Disorganized schizophrenia
| Disorganized schizophrenia | |
|---|---|
| Other names | Hebephrenic schizophrenia, hebephrenia |
| Specialty | Psychiatry |
Disorganized schizophrenia,orhebephrenia,was a subtype ofschizophreniaprior to 2013. Subtypes of schizophrenia were no longer recognized as separate conditions in theDSM 5,published in 2013. Thedisorderis no longer listed in the 11th revision of theInternational Classification of Diseases(ICD-11).
Disorganized schizophrenia was classified withinICD-10[1]the existing classification, in practice, until January 1, 2022,[2]as amentalandbehaviouraldisorder,[1]because the classification was thought to be an extreme expression of thedisorganization syndromethat has been hypothesized to be one aspect of a three-factor model of symptoms in schizophrenia,[3]the other factors beingreality distortion(involving delusions and hallucinations) andpsychomotor poverty(lack of speech, lack of spontaneous movement and various aspects of blunting of emotion).
Presentation
[edit]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 ofHera.[4]The term refers to the ostensibly more prominent appearance of the disorder in persons around puberty.[5]
The prominent characteristics of this form are disorganized behavior and speech (seeformal thought disorder), including loosened associations andschizophasia( "word salad" ), and flat or inappropriateaffect.In addition,psychiatristsmust rule out any possible sign ofcatatonicschizophrenia.
The most prominent features of disorganized schizophrenia are notdelusionsandhallucinations,as in paranoid schizophrenia, although fleeting and fragmentary delusions (unsystemized and oftenhypochondriacal) and hallucinations are 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.[6]
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. Sometimes, there is a complete lack of emotion, includinganhedonia(lack of pleasure), andavolition(lack of motivation). Some of these features are also present in other types of schizophrenia, but they are most prominent in disorganized schizophrenia.
Treatment
[edit]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 poorprognosisbecause of the rapid development of negative symptoms and decline in social functioning.[7]
Use ofelectroconvulsive therapyhas been proposed;[8]however, theeffectiveness after treatment is in question.
See also
[edit]References
[edit]- ^abSartorius, Norman;Henderson, A.S.; Strotzka, H.; et al.The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines(PDF).World Health Organization.pp. 76, 80–1.Retrieved23 June2021– via who.int.
- ^"Event Information - Overview".rcpsych.ac.ukRoyal College of Psychiatrists.Archived fromthe originalon 24 June 2021.Retrieved24 June2021.
- ^Liddle PF (August 1987). "The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy".Br J Psychiatry.151(2): 145–51.doi:10.1192/bjp.151.2.145.PMID3690102.S2CID15270392.
- ^Athanasiadis, Loukas (December 1997)."Greek mythology and medical and psychiatric terminology"(PDF).The Psychiatrist.21(12): 781–782.doi:10.1192/pb.21.12.781.
- ^"The very great majority of cases [of dementia præcox] begin in the second or third decade; 57 per cent, of the cases made use of in the clinical description began before the twenty-fifth year. This great predisposition of youth ledHeckerto the name hebephrenia, "insanity of youth," for the group delimited by him;Cloustonalso, who spoke of an "adolescent insanity," had evidently before everything dementia praecox in view.... Hecker was even inclined to regard the issue of his hebephrenia just as an arrest of the whole psychic life on the developmental stage of the years of puberty. In fact, we find in silly dementia at least many features which are well known to us from the years of healthy development. Among these there is the tendency to unsuitable reading, the naive occupation of the mind with the "highest problems," the crude "readiness" of judgment, the pleasure in catch words and sounding phrases, also sudden changes of mood, depression and unrestrained merriment, occasional irritability and impulsiveness of action. Further the desultoriness of the train of thought, the half-swaggering, boastful, half-embarrassed, shy behaviour, the foolish laughing, the unsuitable jokes, the affected speech, the sought-out coarseness and the violent witticisms are phenomena which in healthy individuals, as in the patients, indicate that slight inward excitement which usually accompanies the changes of sexual development. "FromKraepelin, EmilDementia praecoxandparaphrenia,Chapter IX "Frequency and Causes", Chicago Medical Book. Co., (Text), 1919
- ^American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC. code 295.10 pp314
- ^McGlashan TH, Fenton WS (1993)."Subtype progression and pathophysiologic deterioration in early schizophrenia".Schizophr Bull.19(1): 71–84.doi:10.1093/schbul/19.1.71.PMID8451614.
- ^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.PMID17187911.S2CID20354089.
External links
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