Fibromyalgia, chronic fatigue, and related “neurasthenic” disorders
This chapter presents the modern conceptualization of an illness well recognized at the turn of the 19th century – neurasthenia (Wessely, Hotopf, & Sharpe, 1998). Because the primary feature of neurasthenia was fatigue, the major focus in modernday syndromes discussed in this chapter is fatigue. The “new” syndromes to be described are chronic fatigue syndrome (CFS) and fi bromyalgia (FM). While fatigue is not the primary defi ning feature of FM, fatigue indeed plays a prominent role and thus may also be considered related to the older concept of neurasthenia. Several other syndromes with “unexplained symptoms” have been recognized, such as multiple chemical sensitivity, irritable bowel syndrome, sick building syndrome, temporomandibular disorder (TMD), atypical connective tissue disease after silicone breast implants, mitral valve prolapse, dental amalgam disease, and most recently Gulf War illness (Aaron, Burke, & Buchwald, 2000; Kipen & Fiedler, 1999; Wessely et al., 1998), some of which will be mentioned briefl y toward the end of this chapter.