Prevalence of neurasthenia, comorbidity, and association with impairment among a nationally representative sample of US adults

There are no current psychiatric epidemiological studies examining prevalence estimates of neurasthenia across different racial
and ethnic groups in the US. This study compares prevalence rates of International Classification of Diseases (ICD-10) lifetime and 12-month neurasthenia across racial/ethnic groups in the US (Asians, African Americans, Latinos, and
non-Latino Whites) and by levels of acculturation. We examine comorbidity of neurasthenia with DSM-IV psychiatric disorders
and the association between neurasthenia and impairment.

We used a pooled sample (N = 10, 118) from two nationally representative household surveys of adults ages 18 years and older: the National Comorbidity
Survey-Replication (NCS-R) and the National Latino and Asian American Study (NLAAS).

Among the total sample, the adjusted prevalence rates of lifetime and 12-month neurasthenia with exclusionary criteria were
2.22 and 1.19%. The adjusted prevalence rates for lifetime and 12-month neurasthenia without exclusionary criteria were 4.89
and 2.80%. There were significant racial/ethnic group differences in prevalence for both lifetime and past-year neurasthenia,
with Asians reporting significantly lower prevalence of neurasthenia than their non-Latino White counterparts. Less acculturated
individuals were at a decreased risk for lifetime and past-year neurasthenia. Lifetime neurasthenia was associated with increased
odds of meeting lifetime criteria for any depressive, any anxiety, and any substance use disorder. Respondents with lifetime
or past-year neurasthenia had significantly greater levels of impairment compared to those without neurasthenia.

Neurasthenia is a prevalent condition deserving further research attention given its comorbidity with other psychiatric disorders
and its association with functional impairment.