Disorganized schizophrenia
Mental disorder
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Disorganized schizophrenia, or hebephrenia, is an obsolete term for a subtype of schizophrenia. It is no longer recognized as a separate condition in DSM-5 and ICD-11, published in 2013 and 2022, respectively.[1] It was originally proposed by the German psychiatrist Ewald Hecker in the 1870s.[2][3]
| Disorganized schizophrenia | |
|---|---|
| Other names | Hebephrenic schizophrenia, hebephrenia |
| Specialty | Psychiatry |
Disorganized schizophrenia was classified up to ICD-10[4] as a mental and behavioural disorder,[4] 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,[5] 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). It is considered to have relatively poor prognosis.[6]
Presentation
The subtype was named by Ewald Hecker as hebephrenia,[7] meaning "insanity of youth" after the Greek term for "adolescence" – ἥβη (hḗbē) – and possibly Hebe, the goddess of youth from the Greek mythology.[8] The name referred to the ostensibly more prominent appearance of the disorder in teenagers and young adults.[9]
The prominent characteristics of the subtype were considered to be disorganized behaviour and speech (formal thought disorder), which may include loosened associations and schizophasia ("word salad"), flat or socially inappropriate affect, mannerism, and behaviour. Inappropriateness refers to the quality of an action that, when considering the circumstances under which it is performed, is perceived by social norms to be awkward, offensive or otherwise unacceptable. Delusions, hallucinations and behavioural disorganization may also be present; the lattermost describes one's impaired ability to carry out normal daily activities.[10]
The emotional responses of sufferers diagnosed with the subtype could seem strange or inappropriate, including inappropriate facial expression or laughter, or contrastingly a complete lack of emotion, including anhedonia (lack of pleasure), and avolition (lack of motivation). The subtype was considered to be one in which these features were more prominent than in other types of schizophrenia.