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Schizophrenia - disorganized (hebephrenic)
Alternative namesDisorganized schizophrenia is a type of schizophrenia characterized by disinhibited, agitated, and unorganized behavior.
Causes, incidence, and risk factors
As with all types of schizophrenia, the cause is unknown. The onset of this subtype of schizophrenia is usually in late adolescence or early adulthood, below age 25. A family history of depression or psychosis increases the likelihood of having the disease.
People with this form of schizophrenia are more likely than others to develop substance misuse problems. They are particularly likely to become chain-smokers.
Delusions and hallucinations are common and the emotional responses of people with this condition are often bizarre and inappropriate to the situation. Complete lack of emotion is seen frequently as is indifference, inability to feel pleasure, and lack of motivation.
Some of these symptoms are also seen in other types of schizophrenia, but disorganized speech ("word salad" -- statements which make no sense) and behavior are what characterizes this type.
Disorganized patients are usually active but in an aimless, nonconstructive manner. Incongruous grinning and grimacing are common. The patients' behavior is sometimes described as silly or fatuous.
Signs and tests
A clinical evaluation consisting of an interview, a physical examination, and laboratory tests is used to make the diagnosis. Other causes that may result in the symptoms must be ruled out.
Treatment consists of anti-psychotic medications. The atypical anti-psychotics (the newer ones, such as olanzapine, risperidone, and clozapine) tend to work better, and have fewer side effects. Sometimes the patients need acute hospitalization for their safety, and for faster relief of symptoms.
This is a chronic illness, and recurrence of symptoms is common. However, good management is possible. It is necessary for the patient's family to get involved because disorganized schizophrenics often cannot take care of themselves.
People with this condition often stop taking their medications, either because of unpleasant side effects or because they believe they are cured and don't need the drugs any more.
Family members and community psychiatric services can help ensure that medications are taken appropriately and that side effects are tolerable. The newer medications are far less likely to cause disturbing side effects.
Suicide and self-harm are possible serious complications, as is loss of ability to work and function socially. Drug abuse is a major risk, and is found at a higher rate in patients with schizophrenia.
Calling your health care provider
Call your doctor if you or a loved one is experiencing symptoms of psychosis.
Update Date: 5/13/2002Yvette Cruz, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT