Schizophrenia (disorganized type)

Disorganized schizophrenia is a subtype of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders. This type is characterized by prominent disorganized behavior and speech (see formal thought disorder), and flat or inappropriate emotion and affect. Furthermore, the criteria for the catatonic subtype of schizophrenia must not have been met. This type of schizophrenia is also known as hebephrenia.

Unlike the paranoid subtype of schizophrenia, delusions and hallucinations are not the most prominent feature, although fragmentary delusions and hallucinations may be present.

The emotional responses of people diagnosed with this subtype can often seem strange or inappropriate to the situation. Inappropriate facial responses may be common and behavior is sometimes described as 'silly'. Complete lack of expressed emotion is sometimes seen, as is an apparent indifference, anhedonia (the lack of pleasure), and avolition (a lack of motivation). Some of these features are also present in other types of schizophrenia, but they are most prominent in Disorganized Schizophrenia.

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 poor prognosis because of the rapid development of 'negative' symptoms and decline in social functioning.1

Disorganized schizophrenia is thought to be an extreme expression of the 'disorganization syndrome' that has been hypothesised to one aspect of a three-factor model of symptoms in schizophrenia2. The other factors being 'reality distortion' (involving delusions and hallucinations) and 'psychomotor poverty' (poverty of speech, lack of spontaneous movement and various aspects of blunting of emotion).