The diagnostic category of neurasthenia is examined as a cultural construct with social uses and implications for psychiatric nosologies. The legitimation of otherwise stigmatized symptoms through a diagnosis of neuras thenia is discussed. The re-thinking and re-definition of the category in Chinese psychiatry in the 1980s is reviewed to illustrate the social construction of knowl edge and DSM's influence abroad. The proposal to include neurasthenia in DSM-IV is considered as part of the initiative to increase the cultural validity of the DSM system. Implications for research are suggested, and questions raised about the ability of DSM to resist change and re-produce itself.
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