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Chapter V

Other neurotic disorders - F48


F48.0 Neurasthenia
Considerable cultural variations occur in the presentation of this disorder, and two main types occur, with substantial overlap. In one type, the main feature is a complaint of increased fatigue after mental effort, often associated with some decrease in occupational performance or coping efficiency in daily tasks. The mental fatiguability is typically described as an unpleasant intrusion of distracting associations or recollections, difficulty in concentrating, and generally inefficient thinking. In the other type, the emphasis is on feelings of bodily or physical weakness and exhaustion after only minimal effort, accompanied by a feeling of muscular aches and pains and inability to relax. In both types a variety of other unpleasant physical feelings is common, such as dizziness, tension headaches, and feelings of general instability. Worry about decreasing mental and bodily well-being, irritability, anhedonia, and varying minor degrees of both depression and anxiety are all common. Sleep is often disturbed in its initial and middle phases but hypersomnia may also be prominent.
Fatigue syndrome

Use additional code, if desired, to identify previous physical illness.
    Excludes:
  • asthenia NOS ( R53 )
  • burn-out ( Z73.0 )
  • malaise and fatigue ( R53 )
  • postviral fatigue syndrome ( G93.3 )
  • psychasthenia ( F48.8 )
F48.1 Depersonalization-derealization syndrome
A rare disorder in which the patient complains spontaneously that his or her mental activity, body, and surroundings are changed in their quality, so as to be unreal, remote, or automatized. Among the varied phenomena of the syndrome, patients complain most frequently of loss of emotions and feelings of estrangement or detachment from their thinking, their body, or the real world. In spite of the dramatic nature of the experience, the patient is aware of the unreality of the change. The sensorium is normal and the capacity for emotional expression intact. Depersonalization-derealization symptoms may occur as part of a diagnosable schizophrenic, depressive, phobic, or obsessive-compulsive disorder. In such cases the diagnosis should be that of the main disorder.
F48.8 Other specified neurotic disorders
Dhat syndrome
Occupational neurosis, including writer's cramp
Psychasthenia
Psychasthenic neurosis
Psychogenic syncope
F48.9 Neurotic disorder, unspecified
Neurosis NOS


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