FRENASTHENIA, FRENASTHENICS. - The term is due to the Italian alienist Andrea Verga and was revived by S. De Sanctis, who preferred it to the German schools' "oligophrenia" and to "mental deficiency" because it was more technical.
It denotes a "mental insufficiency due to morbid heredity, anomalies or diseases that struck the brain during the period of its most active evolution," i.e., from the embryonic period to the whole of early childhood. If the morbid cause instead strikes the brain when intellectual organization is nearly complete, i.e., after the age of 5-6, one speaks of mental regression and dementia (q.v.).
In other words, between f. and dementia there is a substantial difference, constituted by the time at which the deficient state was determined. Esquirol already distinguished the two deficits, and his aphorism is well known: "It is a case of dementia when, having been rich, one has become poor; it is a case of frenasthenia when one has never been rich." Yet one may also recognize qualitative psychopathological differences between the two deficits. In dementia, in fact, there is a global reduction of personality, whereas in f. alongside the reduction of higher mental processes there is disharmony; that is, partial gaps in the psychic picture are often noted, along with good memory and even special talents (music, calculation). This is because in frenasthenics the evolutionary force is in conflict with the perturbing cause of psychic development, which proceeds "irregularly, determining that characteristic disharmony of the originally deficient psyche."
S. De Sanctis distinguishes f. into *cerebropathy*, due to brain diseases, which is distinguished by the presence of neurological symptoms, mostly affecting motility (strabismus, paresis, paralysis, etc.); *biopathy*, of hereditary or early congenital nature, in which the subject almost always presents degenerative morphological atypias that are an index of the hereditary morbid burden; *biocerebropathy*, the most frequent, summarizes the two orders of causal factors (familial and individual), so that in it one notes neurological symptoms alongside degenerative morphological atypias.
Among the mass of frenasthenics, moreover, there stand out, because of the peculiarity of certain symptoms, morbid pictures that deserve a more precise clinical denomination: microcephaly, tuberous sclerosis, amaurotic idiocy, infantile cerebral palsy, endemic cretinism, myxedema, mongolism, infantilism, etc.
The classic subdivision of frenasthenics into *idiots, imbeciles, weak-minded*, followed by the majority of authors, is based on the criterion of the degree of mental insufficiency; others, like Binet, classify them according to the criterion of expressive means. Comparing the deficient psyche with the normal variations of mental level over the course of age is considered arbitrary and hence debated. S. De Sanctis has a recognized school in mental insufficiency four degrees (high, medium, intermediate, mild), evaluated by means of special mental tests. Keeping in mind moreover that the mental inferiority of frenasthenics is qualitatively different, case by case, this author has described some types of inferior mentality such as the idiotic, the imbecile, the vesanic, the epileptoid, and the infantile. It is not then rare the case that disturbances combinable with two different types are found, as in the retarded and the simple described by Montesano.
Frenasthenics may be considered divided into two broad categories, namely the more severe or major (idiots, imbeciles) and the less severe or minor (weak-minded): the latter are also called *psychic defectives* (q.v.) and *psychic abnormals*.