Disorganized schizophrenia
Encyclopedia
Disorganized schizophrenia, also known as hebephrenia is a subtype of schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 as defined in the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

, DSM-IV code 295.10.

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, 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
Emotion
Emotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...

 and affect
Affect (psychology)
Affect refers to the experience of feeling or emotion. Affect is a key part of the process of an organism's interaction with stimuli. The word also refers sometimes to affect display, which is "a facial, vocal, or gestural behavior that serves as an indicator of affect" .The affective domain...

. 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
Hebe (mythology)
In Greek mythology, Hēbē is the goddess of youth . She is the daughter of Zeus and Hera. Hebe was the cupbearer for the gods and goddesses of Mount Olympus, serving their nectar and ambrosia, until she was married to Heracles ; her successor was the young Trojan prince Ganymede...

, in reference to the typical age of onset in puberty.

Unlike the paranoid subtype of schizophrenia, delusion
Delusion
A delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...

s and hallucination
Hallucination
A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid,...

s are not the most prominent feature, 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.

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
Anhedonia
In psychology and psychiatry, anhedonia is defined as the inability to experience pleasure from activities usually found enjoyable, e.g. hobbies, exercise, social interaction or sexual activity....

 (the lack of pleasure
Pleasure
Pleasure describes the broad class of mental states that humans and other animals experience as positive, enjoyable, or worth seeking. It includes more specific mental states such as happiness, entertainment, enjoyment, ecstasy, and euphoria...

), and avolition
Avolition
Avolition is a psychological state characterized by general lack of drive, or motivation to pursue meaningful goals. A person may show little participation in work or have little interest in socializing. They may sit still for long periods of time...

 (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
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...

 because of the rapid development of 'negative' symptoms and decline in social functioning.

Use of electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...

 has been proposed; however, the effectiveness after treatment is in question.
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