Hebephrenic Schizophrenic

Hebephrenic schizophrenia, more commonly known as disorganized schizophrenia, is one of the subtypes of schizophrenia. It is a complex and chronic psychiatric disorder. The term “hebephrenic” is an older term which is still used in some classifications of psychiatric disorders with regards to this type of schizophrenia. The primary symptoms include significant impairment in thought processes, speech, behavior, and emotional expression and response.

Characteristics and Symptoms

There are three prominent symptoms which are characteristic of hebephrenic schizophrenia:

Disorganized speech

Disorganized speech may be evidenced in a variety of ways. For example, when responding to a question, the person may give an answer which has little or no relevance to the question. S/he may abruptly jump from one topic to another while talking, or make up words as s/he goes along. In particularly severe cases, the person’s words may be complete nonsense, sometimes referred to as “word salad”.

This impairment in speech is due to significant impairment in the person’s thinking. His/her thought processes are often illogical, and don’t connect very well. Hence it shows up in his/her speech.

Hebephrenic schizophrenics often experience something known as “thought blocking”. They may stop suddenly while talking, as if the thought abruptly left them. They may express feeling as if someone or something removed the thought from their mind.

Disorganized behavior

When a schizophrenic’s behavior is considered “disorganized”, it may mean s/he is unable to or lacks the motivation to start or carry out a given task, such as preparing a meal or getting dressed. Their behavior may be bizarre, such as wearing layer upon layer of clothing in the middle of summer. Or, their behavior may be grossly inappropriate, such as acting out sexually in public. They may completely neglect personal grooming and have a very unkempt appearance.

Blunted or inappropriate emotional expression and response

A person with hebephrenic schizophrenia will often appear to have no emotions. His/her face may look completely blank, and his/her speech may be monotone. At times, s/he may have an emotional response which is completely irrelevant to the context, such as laughing or giggling suddenly, when nothing funny has occurred.

Additional Diagnostic Criteria

In order to meet the diagnosis of schizophrenia, regardless of the type, these other criteria must also be met:

  • A marked decline in functioning, after the onset of symptoms, in at least one of the primary aspects of the person’s life (e.g., work, school, relationships, self-care).
  • Signs of the disorder are present continuously for a period of at least 6 months. For at least one month of that time period (less if they subside due to effective treatment), the active-phase symptoms (e.g. delusions, hallucinations, extremely disorganized behavior, etc.) must be present.
  • Schizoaffective disorder (a disorder similar to schizophrenia but with prominent mood episodes) or other mood disorder have been ruled out.

Other Characteristics

Other characteristics often exhibited by individuals with hebephrenic schizophrenia may include poor job or school performance, social withdrawal, lack of coordination, odd postures, childlike silliness, or grimacing. While they may have hallucinations or delusions, they are not pronounced. Since they are often quite impaired, living independently may be impossible for them.

written by Dr. Cheryl Lane, PsyD

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