F48.0
Neurasthenia
Neurasthenia is a clinical syndrome characterized by a persistent and distressing sense of fatigue after mental effort, or a sense of physical weakness and exhaustion after minimal effort. Often referred to as 'nervous exhaustion' in historical contexts, it is classified within the neurotic, stress-related, and somatoform disorders. The condition is characterized by the patient's perception of reduced efficiency in performing daily tasks, often accompanied by various physical symptoms and an inability to recover with rest. While its prevalence has declined in Western psychiatric practice in favor of diagnoses like Generalized Anxiety Disorder or Chronic Fatigue Syndrome, it remains a common diagnosis in international and cross-cultural clinical settings.
Clinical Symptoms
- Persistent and distressing fatigue following mental effort
- Feeling of bodily weakness and exhaustion after minimal physical activity
- Muscular aches and pains
- Dizziness
- Tension headaches
- Sleep disturbances, including insomnia or unrefreshing sleep
- Inability to relax
- Irritability
- Dyspepsia or other gastrointestinal disturbances
- Anhedonia or mild depressive symptoms
Common Causes
- Prolonged exposure to high-stress environments
- Chronic emotional exhaustion or occupational burnout
- Psychological conflicts or unresolved emotional distress
- Personality traits such as perfectionism or high sensitivity
- Cultural stressors and societal expectations for performance
- Secondary response to chronic physical illness
Documentation & Coding Tips
Distinguish the fatigue from normal tiredness by documenting its persistence and the fact that it is not relieved by sleep or rest.
Example: Patient reports extreme mental exhaustion after reading for 10 minutes, which persists for several hours despite attempts to rest.
Document the absence of underlying organic pathology through appropriate screening to support a psychogenic diagnosis.
Example: Medical workup including CBC, thyroid panel, and metabolic profile are negative for physiological causes of fatigue.
Record the specific somatic symptoms that accompany the fatigue to meet the ICD-10 criteria for other neurotic disorders.
Example: Note the presence of co-occurring tension headaches and dyspepsia associated with the patient's state of exhaustion.