Rethinking neurasthenia: the illness concepts of shenjing shuairuo among Chinese undergraduates in Hong Kong

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Neurasthenia is both a Western disease construct and a popular
Chinese illness concept (shenjing shuairuo, SJSR). Using a
self-report questionnaire, we examined 148 Hong Kong Chinese
undergraduates' concept of its epidemiology, symptomatology,
etiology and treatment. Notwithstanding that fatigue is the
sine qua non of neurasthenia in Western nosology, subjects
believed that SJSR was compatible with a diversity of symptoms
which fell, on factor analysis, into the "neurotic,"
"psychotic," "somatic" and "dysfunctional" subgroups. Contrary
to the popular portrayal of SJSR as a physical or chronic
fatigue disorder, the most common perceived symptoms were
anxiety, insomnia, depression and fright. Logically,
psychological etiology and remedy were highly emphasized. The
perceived high prevalence, non-aggressive nature and
symptomatic diversity of SJSR attested to the notion that it
might camouflage and destigmatize psychiatric labels of
insanity. The contextual study of neurasthenia illustrates how
in its search for legitimacy an originally Western concept
adapts, transforms, and acquires distinctive local meanings in
a non-Western culture.

Lee S, Wong KC

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