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Schizophrenia - disorganized type

Definition

Disorganized schizophrenia is a type of schizophrenia in which behavior is disturbed and has no purpose.

Alternative Names

Hebephrenic schizophrenia; Disorganized schizophrenia

Causes

The cause is unknown. This type of schizophrenia usually begins before age 25. A family history of depression or psychosis increases the likelihood of having the disease.

Symptoms

• Active, but in an aimless and not constructive way
• Bizarre and inappropriate emotional responses
• False, fixed beliefs (delusions)
• Inability to feel pleasure
• Inappropriate grinning and grimacing
• Lack of emotion and motivation
• Seeing or hearing things that aren't there (hallucinations)
• Silly behavior

Some of these symptoms are also seen in other types of schizophrenia. The main difference is erratic behavior, with speech that is not grammatical or is random-ordered.

Exams and Tests

Diagnosis involves:

• Laboratory tests
• Physical examination
• Psychiatric evaluation

These tests can help rule out other causes of the symptoms.

Treatment

Treatment involves anti-psychotic medications. Newer medications such as olanzapine, risperidone, and clozapine may be effective with fewer side effects.

Sometimes, people with this condition may need to go into the hospital for safety reasons and for faster relief of symptoms.

Outlook (Prognosis)

This is a chronic illness, and it is common for symptoms to return. However, good management and return of function is possible. Involving your family in the treatment process can help.

At times, patients with this condition stop taking their medications. This occurs either because the side effects are unpleasant, or because patients believe they are cured and no longer need the medication. Do not stop taking medications without talking about your concerns with your treatment team.

Family members and community psychiatric services can help ensure that you take your medications correctly and manage any side effects. Newer medications are far less likely to cause disturbing side effects.

Possible Complications

• Chain smoking
• Drug and alcohol abuse
• Loss of ability to work and function socially
• Self-harm, suicide

When to Contact a Medical Professional

Call your doctor if you or a loved one has symptoms of psychosis.

References

International Early Psychosis Association Writing Group. International clinical practice guidelines for early psychosis. Br J Psychiatry. 2005;187:s120-s124.

Addington D, Bouchard RH, Goldberg J, Honer B, Malla A, Norman R, Tempier R. Clinical practice guidelines: treatment of schizophrenia. Can J Psychiatry. 2005;50:7s-57s.

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