In the early 1990s a clinical psychologist from London’s Maudsley Hospital began working in the Ukraine with clinicians treating children who had survived the Chernobyl nuclear disaster. Drawing on his experience of treating children who had survived conflict and catastrophe in other parts of the world, he conceptualised their symptoms and therapy in terms of the DSM’s category of Post-Traumatic Stress Disorder. To his surprise, the Soviet-trained psychiatrists working in Kiev insisted instead on ‘neurasthenia’, resulting in some difficulties in conceptual and linguistic translation across the two clinical cultures. Neurasthenia was a ‘civilizational disorder’ coined by American neurologist George Beer in the 1870s. The diagnostic category fell out of use in British psychiatry in the early years of the 20^th century. Indeed, most historians of medicine see neurasthenia as having disappeared from mainstream clinical practise in the west by the 1930s at the latest, due to the vagueness of its boundaries and the rise of depression and anxiety, and later PTSD, as alternative and more specific diagnoses. This narrative omits the fact that neurasthenia remained resilient in the socialist countries of Eastern Europe and the Soviet Union, as well as China and also France, long after the end of  WWII. Indeed, it was even given official credence as a rehabilitated  diagnostic category in the WHO’s International Classification of Diseases in 1967. This paper will reconstruct the meanings of neurasthenia in these later 20th century contexts, why clinicians lobbied for its recognition, and will argue that these events were linked to the intellectual development of psychiatry in the socialist world during the Cold War.

Dr Sarah Marks is a distinguished historian of science and medicine and currently director of the Birckbeck Centre for Interdisciplinary Research on Mental Health. She works on the transnational history of psychotherapy and in collaboration with Dr Dora Vargha and Prof Edna Suarez-Diaz recently received the Wellcome Collaborative Award for a five-year project on ‘Connecting Three Worlds: Socialism, Medicine and Global Health after World War II’.