It is a subtype of schizophrenia, although it is not recognized in the latest version of the Diagnostic and Statistical Manual of mental disorders.
Disorganized schizophrenia is also known as hebephrenia or hebephrenic schizophrenia .
It is recognized only in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
Disorganized schizophrenia is one of the five subtypes of schizophrenia. It is characterized by disorganized behavior and speech and includes disturbance in emotional expression.
Hallucinations and delusions are less pronounced with disorganized schizophrenia, although there is evidence that these symptoms occur.
Hebephrenia is believed to be an extreme expression of the disorganized syndrome that has been formulated as one aspect of a three-factor model of symptoms in schizophrenia.
The other factors being the distortion of reality (involving delusions and hallucinations) and psychomotor poverty (lack of speech, lack of spontaneous movement and various aspects of blunting of emotion).
Fast facts on hebephrenia
Here are some key points about disorganized schizophrenia. Schizophrenia is a serious, lifelong mental disorder that can involve disorganized and illogical thinking and behavior.
Disorganized schizophrenia, or hebephrenia, used to be a subtype, but since 2013, it has been listed under the heading ‘schizophrenia’. Treatment is available, and if a person sticks to it, it can enable them to cope with everyday life.
Complications of schizophrenia can be serious, but the support of family and friends can help a person avoid some of these.
Presentation of hebephrenia
The condition is also known as hebephrenia, named for the Greek term “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 people at puberty.
Characteristics highlighted in this form are disorganized behavior and speech, which includes relaxed associations and schizophasia (“word salad”) and flat or inappropriate affect. Also, psychiatrists must rule out any possible signs of catatonic schizophrenia.
The most prominent features of disorganized schizophrenia are not delusions and hallucinations, as they are found in paranoid schizophrenia, although fragmentary, unsystematized, and often hypochondriacal delusions and hallucinations may be present.
A person with disorganized schizophrenia may also experience disorganized behavior, which can affect their 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 can be common, and the behavior is sometimes described as “silly,” such as inappropriate laughter.
Sometimes, there is a complete lack of emotion, including anhedonia (lack of pleasure) and apathy (lack of motivation). Some of these features are also present in other types of schizophrenia, but are more prominent in disorganized schizophrenia.
Symptoms of Hebephrenia
Disorganized schizophrenia or hebephrenia is one of the five subtypes of schizophrenia. It is characterized by disorganized behavior and speech and includes disturbance in emotional expression.
Signs of schizophrenia are classified into the following categories of key symptoms of all psychotic disorders:
Delusions : the patient has false beliefs of persecution, guilt or greatness. It is not uncommon for people with schizophrenia to describe plots against them or to believe that they have extraordinary powers and gifts. Some patients may hide to protect themselves from an imaginary pursuer.
Hallucinations : They involve seeing, feeling, tasting, or smelling things that are not there. Hearing voices is the most common hallucination.
Hallucinations and delusions are less pronounced with disorganized schizophrenia, although there is evidence that these symptoms occur.
Schizophrenia can make it difficult for people to concentrate and maintain a train of thought, which manifests itself in the way they speak.
People with disorganized speech may speak incoherently, answer questions with unrelated answers, say illogical things, or change the subject frequently. Disorganized speech signs imply the following:
- Loose associations, fast switching between topics without connections between topics.
- Perseverance, repeating the same things over and over.
- Made up words that only have meaning to the speaker.
- Use of rhyming words without meaning.
When cognitive disorganization is severe, it can be almost impossible to understand what the person is saying.
The patient cannot form coherent or logical thoughts, and this is represented by disorganized speech. During a conversation, the person will not be able to stick to the topic. They will jump from topic to topic. In severe cases, speech may be perceived by others as incomprehensible unintelligible.
Schizophrenia has a negative impact on goal-directed behavior. A person with disorganized schizophrenia is likely to have difficulty starting a specific task (for example, cooking a meal) or difficulty finishing a task.
Independent functioning is exceptionally difficult due to this great disorganization. Disorganized behavior can manifest as follows:
- A decrease in general daily functioning.
- Unpredictable or inappropriate emotional responses.
- Lack of momentum control.
- Behaviors that seem strange or lack purpose.
- Routine behaviors like bathing, dressing, or brushing your teeth can be seriously damaged or lost.
Behaviors can range from being childish and goofy, to aggressive and violent. There may be unprovoked agitation or sexual behavior in public.
Excessive movement, strange actions, freezing in place, or lack of response to instructions or conversations are other ways this symptom can manifest.
Affection refers to a person’s emotional responses, including the way emotions are expressed (for example, smiling when feeling happy).
People with disorganized schizophrenia exhibit a flat effect, meaning they show little or no emotion in their facial expressions, tone of voice, or gestures. Sometimes they exhibit an effect that is inappropriate for the situation, such as laughing at something sad.
In addition to a lack of emotional expression, people with disorganized schizophrenia are likely to experience other negative symptoms, such as a lack of eye contact and dull facial expression.
Negative symptoms : This refers to the inability to function normally and can include symptoms such as poor personal hygiene, social withdrawal, and the inability to show emotions, such as avoiding eye contact or speaking in a monotonous voice.
Development and course of hebephrenia
Disorganized schizophrenia is associated with early onset, between the ages of 15-25. The earlier age of onset is traditionally associated with a poorer prognosis due to lower educational performance, more prominent negative symptoms, and cognitive deficits.
Early detection, diagnosis, and treatment of the disorder contribute to better outcomes.
Causes and risk factors of hebephrenia
Experts aren’t sure what causes schizophrenia, but research suggests there is some type of brain dysfunction, likely influenced by a combination of biological and environmental factors.
Chemicals in the brain, such as the neurotransmitters dopamine and serotonin, may be involved in the onset of schizophrenia.
The condition could be caused by faulty cell-to-cell signaling in the brain, according to 2009 research published in the journal Molecular Psychiatry.
The scientists in the study identified 49 genes that function differently in the brains of schizophrenia patients compared to controls.
Risk factors for schizophrenia include:
Genetics: People with a family history of schizophrenia are at increased risk of developing the condition. If there is no history of schizophrenia, the chances of developing it are less than 1 percent.
However, that risk increases to 10 percent if one of the parents has the condition. Research has suggested that schizophrenia and bipolar disorder have the same genetic basis.
Viral infection : If a fetus is exposed to a viral infection, there is an increased risk of developing schizophrenia. There is no definitive list of viruses that pose a risk, but potential candidates include influenza, herpes, toxoplasmosis, and rubella.
Fetal malnutrition : If the fetus suffers from malnutrition during pregnancy, there is an increased risk of developing schizophrenia.
Severe stress during early life : Children who experience extreme forms of stress early in life may be at risk for schizophrenia. This could be due to child abuse or trauma.
Parents’ age when the baby is born : Children of older parents have a higher risk of schizophrenia than children of younger parents.
Drugs : The use of substances that affect the mind or mental processes during adolescence can increase the risk of developing schizophrenia.
Illegal drug use is common among people with schizophrenia, although it is not certain whether such drug use is a cause or an effect of the illness.
Diagnosis of hebephrenia
If schizophrenia is suspected, a series of medical and psychological tests will be carried out to rule out other conditions. Such tests include:
Physical exam : The patient’s height, weight, pulse, blood pressure, and temperature are checked. The doctor will also listen to the heart and lungs and check the abdomen to rule out other physiological causes.
Complete blood count : to check alcohol and drug use, as well as thyroid function.
Magnetic resonance imaging or CT scan : These imaging techniques are used to look for brain lesions or other abnormalities in the structure of the brain. An EEG can also be used to check brain function.
Psychological evaluation : A doctor or psychiatrist will check mental health status by asking patients about their thoughts, feelings, and behavior patterns.
They will look for anything unusual in the patient’s appearance or behavior, and take a detailed personal and family medical history.
To receive a diagnosis of schizophrenia, several criteria must be met. The DSM-5 describes the criteria for symptoms.
The symptoms are:
- Disorganized speech.
- Disorganized behavior
- Negative symptoms.
The person must experience two of the five key symptoms of psychotic disorders, and at least one symptom must be among the first three listed.
Treatment for hebephrenia
People with schizophrenia will need ongoing treatment, even when symptoms seem to have gone away. At these times, patients may believe that they are fine and do not need further help, but if they stop using their medicine, the symptoms will usually return.
Treatment varies depending on the severity and types of symptoms, the patient’s health, age, and other factors.
This form of schizophrenia is typically associated with early onset (often between the ages of 15 and 25 years) and is believed to have a poor prognosis due to the rapid development of negative symptoms and decreased social functioning.
The use of electroconvulsive therapy has been proposed; however, efficacy after treatment is in question.
Starting treatment as soon as possible is crucial for recovery. Treatment for disorganized schizophrenia involves a multimodal approach, including the following:
Medication management : Medications for schizophrenia can help reduce hallucinations and delusions, paranoia, and cluttered thinking. Finding the correct drug depends on the prominent symptoms of the disease.
Atypical or second-generation antipsychotic drugs are used to treat psychiatric conditions. They differ from typical or first-generation antipsychotics in that they are less likely to cause extrapyramidal symptoms (EPS).
Extrapyramidal symptoms include Parkinsonian-like movements, stiffness, and tremor. Side effects of atypical antipsychotics include weight gain, diabetes, and high cholesterol.
Other medications can be used to treat additional mental health problems in people with schizophrenia, such as antidepressants or anti-anxiety medications.
Psychotherapy : Cognitive Behavioral Therapy (CBT) is recommended to reduce certain symptoms and improve general functioning.
Through cognitive behavioral therapy, people identify goal problems and work to develop specific coping strategies for those problems.
Counseling or psychotherapy may be suggested, usually in conjunction with medications. These techniques treat problems with mental health and emotional regulation.
Psychotherapy helps people identify their feelings and ways of thinking, increasing their ability to cope with challenging situations.
Hospitalization : when symptoms are severe, the patient may need to be hospitalized. A hospital environment can be safer and increases the chances that the patient will get adequate nutrition, better sleep, and help with hygiene.
Life skills training : Life skills assistance can help people with disorganized schizophrenia improve social interactions and increase daily living skills, with the goal of increasing independence.
This training can help the person live independently. This is a vital part of recovery. The therapist can help the patient learn proper hygiene, meal preparation, and communication skills.
There may be help finding work, housing, and joining self-help groups.
Supported Employment Services : People with disorganized schizophrenia benefit from training in the area of finding and keeping a job.
Family education and support : People with disorganized schizophrenia benefit from continued contact with the family. Support in educating the family about treatment and how to support a family member with schizophrenia is crucial.
Family support increases family members’ understanding of the disorder and helps family members develop coping strategies.
Although the signs of disorganized schizophrenia tend to appear at a younger age, they can be difficult to detect. The symptoms of this subtype are often very gradual and are unlikely to go away.
However, with proper and ongoing treatment, the prognosis for disorganized schizophrenia improves.
Help with daily living skills, educational achievement, employment services, and family support play a key role in improving the course of the illness for people diagnosed with disorganized schizophrenia.
Electroconvulsive therapy involves sending an electrical current through the brain to produce controlled seizures or seizures.
It can help patients at high risk for suicide, depression, or those with other serious symptoms who have not responded to other treatments or who cannot take antidepressants.
The controlled seizure triggered by electroconvulsive therapy is believed to cause a significant neurochemical release in the brain. Side effects can include short-term memory loss, which usually resolves quickly.
The doctor should clearly explain the pros and cons of electroconvulsive therapy to the patient and his guardian or family member before carrying out the treatment.
The importance of compliance in treatment
A key issue in treating schizophrenia is compliance. Also known as compliance, compliance in medicine means following the treatment plan.
This can be challenging for schizophrenia patients, and a significant number stop taking their medication within the first 12 months, making things worse for themselves and those around them.
Complications of schizophrenia can include:
- Depression , suicidal thoughts, and suicidal behavior.
- Hygiene problems.
- Substance abuse.
- Inability to find or keep a job that can result in poverty and homelessness.
- Family problems.
- Inability to study or attend school.
- Becoming a victim of crime.
- Smoking-related issues.
Some people with schizophrenia say that smoking helps them focus, but it can interfere with medications and cause serious health problems.
Schizophrenia is a serious, lifelong condition. Being aware of what it entails can help family and friends support a loved one with this condition.
Recovery and prevention of disorganized schizophrenia or hebephrenic schizophrenia
Recovery from disorganized schizophrenia or hebephrenic schizophrenia is a long-term process and not a one-time event. Disorganized schizophrenia or hebephrenic schizophrenia cannot be cured.
Treatment is aimed at eliminating psychotic episodes and managing signs and symptoms.
Having short-term goals and reaching them will help in the recovery process from disorganized schizophrenia or hebephrenic schizophrenia.
Learn about disorganized schizophrenia or hebephrenic schizophrenia and monitor its signs, request the help you need from your partners and a motivated and fulfilling life for yourself. Never forget that you are not the only one experiencing disorganized schizophrenia or hebephrenic schizophrenia.
Disorganized schizophrenia or hebephrenic schizophrenia treatments mean alleviating current side effects, staying away from future psychotic events, and restoring your ability to appreciate an imperative life.
A treatment schedule that is coupled with medicine along with stable services in addition to treatment is the main viable methodology for monitoring disorganized schizophrenia or hebephrenic schizophrenia.
Prevention of disorganized schizophrenia or hebephrenic schizophrenia
Since genetic / hereditary factors are involved, it is not possible to prevent disorganized schizophrenia or hebephrenic schizophrenia.
It is a good idea to begin treatment for disorganized schizophrenia or hebephrenic schizophrenia as soon as it is identified and to follow the plan given by the team of doctors throughout life.
Ongoing treatment will help control the real side effects of disorganized schizophrenia or hebephrenic schizophrenia and allow the person to access the manual for a more important life.
One cannot keep a strategic distance from the likelihood of disorganized schizophrenia or development of hebephrenic schizophrenia. This ailment is normally unavoidable.
Disorganized schizophrenia or hebephrenic schizophrenia has an exceptionally strong association with hereditary qualities, particularly with first degree relatives, eg, biological or relative parents.
Different imaginable outcomes for the creation of disorganized schizophrenia or hebephrenic schizophrenia incorporate an introduction to viral contamination in the prenatal periods, having low oxygen levels in labor, weakness to infections in the early stages, sexual abuse in childhood.
There are social security disability benefits for disorganized schizophrenia or hebephrenic schizophrenia. To recognize the medicinal conditions, the social security has published announcements of debilitation that can help to qualify the disability.
With the ultimate goal of getting the benefits offered to people with schizophrenia problems in mind, he or she should experience the negative effects of:
- Delusions or hallucinations.
- Catatonic behavior or being interrupted.
- Illogical or mixed speech.
- Social withdrawal or lack of cooperation.
In addition to all this, the individual must have therapeutic records that have produced lockdowns of action every day due to disorganized schizophrenia symptoms or hebephrenic schizophrenia problem.
- Participate in day-to-day work or activity.
- Social skills.
- Focusing on any task.
- Have a large sample of indications that are declining.
Prognosis for disorganized schizophrenia or hebephrenic schizophrenia
Victims of disorganized schizophrenia or hebephrenic schizophrenia display disorganized behavior in many ways.
Patients with disorganized schizophrenia or hebephrenic schizophrenia are unable to begin a particular task (for example, bathing or dining) or complete it once they begin.
This is one reason why the anticipation / prognosis is particularly poor for disorganized schizophrenia or hebephrenic schizophrenia.
His serious confusion makes it difficult to work alone. As a result of their great confusion, they often ignore their own cleanliness and appear disoriented.
It is a misconception that disorganized schizophrenia or hebephrenic schizophrenia has no chance of recovery or improvement, the fact is that a large number of people recover.
Think of disorganized schizophrenia or hebephrenic schizophrenia in a similar way to a constant therapeutic infection like diabetes: although there is currently no perpetual treatment, it can be adhered to and the indications can be controlled with medications in addition to strong treatments.