Exhaustion disorder: the genesis of a diagnosis that exists only in Sweden.

Abstract

In a scientific report published 2003 a psychiatric research group in Sweden proposed to the National Board of Health and Welfare that a new diagnosis with the name "exhaustion disorder" ("utmattningssyndrom") (ED) should be created in the Swedish diagnostic system. Two years later the board approved the proposal and the diagnosis was registred in the Swedish version of ICD-10. Since 2005 the prevalence of ED in Sweden has gradually increased and at the current date more than 40 000 people are on long-term sick leave as a result of the diagnosis. Interestingly, there is no corresponding medical diagnosis outside of Sweden, although patients in other countries are declared ill with similar symptoms, receiving other diagnoses, such as burnout, depression, acute stress or adjustment disorder. In this paper, the history of ED is told and an attempt is made to answer the question why it has come to exist and prevail in Sweden despite no evidence of validity. The analysis is performed by scrutinizing the criteria for the diagnosis and how it has been connected to the granting of sick leave in the Swedish social insurance system. In conjunction with this, a phenomenological analysis is provided of how ED has been named and interpreted in the Swedish society as a particular form of life-narrative pattern. This pattern of break-down and rebuild of a more in-tune-with-nature version of oneself in recovering from ED is found in Swedish popular culture, and it is supported by academic studies, self-help books and the strategies of rehabcenters.