Hebephrenic schizophrenia, also known as disorganized schizophrenia, is a presentation of schizophrenia marked by disorganized thoughts and behaviors. Once considered to be a subtype of schizophrenia, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) doesn’t treat it as a separate diagnosis. Previously, they treated the 5 subtypes (catatonic schizophrenia, hebephrenic schizophrenia, undifferentiated schizophrenia, residual schizophrenia, and paranoid schizophrenia) separately. Now the term hebrephrenic schizophrenia is used to describe the symptom of disorganization that someone with schizophrenia may experience.

Signs & Symptoms of Disorganized (Hebephrenic) Schizophrenia

Schizophrenia symptoms are divided into three main categories.

  • Positive symptoms: Impact a person’s perception of reality and may include hallucinations and delusions
  • Negative symptoms: Involve an absence of normal mental functions, like motivation and emotional response
  • Cognitive symptoms: Affect memory, concentration, and the ability to organize thoughts

People with hebephrenic schizophrenia are most likely to experience cognitive symptoms. These symptoms can interfere with the way that the brain uses and stores information.

“Disorganized schizophrenia’s major description is in the name. Disorganized thinking, which causes difficulty in doing everyday tasks and misalignment of facial expressions that don’t fit social cues, are consistent with this disorder. Medication and therapy can help manage these symptoms.”

Talkspace therapist Karmen Smith, LCSW, DD

 

Hebephrenic schizophrenia signs

When a person has disorganized schizophrenia, they may show signs that their cognitive function is impaired. Behaviors associated with this presentation of schizophrenia include:

  • Using nonsense words 
  • Responding to questions with an unrelated answer
  • Using words out of order
  • Having inappropriate emotional responses
  • Struggling with basic hygiene and everyday tasks  
  • Struggling with working memory
  • Frequently losing things
  • Writing words or phrases that don’t make sense
  • Repeating words or phrases
  • Experiencing reduced impulse control
  • Finding it difficult to complete tasks

Hebephrenic schizophrenia symptoms

The word hebephrenic comes from the Greek “hebephrenie,” which means “mental disorder that occurs during puberty.” However, schizophrenia symptoms typically appear during the late teen years or early 20s. The accepted hebephrenic definition states that it’s a form of schizophrenia marked by incoherence and inappropriate emotional responses.

Disorganized schizophrenia can impact speech, thoughts, emotions, and behavior. It can significantly interfere with one’s ability to function every day. Some of the symptoms associated with this presentation of schizophrenia include:

  • Issues with speech 
  • Difficulty concentrating
  • Inappropriate emotions and facial expressions
  • A flat emotional affect 
  • Problematic or poor decision-making

Complications for those with disorganized schizophrenia

This form of schizophrenia can lead to many complications and struggles in life, especially when the condition goes untreated. Perhaps the most serious, people with schizophrenia have an increased risk of depression and suicide. 

Other potential complications of hebephrenic schizophrenia can include:

  • Issues with personal hygiene
  • Poor living conditions 
  • Unemployment
  • Poverty
  • Malnutrition
  • Homelessness
  • Substance abuse

Diagnosing Disorganized (Hebephrenic) Schizophrenia

Before someone can be diagnosed with schizophrenia, healthcare providers must rule out other possible conditions that might be causing or contributing to symptoms. During an assessment, a doctor might ask someone to undergo drug screenings, blood tests, and brain scans. Once all other factors have been ruled out, a full psychiatric evaluation will likely be the next step. 

A psychiatric evaluation can offer more information about a person’s family history, symptoms, and lifestyle. For someone to be diagnosed with schizophrenia, they must have at least 2 of the following 5 symptoms:

  • Hallucinations 
  • Delusions
  • Disorganized speech 
  • Catatonic or disorganized behavior
  • Negative symptoms

Additionally, symptoms must interfere with daily life and relationships and be present for at least 6 months. If someone has schizophrenia symptoms that have been present for less than 6 months, they may be diagnosed with brief psychotic disorder or schizophreniform disorder (which presents with all the psychotic symptoms of schizophrenia but only lasts for 1 – 6 months rather than the rest of someone’s life). If symptoms persist beyond that 6 month mark, the diagnosis may be updated to schizophrenia.

What Causes Disorganized (Hebephrenic) Schizophrenia?

Experts don’t know the exact cause of schizophrenia, but it’s unlikely that it has just one single cause. Most research suggests that people develop schizophrenia due to a combination of genetic and environmental factors. 

Risk factors that have been linked to schizophrenia include:

Genetics and heritability
Genetics are likely to play a role in the development of schizophrenia. Twin studies show that schizophrenia is highly heritable, with estimated heritability rates as high as 79%. Some of our research indicates that genetics might make someone vulnerable to schizophrenia, but it won’t always cause them to definitely develop the condition. 

Brain structure and function
It’s also probable that brain function and structure play a role. Brain scans consistently show that people with schizophrenia have deficits in gray matter. Other recent research indicates that schizophrenia symptoms may be linked to an imbalance in neurotransmitters like dopamine, serotonin, and glutamate.

“In families, people can be shamed for not holding a job or being a responsible adult, not realizing that these symptoms could be disorganized (hebephrenic) schizophrenia. People who feel shame but have no understanding of their condition could be further harmed by the judgment of others. Therapy and medication can help these individuals work on their goals.”

Talkspace therapist Karmen Smith, LCSW, DD

Treatment for Disorganized (Hebephrenic) Schizophrenia

A combination of medication and psychotherapy is usually recommended as a treatment for schizophrenia. There is no cure for schizophrenia, but treatment can have a significant impact, especially for people with disorganized schizophrenia. Managing psychotic symptoms can make it possible for someone with schizophrenia to find employment, establish and nurture healthy relationships, and live independently. 

Medication

There are several types of medication for schizophrenia. All medication won’t work the same way for everyone, though. Some people may respond more positively to certain medications than others. That said, the right medication can significantly improve function and concentration while reducing disordered thinking in many cases. 

Atypical and Typical Antipsychotics
Antipsychotic medications can reduce the severity and frequency of several schizophrenia symptoms, including hallucinations, delusions, and disorganized thinking. 

Antidepressants
In addition to antipsychotics, other medications like antidepressants might be suggested to treat symptoms of depression.

Mood stabilizers
For some people, mood stabilizers might be an effective option in treating schizophrenia. 

Psychotherapy

While medication might be helpful for some people in managing schizophrenia symptoms, combining medication with talk therapy will almost always result in better outcomes. Psychotherapy can give people a solid understanding of their symptoms and help them develop essential skills and coping strategies. 

A form of psychotherapy known as cognitive behavioral therapy (CBT) is often used in the treatment of schizophrenia. In studies, CBT has been found to be an effective way to treat schizophrenia symptoms that are resistant to medication. 

Combining CBT with medication can often quickly reduce the severity of positive symptoms, ultimately helping people learn valuable skills like emotional regulation, which is a classic struggle for those with schizophrenia.

Get Professional Help with Talkspace

While schizophrenia is strongly associated with positive symptoms such as hallucinations and delusions, it can present in other ways as well. Many people aren’t familiar with any kind of hebephrenic definition, which means that those who might be suffering may not have support in seeking treatment. If you or a loved one has shown symptoms of this condition, a diagnosis and treatment can help you manage symptoms and get more out of life. 

If you’re concerned about hebephrenic schizophrenia, in yourself or in someone you know, you should reach out for help. Not sure where to start? Consider Talkspace, the online therapy platform that’s changing the experience of therapy for countless people. 

When therapy is easy to access, affordable, and convenient, you’re much more likely to use it to overcome mental health challenges and conditions (like disorganized schizophrenia). If you’re ready to deal with hebephrenic schizophrenia, or just want more information if you’re concerned for yourself or a loved one, reach out to Talkspace today.