Disorganized schizophrenia

Hebephrenic schizophrenia
Classification and external resources
ICD-10	F20.1
ICD-9	295.1
MeSH	D012562

Disorganized schizophrenia, also known as hebephrenia is a subtype of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV code 295.10.^[1]

Disorganized schizophrenia is thought to be an extreme expression of the disorganization syndrome that has been hypothesised to be one aspect of a three-factor model of symptoms in schizophrenia,^[2] the other factors being reality distortion (involving delusions and hallucinations) and psychomotor poverty (poverty of speech, lack of spontaneous movement and various aspects of blunting of emotion).

Presentation

This type is characterized by prominent disorganized behavior and speech (see formal thought disorder) including schizophasia, and flat or inappropriate emotion and affect. The criteria for the catatonic subtype of schizophrenia must not have been met as well. This type of schizophrenia is also known as hebephrenia, and is named after the Greek goddess of youth, Hebe, in reference to the typical age of onset in puberty.^[3]

Unlike the paranoid subtype of schizophrenia, delusions and hallucinations are not the most prominent feature,^[4][5] although fragmentary delusions and hallucinations may be present.

A person with disorganized schizophrenia may also experience behavioral disorganization which may impair his/her ability to carry out activities of daily living such as showering or eating.^[6]

The emotional responses of people diagnosed with this subtype can often seem strange or inappropriate to the situation. Inappropriate facial responses may be common and behavior is sometimes described as 'silly', such as inappropriate laughter. Complete lack of expressed emotion is sometimes seen, as is an apparent indifference, anhedonia (the lack of pleasure), and avolition (a lack of motivation). Some of these features are also present in other types of schizophrenia, but they are most prominent in Disorganized Schizophrenia.

Treatment

This form of schizophrenia is typically associated with early onset (often between the ages of 15 and 25 years) and is thought to have a poor prognosis because of the rapid development of 'negative' symptoms and decline in social functioning.^[7]

Use of electroconvulsive therapy has been proposed;^[8] however, the effectiveness after treatment is in question.

See also

• Paranoid schizophrenia
• Catatonia

References

1. ^ Schizophrenia DSM
2. ^ Liddle PF (August 1987). "The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy". Br J Psychiatry 151: 145–51. doi:10.1192/bjp.151.2.145. PMID 3690102. 
3. ^ Athanasiadis, Loukas (December 1997). "Greek mythology and medical and psychiatric terminology". The Psychiatrist 21 (12): 781. doi:10.1192/pb.21.12.781. http://pb.rcpsych.org/cgi/reprint/21/12/781.pdf. 
4. ^ How Schizophrenia is diagnosed
5. ^ Hebephrenic Schizophrenia Diagnostic Criteria
6. ^ American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC. code 295.10 pp314
7. ^ McGlashan TH, Fenton WS (1993). "Subtype progression and pathophysiologic deterioration in early schizophrenia". Schizophr Bull 19 (1): 71–84. PMID 8451614. http://schizophreniabulletin.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8451614. 
8. ^ Shimizu E, Imai M, Fujisaki M, et al. (March 2007). "Maintenance electroconvulsive therapy (ECT) for treatment-resistant disorganized schizophrenia". Prog. Neuropsychopharmacol. Biol. Psychiatry 31 (2): 571–3. doi:10.1016/j.pnpbp.2006.11.014. PMID 17187911. http://linkinghub.elsevier.com/retrieve/pii/S0278-5846(06)00408-8.