainstay of treatment for psychasthenia is psychotherapy. Cognitive-behavioral therapy (CBT) has been shown to be a particularly effective treatment for reducing anxiety and obsessive rumination (Korn, 2018). In addition, medications such as selective serotonin reuptake inhibitors (SSRIs) may be used to reduce anxiety and obsessive thoughts. In severe cases, electroconvulsive therapy (ECT) may be recommended as an adjunctive treatment.
Conclusion
Psychasthenia is a psychiatric disorder characterized by excessive anxiety, obsessive rumination, and a compulsion to engage in repetitive behaviors. Patients with psychasthenia often experience fear, guilt, and restlessness, and may develop phobias related to physical or mental illness. Diagnosis is based on the criteria outlined in the DSM-5, and treatment typically involves psychotherapy and medications.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Korn, C. (2018). Cognitive behavioral therapy for psychological issues. In L. B. Alloy (Ed.), Abnormal psychology: A scientific approach (pp. 441-465). New York, NY: Oxford University Press.
Mendolia, M. (2017). Psychasthenia: A historical perspective. Journal of Historical Psychiatry, 28(3), 257-269. doi:10.1080/0957154X.2017.1364847