title: Asthenia--does it exist in space?
abstract: OBJECTIVE
  First popularized as neurasthenia in the late 1800s by American George Beard, asthenia has been viewed by Russian psychologists and flight surgeons as a major problem that affects cosmonauts participating in long-duration space missions. However, there is some controversy about whether this syndrome exists in space; this controversy is attributable in part to the fact that it is not recognized in the current American psychiatric diagnostic system.
  
  
  METHODS
  To address this issue empirically, we retrospectively examined the data from our 4 1/2-year, NASA-funded study of crew member and mission control interactions during the Shuttle/Mir space program. Three of the authors identified eight items of stage 1 asthenia from one of our measures, the Profile of Mood States (POMS). Scores on these items from 13 Russian and American crew members were compared with scores derived from the opinions of six Russian space experts.
  
  
  RESULTS
  Crew members' scores in space were significantly lower than the experts' scores on seven of the eight items, and they generally were in the "not at all" to "a little" range of the item scales. There were no differences in mean scores before and after launch or across the four quarters of the missions. There were no differences in response between Russian and American crew members.
  
  
  CONCLUSIONS
  We could not demonstrate the presence of asthenia in space as operationally defined using the POMS. However, the POMS addresses only emotional and not physiological aspects of the syndrome, and the subject responses in our study generally were skewed toward the positive end of the scales. Further research on this syndrome needs to be done and should include physiological measures and measures that are specific to asthenia.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, and the Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA. nick21@itsa.ucsf.edu
authors.forename: N
authors.initials: N
authors.lastname: Kanas
authors.forename: V
authors.initials: V
authors.lastname: Salnitskiy
authors.forename: V
authors.initials: V
authors.lastname: Gushin
authors.forename: D S
authors.initials: DS
authors.lastname: Weiss
authors.forename: E M
authors.initials: EM
authors.lastname: Grund
authors.forename: C
authors.initials: C
authors.lastname: Flynn
authors.forename: O
authors.initials: O
authors.lastname: Kozerenko
authors.forename: A
authors.initials: A
authors.lastname: Sled
authors.forename: C R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D000328:Adult; D001247:Asthenia / Q000175:diagnosis*; D003431:Cross-Cultural Comparison; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis; D012189:Retrospective Studies; D012426:Russia; D012720:Severity of Illness Index; D013026:Space Flight; D013997:Time Factors; D014481:United States