Frenasthenia, Frenasthenics

FRENASTENIA, FRENASTENICI. – The term is due to the Italian alienist Andrea Verga and was restored to favor by S. De Sanctis, who preferred it to the term “oligophrenia” used by the German schools and to that of “mental deficiency,” because it is more technical.

It denotes a “mental insufficiency” due to morbid heredity, to anomalies, or to diseases that affected the brain during the period of its most active evolution, “that is, from the embryonic period through the whole of early childhood.” If, on the other hand, the morbid cause affects the brain when intellectual development has been more or less completed, that is, after the age of 5–6, one speaks of mental regression, “dementia (v.).

In other words, there is a substantial difference between f. and dementia, consisting in the period at which the deficient state was determined. Esquirol already differentiated the two deficiencies, and his aphorism is well known: he is demented who, having been rich, has become poor; he is frenastenic who has never been rich. Nevertheless, qualitative psychopathological differences between the two deficiencies can also be recognized. In dementia there is, in fact, a global reduction of the personality, whereas in f., in addition to the reduction of the higher mental processes, there is disharmony; that is, partial gaps are often observed in the psychic picture, together with good memory and even special talents (music, calculation). This is because, in frenastenics, the evolutionary force is engaged in a struggle with the cause disturbing psychic development, which proceeds irregularly and produces the disharmony characteristic of the original deficient psyche.

S. De Sanctis distinguishes f. into cerebropathic, due to diseases of the brain, characterized by the presence of neurological symptoms, mostly affecting motility (strabismus, paresis, paralysis, etc.); biopathic, of hereditary or early congenital nature, in which the subject almost always presents degenerative morphological atypias that indicate the hereditary morbid burden; and biocerebropathic, the most frequent form, which combines the two orders of causal factors (familial and individual), so that neurological symptoms occur alongside degenerative morphological atypias.

Within the mass of frenastenics, moreover, certain morbid conditions stand out because of the peculiarity of some of their symptoms and require a more precise clinical designation: microcephaly, tuberous sclerosis, amaurotic idiocy, infantile cerebral paralysis, endemic cretinism, myxedema, mongolism, infantilism, etc.

The classic division of frenastenics into idiots, imbeciles, and the weak-minded, followed by the majority of authors, is based on the criterion of the degree of mental insufficiency; others, such as Binet, classify them according to the criterion of expressive means. Comparing the deficient psyche with the normal variations in mental level over the course of life is considered arbitrary and is therefore debated. S. De Sanctis and his school recognize four degrees of mental insufficiency (high, medium, intermediate, slight), assessed by means of special mental tests. Also bearing in mind that the mental inferiority of frenastenics is qualitatively different from case to case, this author has described certain types of inferior mentality, such as the idiotic, imbecilic, vesanic, epileptoid, and infantile types. It is not uncommon, moreover, for disorders attributable to two different types to be combined, as in the cases of the retardés and the simpletons described by Montesano.

Frenastenics may be considered divided into two large categories: the more serious, or major, cases (idiots, imbeciles) and the less serious, “minor (weak-minded)” cases; the latter are also called the mentally handicapped (v.) “psychically abnormal.”

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