Neurasthenia (from the Ancient Greek νεῦρον neuron "nerve" and ἀσθενής asthenés "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North America during the late nineteenth and early twentieth centuries after neurologist George Miller Beard reintroduced the concept in 1869. As a psychopathological term, the first to publish on neurasthenia was Michigan alienist E. H. Van Deusen of the Kalamazoo asylum in 1869, followed a few months later by New York neurologist George Beard, also in 1869, to denote a condition with symptoms of fatigue, anxiety, headache, heart palpitations, high blood pressure, neuralgia, and depressed mood. Van Deusen associated the condition with farm wives made sick by isolation and a lack of engaging activity, while Beard connected the condition to busy society women and overworked businessmen. Neurasthenia was a diagnosis in the World Health Organizations ICD-10, but is no more diagnosed in ICD-11, marked as deprecated. It also is no longer included as a diagnosis in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders. The condition is, however, described in the Chinese Society of Psychiatrys Chinese Classification of Mental Disorders. Americans were said to be particularly prone to neurasthenia, which resulted in the nickname "Americanitis" (popularized by William James). Another, rarely used, term for neurasthenia is nervosism. Symptoms
The condition was explained as being a result of exhaustion of the central nervous systems energy reserves, which Beard attributed to modern civilization.
Exposure
Prenatal alcohol exposure is determined by interview of the biological mother or other family members knowledgeable of the mothers alcohol use during the pregnancy (if available), prenatal health records (if available), and review of available birth records, court records (if applicable), chemical dependency treatment records (if applicable), chemical biomarkers, or other reliable sources. Exposure level is assessed as confirmed exposure, unknown exposure, and confirmed absence of exposure by the IOM, CDC and Canadian diagnostic systems. The "4-Digit Diagnostic Code" further distinguishes confirmed exposure as High Risk and Some Risk:
High Risk: Confirmed use of alcohol during pregnancy known to be at high blood alcohol levels (100 mg/dL or greater) delivered at least weekly in early pregnancy. Some Risk: Confirmed use of alcohol during pregnancy with use less than High Risk or unknown usage patterns. Unknown Risk: Unknown use of alcohol during pregnancy. No Risk: Confirmed absence of prenatal alcohol exposure. Confirmed exposure
Amount, frequency, and timing of prenatal alcohol use can dramatically impact the other three key features of FASD. While consensus exists that alcohol is a teratogen, there is no clear consensus as to what level of exposure is toxic. The CDC guidelines are silent on these elements diagnostically. The IOM and Canadian guidelines explore this further, acknowledging the importance of significant alcohol exposure from regular or heavy episodic alcohol consumption in determining, but offer no standard for diagnosis.