FRENASTHENIA, FRENASTHENICS. - The term is due to the Italian alienist Andrea Verga and was brought back into favor by S. De Sanctis, who preferred it to that of "oligophrenia" of the German schools and to that of "mental deficiency" because it is more technical.
By it is meant a "mental insufficiency" due to morbid heredity, to anomalies or diseases that overtook the brain during the period of its most active evolution "that is, from the embryonic period through the whole of early infancy." If the morbid cause instead strikes the brain when its intellectual organization is more or less achieved, that is, after 5-6 years of age, one speaks of mental regression "dementia (v.).
In other words, between f. and dementia there is a substantial difference, constituted by the epoch in which the deficient state was determined. Esquirol already differentiated the two deficits, and his aphorism is well known: he is demented who, being rich, has become impoverished; he is frenastenic who has never been rich. Nevertheless, among the two deficits one can also recognize qualitative psychopathological differences. In dementia there occurs in fact a global reduction of the personality, whereas in f., beyond the reduction of the 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 frenastenics the evolutionary force is struggling with the disturbing cause of psychic development, which proceeds irregularly, determining that disharmony characteristic of the original deficient psyche.
S. De Sanctis distinguishes f. into cerebropathic, due to diseases of the brain, which is distinguished by the presence of neurological symptoms mostly affecting motility (ataxia, paresis, paralysis, etc.); biopathic, 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; biocerebropathic, the most frequent, which combines the two orders of causal factors (familial and individual), so that in it neurological symptoms are noted alongside degenerative morphological atypias.
Within the mass of frenastenics there also stand out, because of the peculiarity of certain symptoms, morbid pictures to which a more precise clinical denomination belongs: microcephaly, tuberous sclerosis, amaurotic idiocy, infantile cerebral palsy, endemic cretinism, myxedema, mongolism, infantilism, etc.
The classic subdivision of frenastenics into idiots, imbeciles, and 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 on the criterion of the means of expression. To compare the deficient psyche with the normal variations of the mental level over the course of age is held to be arbitrary and therefore disputed. S. De Sanctis and his school recognize four degrees in mental insufficiency (high, medium, intermediate, slight), assessed by means of special mental tests. Bearing in mind furthermore that the mental inferiority of frenastenics is qualitatively different, according to the cases, this author has described certain types of inferior mentality such as the idiotic, the imbecilic, the vesanic, the epileptoid, and the infantile. It is not rare, moreover, for disturbances traceable to two different types to be combined, as in the retardates and the simpletons described by Montesano.
Frenastenics can be considered divided into two great categories, namely the more severe or major (idiots, imbeciles) and the less severe "minor (weak-minded)": the latter are also called mental defectives (v.) "psychic abnormals."