Kretschmer was the first to describe the persistent vegetative state which has also been called Kretschmer's syndrome. Another medical term coined after him is Kretschmer's sensitive paranoia.[2] This classification has the merit of singling out "a type of paranoia that was unknown" prior to Kretschmer, and which "does not resemble the stereotypical image [...] of sthenic paranoia".[3] Furthermore, between 1915 and 1921 he developed a differential diagnosis between schizophrenia and manic depression.
Kretschmer is also known for developing (in the first quarter of the 20th century) a classification system that can be seen as one of the earliest exponents of a constitutional (the total plan or philosophy on which something is constructed) approach. He based his classification system on four main body-types:
The essential characteristic of the asthenic type, in Kretschmer's words, is "a deficiency in thickness combined with an average unlessened length". The deficiency is present in all parts of body: muscle, bone, neck, face, trunk, extremities, and in all the tissues (skin, bone, fat, muscles and vessel system.[4] The average weight as well as the other body measurements are below the general value for males.[4]
The athletic type among females corresponds to the male form.[4] The certain characteristic deviation is the development of fat, it's rich, but not electively abnormal as with pyknics.[4] Besides these athletic-type women with feminine rounded figures, there are also those women who have outstanding musculature in body and face. In many cases, athletic-type women are actually masculine in muscle relief.[4]
Kretschmer's pyknic type is characterized by the peripheral development of the body cavities (breast, head, and stomach), and a tendency to a distribution of fat about the torso.[4] They also have a more graceful construction of the motor apparatus (limbs and shoulders).[4]
The pyknic type tends emphatically to a covering of fat.[4] The obesity of the pyknic is restricted within moderate limits for the most part. The female pyknics' covering of fat is more strongly concentrated over the hips and chest.[4]
Analysis of asthenic reactions and phases that occur periodically in persons suffering from psychopathies of the sthemic pole (33 cases) has demonstrated that the structure of the syndrome is determined by the combination of the two signs: phenomena of irritative weakness and symptomatology of the somatopsychic circle. Two types of asthenic conditions were distinguished: conversion and psychovegetative asthenia. As to the first type, the asthenic manifestations proper were of the demonstrative-exaggerated character, whereas somatopsychic disorders occurred in accordance with the hysterical conversion mechanism. Consequently, the structure of the syndrome is marked by the predominance of characteristic abnormalities in the sphere of somatopsychics (bodily hysterical stigmas, with the intensity of ergic disorders being minimum). As to the second type, asthenia was marked by relatively uniform ergic and somatopsychic manifestations. The latter ones (algias, sleep disturbances, "pseudosomatic" crises) as if masked asthenia proper. The typological differentiation of asthenic disorders provided here is adequate to the nature of the constitutional proneness as a system of factors that determine the clinical differences. Conversion asthenia occurs preferably in persons of the histrionic and excitable mould whereas psychovegetative asthenia in persons showing the predominance of anancastic and expansive schizoid traits.
Using a clinico-psychological approach, personality changes have been studied in 40 patients with attack-like schizophrenia presenting asthenic (n = 22) or sthenic (n = 18) types of remissions. The common regularities have been identified, namely personality alterations of a superficial level with the preservation of "the nucleus of personality". In an asthenic type of remission the defect is total and all the main components of the personality are involved. This variant of schizophrenic defect is distinguished by impairment of the motivational-stimulating component of mental activity without reduction in its other components (exhaustion, fatigue, etc.) characteristic of asthenic syndromes of other etiology. In a sthenic type of remission personality changes are partial.
Conclusions. Features of asthenic manifestations in patients with type 2nd DM in clinical and psychological perspective were investigated. The detection rate of asthenic manifestations among patients with type 2nd DM and the factors for their amplification were established. The organic etiology of asthenic manifestations have been proven; presentation about the stages of development of asthenic symptoms in patients with type 2nd DM were improved.
Kretschmer was a German psychiatrist who on the basis of his observation of patients classified people into four types. He used the physical constitution and temperament for this purpose The four types he talked about included: (i) Pyknik type (ii)Asthenic type (iii)Athletic type (iv) Dysplastic type.
Medical opinion, from the days of Hippocrates to the present, has associated tuberculosis with individuals having a thin, long ectomorphic bodily frame. This habitus phthisicus has been suggested by some writers as contributing to a lack of resistance among individuals who develop tuberculosis. Others have maintained that this body type is a resultant of biochemical factors which make certain people prone to tuberculosis in ways independent of their physique. The aim of this study was to investigate the relationship of body type to tuberculosis by using reliable somatotype procedures (in contrast to the faulty techniques for measuring physiques employed in the past).
The alleged relationship between body build and tuberculosis in the past has been attributed by the present authors to a confusion between weight loss or emaciation that may have developed as a consequence of the disease and the fundamental physique which existed prior to the onset of the illness. As a result of using a somatotype procedure that can reliably classify physique despite fluctuations in weight, the alleged positive relationship between a particular variety of physique and tuberculosis does not appear to exist.
Experts distinguish 3 types of physique: asthenic, normosthenic and hypersthenic. To understand what kind of person a person belongs to, the Pignet index, which takes into account height, weight and chest circumference, will help. From the figure denoting growth in centimeters, subtract the sum of the volume of the chest and body weight in kilograms. A number above 30 means that the person belongs to the asthenic type.
Asthenics or ectomorphs are thin, thin-boned people. This feature is manifested even in infancy, the ectomorph child has a very small weight, grows slowly, and does not eat well. In adolescence, representatives of this type are sharply drawn out, most adults are taller than average. However, there are also miniature asthenics, more often among women. Among men there are real giants with extremely long limbs.
Asthenic type men do not gain muscle mass well, they may look clumsy and haggard. Girls are distinguished by a slightly boyish figure without feminine curves. They are characterized by a small chest, flat buttocks, a hollow abdomen and a relatively wide waist. Often there is an underdevelopment of the body associated with a reduced production of female sex hormones. Representatives of both sexes rarely suffer from obesity, they gain weight poorly, but they lose weight very quickly. Bright representatives of the asthenic type are residents of some Asian countries, especially the Japanese and Vietnamese.
Asthenics are often cold, they almost always have cold hands and feet and low blood pressure. Representatives of this type do not tolerate cold and temperature changes, they catch cold easily. Susceptible to respiratory infections, prone to depression. People with asthenic physique speak softly, rarely raise their voices. To rest and recuperate, they need more time than normosthenics and athletes. At the same time, asthenics are distinguished by superficial sleep and often suffer from insomnia. Representatives of this type often get sick and recover for a long time.
Representatives of the asthenic type may experience breathing problems, among them there are many asthmatics. Another common problem is stoop. It is especially typical for teenagers. At the same time, ectomorphs can look very graceful, girls and women are characterized by a light gait, smooth movements, and innate musicality.
Asthenics prefer to lead a measured lifestyle, they do not cope well with stressful situations. According to psychologists, representatives of this type love nature, long walks, avoid noisy companies, preferring the company of close friends.
People of the asthenic type need constant stimulation of taste buds. They like spicy, salty and sour tastes, a variety of spices and seasonings. Women and children cannot imagine their lives without sweets, many asthenic men are also partial to desserts. To keep fit and not experience health problems, it is useful for ectomorphs to eat small portions, avoiding overeating and rigid diets.
Asthenics are very sensitive, any failure can unsettle them for a long time. They often misjudge the situation, jump to conclusions, and tend to be negative. Very distrustful, feel uncomfortable in the company of strangers. They do not tolerate rudeness, they are distinguished by vindictiveness and suspiciousness. Many representatives of this type need the support of a psychologist who corrects bouts of depression and bad mood. In old age, negativistic character traits intensify, people become very suspicious and distrustful, they demand accountability from loved ones in any deeds and actions. It is difficult to get along with representatives of their type; more balanced and vital normosthenics are suitable for them as permanent partners and friends.
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