Masturbation as a Cause of "Sexual Neurasthenia": Anton Chekhov's Medical Report (1883)

ABSTRACT

In the 18th and 19th centuries, in Europe and the United States, masturbation was seen not only as a deviant form of sexual activity but also as a cause of nervous diseases. Masturbation was originally thought to cause insanity, but with the introduction of George Miller Beard's concept of neurasthenia, it came to be considered a form of nervous exhaustion. In the current article, we analyzed the almost forgotten medical report of a "sexual neurasthenic," written by the famous Russian writer and physician Anton Chekhov (1860-1904). This report gives us detailed information about the treatment of a patient allegedly experiencing the effects of masturbation, and thus reflects the medical discourse on masturbation in Russia in the early 1880s. It shows that although the international debate on the causes of neurasthenia had just begun, the concept of neurasthenia toward masturbation had already been put into practice at the Moscow University Clinic in 1883.

[The complex of neurological symptoms of substance abuse]

Standard neurological examination was performed in 85 patients of military service age (the average age was 32,6±5,3 years - from 19 to 44 years) with a confirmed diagnosis of substance abuse, caused by the use of narcotic drugs and psychotropic substances: cocaine and amphetamine in 12 patients, opioids - in 73 patienls. Some symptoms of nervous system damage had statistically characteristic peculiarities for different forms of substance abuse. Mydriasis, signs a bilateral pyramidal insufficiency, hyperkinetic disorder are often characteristic for cocaine and amphetamine abuse. Opioid abuse is characterised by more severe symptoms of nervous system damage, disseminated neurologic symptomatic and polyneurotic disorders. Symptoms of neurasthenia and vegetative-vascular dystonia, which are usually accompanied by the; symptoms of organic lesions of the central and peripheral nervous system, were observed in all patients with substance abuse. In order to detect the symptoms of nervous system damage in patients, which are supposed to be conscribe, it is necessary to take medical history.

Treating emotion-related disorders in Japanese traditional medicine: language, patients and doctors

This paper analyses how the conceptual and therapeutic formation of Japanese traditional medicine (Kampo) has been socially constructed through interactions with popular interpretations of illness. Taking the example of emotion-related disorders, this paper focuses on the changing meaning of constraint (utsu) in Kampo medicine. Utsu was once a name for one of the most frequently cited emotion-related disorders and pathological concerns during the Edo period. With the spread of Western medicine in the Meiji period, neurasthenia replaced utsu as the dominant emotion-related disorder in Japanese society. As a result, post-Meiji doctors developed other conceptual tools and strategies to respond to these new disease categories, innovations that continue to influence contemporary practitioners. I begin this history by focusing on Wada Tōkaku, a Japanese doctor of the Edo period who developed a unique theory and treatment strategy for utsu. Secondly, I examine. Yomuto Kyūshin and Mori Dōhaku, Kampo doctors of the early twentieth century, who privileged neurasthenia over utsu in their medical practice. The paper concludes with a discussion of the flexibility and complexity of Kampo medicine, how its theory and practices have been influenced by cross-cultural changes in medicine and society, while incorporating the popular experience of illness as well.

Symptoms of neurasthenia following earthquake trauma: re-examination of a discarded syndrome

The authors examined symptoms of neurasthenia in the context of trauma through a survey conducted 10 months post-earthquake, among a sample of earthquake survivors in rural Taiwan. An algorithm closely resembling neurasthenia as defined in ICD-10 was designed a priori. Three diagnostic groups were identified, including those with "pure" neurasthenia (n=27) who did not exhibit any Axis I disorder, those with an Axis I disorder but without neurasthenia (n=46) and controls who were without neurasthenia or an Axis I disorder (n=152). Those with neurasthenia were demographically similar to non-psychiatrically disordered controls and did not differ with respect to impact of trauma. Greater severity of intrusive and avoidant/numbing posttraumatic stress disorder (PTSD) symptoms and less resilience characterized neurasthenia relative to controls. Morbidity was similar for neurasthenia and Axis I disorders, except for the presence of less resilience in the neurasthenia group. Thus, "pure" neurasthenia appears to be independent from other psychopathology in a significant number of earthquake survivors, and was not closely related to the impact of earthquake trauma. The meaningful number of subjects meeting criteria for our algorithm of neurasthenia suggests that further study of this syndrome employing exact ICD-10 diagnostic criteria is warranted.

Unloading the trunk: neurasthenia, CFS and race

The aetiologies of both chronic fatigue syndrome (CFS) and its predecessor neurasthenia, have been linked to technological advances in 'developed' countries. This paper discusses how this has led to a form of race thinking within discussions about fatigue which has persisted for more than a century. We review the historical development of this race thinking from neurasthenia to CFS and describe how it is manifested in both the lay- and medical literature. We also review the epidemiological literature on CFS and ethnicity to better understand the relatively low percentage of non-white patients seen in tertiary referral clinics for CFS. The aim of this paper is to act as a starting point for a debate on race and CFS.

[Borderline mental disorders in patients with prostate cancer]

Sixty five patients, aged 48-87, with prostate cancer at different stages were studied. Borderline mental disorders were found in all the patients. In the majority of them, affective disorders in the form of anxiety-depressive (52.3%) and astheno-depressive (24.6%) syndromes were observed. Astheno-hypochondriacal and dysphoric syndromes were detected less frequently (in 15.4% and 7.7% of the cases, respectively).

A literature review of medical side effects from radio-frequency energy in the human environment: involving cancer, tumors, and problems of the central nervous system

Occupational or residential exposures to radiofrequency energy (RFE), including microwaves, have been alleged to result in health problems. This paper is a review of the recent medical and scientific literature (from mid-1998 through 2002) dealing with possible effects of RFE on brain tumors and malignancies, leukemia, other cancers, and the central nervous system. A large number of studies were related to exposures from cellular telephones. On the basis of previous reviews of older literature and the current review of recent literature, one can conclude that the evidence for any proven health effects (related to the topics above) of low-level RFE exposure is minimal.

"Russian nervousness": neurasthenia and national identity in nineteenth-century Russia

“Nothing dies so hard as a word”, wrote Harry Quilter in 1892, “—particularly a word nobody understands.” At the end of the nineteenth century, one such word—first uttered in America, but soon reverberating across the Western world—was “neurasthenia”. Popularized by the American neurologist George M Beard, this vaguely defined nervous disorder seemed to crop up everywhere, from medical journals to the popular press to belles lettres. Looking back at the years leading up to the Second World War, Paul Hartenberg recalled its remarkable pervasiveness: “It could be found everywhere, in the salons, at the theatre, in novels, at the Palace. It was used to explain the most disparate individual reactions: suicide and decadent art, fashion and adultery; it became the giant of neuropathology.” Its sufferers included American intellectuals from Beard himself to Theodore Roosevelt, Edith Wharton, and Henry Adams; for European commentators less convinced of the disease's modern American pedigree, the list could be expanded to include everyone from Alcibiades to Tiberius to Napoleon. Anybody who was anybody, it seemed, was neurasthenic.

[Subjective blockage in Parkinson's disease]

Akinetic symptoms or off-period motor signs in patients with Parkinson's disease and motor fluctuations can be associated with subjective symptoms. A systematic interview was conducted in a series of 24 patients. Sixteen out of 24 (67 p. cent) experienced these subjective symptoms as on-off non motor symptoms that were classified in three groups: energy lost consistent with a severe asthenia, perceptive and cognitive alterations, and emotional troubles such as panic and depression. These phenomenons could be combined in some patients and were sometimes asynchron to akinesia. In some patients (six cases reported), they occurred without any akinesia but could totally inhibit patients daily activities, and so could be described as subjective off-period . Frequently, the patients did not distinguish them from motor disability. Their persistence, after subthalamic nucleus stimulation or intrastriatal transplant, could interfere with functional results, even though akinetic symptoms had disappeared.

CONCLUSION

subjective phenomenons during off-periods are frequent. Their frequency is underestimated due to a non-targeted examination. Subjective off-periods are symptoms of Parkinson's disease, partly independent from off motor symptoms, and important to consider in evaluation of therapeutics, especially surgery.

Proof of a gunshot wound and its delayed effects 54 years post injury

In 1945 a 6-year-old girl received a tangential gunshot injury to the left posterior inferior skull. After hospitalisation because of septicemia she was unable to walk for several months. Since 1967 she had been repeatedly applying for compensation because of pseudoneurasthenia and residual ataxia and many medical examinations were performed including X-ray, CT and MRI. Although certain objective findings (e. g. cerebellar atrophy) could be verified, a causal connection between the gunshot injury and the clinical findings could not be established. Therefore previous investigators concluded on a vascular origin of the disease. During the present re-examination of the patient, the authors found patch-like scars at the left posterior inferior skull base and behind the left ear, a cord-like scar formation in the subcutaneous tissue, connecting both skin scars, a gutter-like defect in the left occipital base of the skull and an indention of the left mastoid process, both again in line between the skin scars and a large defect of the left cerebellar hemisphere. It could be concluded with certainty that the anatomical findings and the clicinal symptoms were the direct result of a gunshot injury. Previous investigations had failed because of deficient investigations and techniques. In addition to an anatomical reconstruction, three dimensional reconstructions from CT scans proved most helpful.

[Balneotherapy of children with complications of craniocerebral injuries]

Children with aftereffects of craniocerebral trauma have received sanatorium treatment including exercises, massage, mineral baths of different chemical composition. Adequate therapeutic measures taken in due time diminish the number of the aftereffects and their severity.

[Effects of electromagnetic radiation from cellular telephone handsets on symptoms of neurasthenia]

In order to study the effects of electromagnetic radiation from cellular telephone handsets on symptoms of neurasthenia, 115 and 101 persons with or without handsets were selected. The subjects were investigated by questionnaire on their general health, lifestyle, habit, mental stress, the frequency of using the handsets, living and working environment, the cases of suffered from diseases and symptoms of neurasthenia. The data were analyzed by Chi-square test and Logistic regression statistics. The results showed that the time of using handset was positively associated with depression (P < 0.05), nausea (P < 0.01) and loss of appetite(P < 0.05). The results showed that long time use of cellular telephone handset could induce the symptoms of neurasthenia.

Chronic fatigue syndrome and Australian psychiatry: lessons from the UK experience

OBJECTIVE

The aim of this paper is to outline the opportunities and dangers the chronic fatigue syndrome (CFS) issue presents to Australian psychiatry.

METHOD

The scientific literature of the last 50 years on CFS in adults was reviewed and samples of recent media portrayals of CFS in the UK and Australia were collected. The author has worked in both the UK and Australia managing adult CFS patients in specialist outpatient consultation-liaison (C-L) psychiatry settings.

RESULTS

Chronic fatigue syndrome has been at the heart of an acrimonious debate in the UK, both within the medical profession and in the wider community. UK psychiatry has been drawn into the debate, at times being the target of strong and potentially damaging criticism, yet UK psychiatry, especially the C-L subspecialty, has played a crucial role in clarifying appropriate research questions and in devising management strategies. The issue has served to enhance and broaden psychiatry's perceived research and clinical role at the important medicine-psychiatry interface in that country.

CONCLUSIONS

Handled properly, the CFS issue offers Australian psychiatry, especially C-L psychiatry, an opportunity to make a useful contribution to patient care in a clinically difficult and contentious area, while at the same time serving to help broaden psychiatry's scope in the Australian medical landscape.

[On diagnosis and prophylaxis of asthenoneurotic syndrome in cosmonauts in long-term mission]

Based on longer than 20 years experience of observation and investigation of the neuropsychic state of cosmonauts in long-term missions to the space stations and volunteers in ground studies of some of the spaceflight (SF) effects, principles of diagnostics, prophylaxis and correction of asthenoneurotic and psychoasthenic disorders in members of long-term orbital mission have been established. The authors give consideration to the most probable pathophysiological mechanisms of these disorders during SF and some potential lines of exploration and development of countermeasures against and methods for correction of the psychoneurologic disorders during long-term missions.

[Astrocytes--anonymous cells in the brain, participating in neurasthenic symptoms]

During rehabilitation after brain damage due to stroke or trauma, or after meningitis, patients often suffer from mental fatigue and decreased capacity for concentration and learning. We hypothesize that one pathogenic cause of these symptoms could be a failure on the part of astroglia to remove glutamate and K+ from synaptic regions during glutamatergic transmission. As astroglial support of neuronal glutamate transmission has been shown to be of utmost importance, such an astroglial failing might lead to a decreased signal-to-noise ratio in glutamatergic neurotransmission, especially when the transmission is intense for a considerable time period. Three aspects of astroglial failing are focused upon: decreased capacity of the astroglial glutamate transporters, depolarization of the astroglial network, and uncoupling of the gap junction coupled astroglial network. It has been shown that several neuroactive substances, present within the nervous system even long after damage or infection, influence upon these three astroglial properties.

[Complaints as reflection of psychic status in patients with duodenal ulcer exacerbation]

AIM

Study of relationship between leading complaints of patients with duodenal ulcer (DU) exacerbation and their psychic status, attitude to the disease and quality of life.

MATERIALS AND METHODS

Psychological questionnaire surgery enrolled 94 males with endoscopically revified uncomplicated recurrence of DU.

RESULTS

Patients complaining of dull epigastric pains only demonstrated minimal psychological changes. Their attitude to the disease is primarily ergopathic, sensitive and anosognosic. Nausea and vomiting complains come along with neurotization, maladaptation (anxiety, neurasthenia, egocentric attitude) and deterioration of quality of life.

CONCLUSION

Patients with nausea and vomiting complaints need correction of psychic status to achieve psychological compensation in remission of DU.

[Results of psychological testing of patients with keratoconus]

Psychological testing of 63 normal subjects and 84 patients with keratocone was carried out separately for men and women aged 18-64 years using 11 scores of a brief multifactorial questionnaire for personality examination (BMQP). Comparison of averaged profiles of examined men and women with keratocone showed features of sensitive and psychasthenic personalities. According to BMQP scores, the population of men with keratocone is characterized by increased levels of psychasthenia and schizophrenia, whereas women develop depression, psychasthenia, and schizophrenia.

[Observations of changes in neurobehavioral functions in workers exposed to high-frequency radiation]

OBJECTIVE

To study the effects of exposure to high-frequency radiation on neurobehavioral function of the exposed workers and its measurement in evaluating occupational hazards caused by it.

METHODS

Four neurobehavioral functions were tested for the workers exposed to high-frequency radiation with Neurobehavioral Core Tests Battery recommended by WHO.

RESULTS

Scores for various indicators in exposed workers were significantly lower than those in controls, and correlated to the detection of neurasthenia in the exposed workers, to certain extent.

CONCLUSION

Changes in neurobehavioral function in workers exposed to high-frequency radiation can reflect its important adverse effects.

[The characteristics of the cerebral asthenia syndrome in persons who were victims of the accident at the Chernobyl Atomic Electric Power Station]

A total of 107 patients (81 males, 26 females), their age ranging between 34 to 45 years, diagnosed as having discirculatory encephalopathy with underlying cerebrasthenic syndrome, were examined. All the examinees took part in the elimination of the Chernobyl accident effects in 1986. It was found out, that cerebrasthenia which is present in the structure of all clinical variants of organic affection of the brain is the most mobile (functional) link of the morbid process when a disorder sets in rather than the failure of the organ to perform its function. It ranks among other asthenic syndromes reflecting a specific character of exogenous radiation effect on the organism, being a result of a characteristic interaction between the organism and a health hazard. Measures to dispel the asthenic component at the initial stages of development of the disorder will make for reduction or arrest of progression of organic symptomatology.

[Etiology of isolated general malaise]

Isolated general malaise (IGM) is defined as an imprecise sensation of feeling bad, without any other signs or symptoms that suggest even a diagnostic orientation. 137 patients who demanded medical help for IGM were selected and divided into three groups, according to their evolution: IGM of banal or benign cause; IGM of easy or attainable diagnosis; and IGM of difficult or prolonged diagnosis. The 37 patients of the latter group were integrated under the title of Unexplained General Malaise Syndrome (UGMS). The criteria of these syndromes are defined. The patients with UGMS were studied in order to make a diagnosis of its unknown disease, which was achieved in all cases except two. The non-specific symptoms that the patients with UGMS manifest and their relation to final diagnosis are described. When the final diagnosis was made, the number of diagnostic tests used, the time of hospitalisation and the derived economic cost was estimated in each case compared to the corresponding mean data, obtained. Depression as the most frequent aetiology detected in the patients with UGMS, should be the first consideration made in any evaluation.

[Research about fatigue in France over the past 20 years]

The author reported the works of the "Fatigue Studies Group" founded 20 years ago to explore the different dimensions of "fatigue" complaint. The emphasis is placed on the asthenic syndromes evaluation instrument created by the group, which takes into account the socio-demographic data of the patient, clinical signs and their severity as well as the potential etiological factors. Its first version (GEF-3) enabled to isolate 4 groups of asthenia (overworking, somatic, psychosomatic and psychic), each of them requesting a specific treatment. An ulterior version (GEF-4) has been elaborated to describe better the psychiatric semeiology. Finally, a simplified version (GEF-10) was used as an evaluation instrument in different therapeutic researches. At the same time, the group continued its researches on the fatigue psychosocial dimensions and its nosographic status, especially in comparison with dysthymic disorders.

[The differential use of trace element electrophoresis in neurasthenia]

Copper and cobalt deficiencies were found in the blood of hypersthenic neurasthenia, while hyposthenic neurasthenia patients lacked manganese. Pathogenetic physiotherapeutic methods are proposed for differentiated treatment of neurasthenia--cobalt or copper electrophoresis in hypersthenic and manganese electrophoresis in hyposthenic neurasthenia.

[Structure of psychological needs of patients over 60 years of age, hospitalized for ischemic heart disease complicated by asthenic- depressive syndrome, and in healthy persons]

Using psychotherapy methods such as MMPI-Wiskad, ACL-37 and 16PF the patterns of psychological needs were studied in postproductive-age subjects with ischaemic heart disease complicated or not with asthenia-depression syndrome and in healthy subjects. Statistical analysis showed that in relation to old people with ischaemic heart disease or without it patients with ischaemic heart disease and depression with asthenia showed a higher psychological sensitivity and their needs were concentrated around the need for self-manifestation, aid-seeking and taking care of oneself. In old people a tendency was maintained for persistence of psychological needs in the previously formulated forms.

[A cerebral syndrome appearing after the accident at the Chernobyl Atomic Electric Power Station]

Sixty participants of liquidation of the sequels of the Chernobyl atomic station accident were examined. All of them were subjected to the effect of different doses of ionizing radiation. A complex of symptoms is described characterizing the cerebrosthenic syndrome with vegetative paroxysms and intellectual-mnestic disorders. In accordance with this, approaches to treatment and rehabilitation of these patients are discussed.

Neurasthenia and chronic fatigue syndrome: the role of culture in the making of a diagnosis

Chronic fatigue syndrome is an increasingly popular diagnosis consisting of multiple psychiatric and somatic symptoms. It bears a striking resemblance to the nineteenth-century diagnosis of neurasthenia. Both disorders arose during periods characterized by a preoccupation with commerce and material success and major changes in the role of women. They illustrate the role of culture in the development of a new diagnosis that emphasizes a "medical" rather than "psychiatric" etiology. The authors argue that chronic fatigue syndrome will meet the same fate as neurasthenia--a decline in social value as it is demonstrated that the majority of its sufferers are experiencing primary psychiatric disorders or psychophysiological reactions and that the disorder is often a culturally sanctioned form of illness behavior.

Depression and allergies: survey of a nonclinical population

The possible association between depression and type I allergies (i.e. immunoglobulin E-mediated hay fever, asthma, eczema, hives) was examined in a nonclinical sample of 379 college students. Measures included self-reports of depression, tiredness, fearfulness, allergic disorders, and environmental allergens and irritants. Seventy-one percent of the subjects who had ever received a professional diagnosis of depression also indicated a history of allergy: those with greater self-rated current depression overall reported a significantly higher prevalence of asthma (p less than 0.05). Type I allergic (43%) and nonallergic subjects did not differ in self-rated frequency of depression, fatigue, or anxiety. However, type I subjects reported significantly worse mood after the flu than did nonallergic subjects (p less than 0.001). The data support the hypothesis that individuals prone to clinical depression have more allergies than nondepressives. Allergics may experience more postflu mood worsening but not current depression in comparison with nonallergics.

Chronic fatigue syndrome: thoughts on pathogenesis

Studies have shown that a proportion of patients with severe chronic infection due to Epstein-Barr virus (EBV) lack antibody to a component of EBV nuclear antigen. However, it is not clear whether this circumstance is one of cause or effect in regard to the pathogenesis of chronic fatigue syndrome (CFS); it is clearly not pathognomonic since it also occurs in persons infected with the human immunodeficiency virus and--rarely--in those with other EBV-related conditions. Stress and depression may be other pathogenetic mechanisms that could reactivate EBV and lead to CFS; examples of this phenomenon are given. The syndrome might also follow certain other viral infections as part of a process that has been called postinfectious neurasthenia. Currently, the cause(s) and cure of CFS, a common and distressing syndrome, are enigmatic and require multidisciplinary study.

[Preliminary investigation of neurasthenic syndrome induced by occupational hazards]

In this article, an investigation on prevalence of neurasthenic syndrome applying the Clinical Operational Diagnostic Criteria formulated by the Editorial Committee of Chinese Journal of Neurology and Psychiatry (1985), in 166 workers exposed to three kinds of occupational hazard including industrial noise, high frequency magnetic field, and benzene compounds, and matching with 166 workers selected from other workshop in same factory as the controls, was carried out in a diesel engine factory at suburban area, Changzhou City. It was found that the prevalence of neurasthenic syndrome in former group were 26.6%, 35.4%, and 33.3%, respectively. In corresponding control group were 1.06%, 4.2%, and zero percent, respectively. The results revealed no statistic difference among three subgroups of the former, but there were significantly higher then that of the control group with P value in 0.01 level. Base on above data, the authors considered that along the development of industrial modernization, the occupational hazardous factors will be seriously affected the workers health from various aspect. Therefore, these occupational health problems, should be concerned as a top priority in industrial hygiene. We also stressed that the personal protective measure must be set up and put into practice immediately, as it may be play an important role to decrease the prevalence of neurasthenic syndrome. Finally, the possible mechanism of occupational hazards damaging the function of C.N.S. and some related questions were briefly discussed.

[5-HT contents change in peripheral blood of workers exposed to microwave and high frequency radiation]

The relationship between 5-HT contents in peripheral blood and power density among workers exposed to microwave or high frequency radiation in the workshops were studied. At the same time, systems and disorder of central nervous system and cardiovascular system were examined. The results of study showed that the average 5-HT content in whole blood for high frequency radiation exposure group was lower than that of the control, but without statistical significance. Value for the microwave exposure group was significantly lower than that of the control (P less than 0.01). The 5-HT content of mechanical maintainers exposed to microwave of high frequency radiation were all lower than the contents of their corresponding control groups (P less than 0.01). But for the mechanic operators as compared with their corresponding control, no significant difference was found (P greater than 0.05). The power density exposed by the maintainers of both tested groups were all higher than that of the operators. The 5-HT contents in the whole blood were inversely proportional to the power density of microwave and high frequency groups. The incidence of neurasthenic syndrome, unsymmetric skin temperature in both limbs and hypotension was higher in the microwave and high frequency radiation groups than that in the control group. The incidence of bradycardia and some abnormal items of electrocardiograph in the microwave group was obviously greater than that in high frequency group, which may be related to different frequency exposed for these two exposure groups. Whether it is related to the contents of 5-HT needs further investigation.

[Differential diagnosis of so-called premature performance failure or premature aging]

In a district of about 70,000 inhabitants (two thirds urban, one third rural population) from 1978 to 1987 32 women at the age between 50 and 60 years and 63 men at the age between 50 and 65 years with premature decrease in vitality on cerebrovascular basis were observed and treated. The cases were differential-diagnostically subdivided. 32 patients belonged to the group of more distinct chronic cerebro-organic psychosyndromes, additionally also involution psychoses; the number of the untimely retirement from the working process was 100%. In 24 patients there were pseudoneurasthenic syndromes of the cerebral arteriosclerosis; 75% early retired from the working process. In 39 patients the cases in question were the proper premature decrease in vitality or a so-called premature ageing on biophysical basis; 41% early retired. A premature ageing may exist also without any so-called organ-valued findings, the symptoms are credibly described. Conflicts with the environment and psychic false reaction may be the result. Optimum therapeutic and rehabilitative troubles may bring successes which are not to be underestimated in the cases without distinct organic processes. The question of invalidization is thoroughly to be examined individually.

Neurasthenic complaints and psychometric function of toluene-exposed rotogravure printers

In 1985, 30 rotogravure printers exposed to toluene for 4-43 years (median 29) were examined by means of interviews and psychometric testing. They were 33-61 years of age (mean 50). Comparisons were made with a reference group of 72 men aged 27-69 (mean 47). The referents had never been exposed to solvents and were all in good health. The printers were employed by two Swedish companies. The mean exposure levels were 43 and 157 mg/m3 of toluene, respectively, at the two printing shops. Before 1980 the exposure levels had exceeded 300 mg/m3. On Monday mornings, before psychometric testing at the department of occupational medicine, toluene was measured in venous blood samples from most of the exposed subjects. A high proportion of the printers reported fatigue (60%), recent short-term memory problems (60%), concentration difficulties (40%), mood lability (27%), and other neurasthenic symptoms. In the psychometric tests their performance was poorer than the reference group's in most of the tests applied. Even performance on the synonyms test, usually considered resistant to mild brain affliction, was worse in the group of printers. Adjusting for this difference in the group comparisons reduced the group differences substantially. Alcohol consumption above 200 g/week was found to reduce the subjects' psychometric function more than toluene exposure. The printers' sum of neurasthenic complaints correlated negatively with their score in several tests. Exposure variables showed only weak associations with test results. Blood toluene levels were positively correlated with scores in spatial tests. The direction of the correlations suggests that the influence of acute pharmacologic effects is undetectable on Monday mornings before work. In conclusion, we found that exposure to toluene at levels below 157 mg/m3 following long-term exposure did induce neurasthenic problems and might reduce psychometric test performance.

[Work psychopathology]

Work psychopathology concept is outlined, restricted, however, to different disorders and conflicts whose actual cause is to be found in the intrinsic mechanism of work-related activity. Environment- and life condition-related causes are disregarded. Nervous fatigue neurasthenoid syndrome is understood as a result of a dephasing between CNS neurophysiological timing and work rhythms. The author stresses that taking productivity as a parameter for nervous fatigue measurement--which substituted for the former muscular fatigue criterion in industry--is quite erroneous an opinion. Ergonomy is to be developed: Ergonomy is an interdisciplinary science which studies concordance between Man's physical and psychophysiological possibilities and properties, and possibilities and properties of contemporary work technical systems and their functioning conditions as well.

Psychopathology in mountaineering--mental disturbances under high-altitude stress

In the years 1960-1985 psychiatric and psychological research was conducted among a group of 80 Polish alpinists. Experimental research was conducted during the expeditions to the Hindu Kush mountains and to the Andes (1971, 1973-74, 1979, 1985). The aim of the research was to describe the personality of the alpinists, their motivation, as well as mental disturbances caused by staying at high altitudes. On the basis of an interview and the Cattell personality questionnaire, two types of personality were distinguished: the schizoid-psychasthenic type (53 persons, i.e. 66%) and the asthenic-neurotic type (23 persons, i.e. 30%). As regards the motivation for mountain climbing, situational and personality factors were described, among them, the need to experience "powerful situations" and compensating for an inferiority complex. A so called integrational fear which mobilizes the psychophysical capabilities to overcome the hardships of the climb, was described as characteristic of the alpinists. Depending on the altitude and the duration of one's stay at it, the mental disturbances, in most cases took on the form of the neurasthenic syndrome (asthenic or sthenic) at low altitudes (3000-4000 m), the cyclothymic syndrome at medium altitudes (4000-5000 m), and the acute organic brain syndrome at high altitudes (above 7000 m). In 24 (35%) cases, there occurred psychotic disturbances with profound disturbances of consciousness and orientation. These states were accompanied by symptoms of high-altitude deterioration with a break-down in the physical condition, disturbances in the hydro-electrolyte equilibrium, and a considerable loss of bodily weight.(ABSTRACT TRUNCATED AT 250 WORDS)