Abstract

Brain fag syndrome (BFS) was described by RH Prince in 1960. It was first discovered in Nigeria, describing high school and university students with symptoms including somatic, sleep-related and cognitive complaints, head and neck pains, difficulty in concentrating and retaining information, and eye pain. It is caused by excessive external pressure to be successful among the young.

Classification

BFS is classified in the fourth revision of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) as a culture-bound syndrome. Individuals with "symptoms" of brain fag must be differentiated from those with the "syndrome" according to the Brain Fag Syndrome Scale (BFSS); Ola "et al" said it would not be "surpris[ing] if BFS was called an equivalent of either depression or anxiety".

Causes

Morakinyo found in 20 persons with BFS an achievement drive that was anxiety-related that led to the use of psychostimulants and consequent sleep deprivation which contributed to cognitive disruption; Omoluabi related BFS to test anxiety.

Treatment

Anumonye reported treatment success with lorazepam; others found benefit with antidepressants and relaxation exercises.

Epidemiology

BFS has been reported in other African cultures, and also in Brazil, Argentina, and Ethiopian Jews. Historic higher reported prevalence among males may be due to more males being present in higher education in African countries. Studies since the 1990s have not verified gender differences. Other studies found a possible association with low socioeconomic status, an association with average or higher intelligence, and a high association with neuroticism. Individuals with BFS have been found to have problems with isolation, poor study habits, and the use of psychostimulants as well as physical changes including in muscle tension and heart rate.

History

Prince named the condition based on the term "brain fag" used by students who believed their symptoms were attributed to "brain fatigue". However, this term was used in the United States and Europe dating back to 1839.