Concept

Disorganized schizophrenia

Disorganized schizophrenia, or hebephrenia, was a subtype of schizophrenia prior to 2013. Subtypes of schizophrenia were no longer recognized as separate conditions in the DSM 5, published in 2013. The disorder is no longer listed in the 11th revision of the International Classification of Diseases (ICD-11). Disorganized schizophrenia was classified within ICD-10 the existing classification, in practice, until January 1, 2022, as a mental and behavioural disorder, because the classification was thought to be an extreme expression of the disorganization syndrome that has been hypothesized 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 (lack of speech, lack of spontaneous movement and various aspects of blunting of emotion). The condition is also known as hebephrenia, named after the Greek term for "adolescence" – ἥβη (hḗbē) – and possibly the ancient-Greek goddess of youth, Hebe, daughter of Hera. The term refers to the ostensibly more prominent appearance of the disorder in persons around puberty. The prominent characteristics of this form are disorganized behavior and speech (see formal thought disorder), including loosened associations and schizophasia ("word salad"), and flat or inappropriate affect. In addition, psychiatrists must rule out any possible sign of catatonic schizophrenia. The most prominent features of disorganized schizophrenia are not delusions and hallucinations, as in paranoid schizophrenia, although fragmentary delusions (unsystemized and often hypochondriacal) and hallucinations may be present. A person with disorganized schizophrenia may also experience behavioral disorganization, which may impair his or her ability to carry out daily activities such as showering or eating. The emotional responses of such people often seem strange or inappropriate. Inappropriate facial responses may be common, and behavior is sometimes described as "silly", such as inappropriate laughter.

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