Disorganized Schizophrenia

It’s never easy dealing with mental health problems. The symptoms of disorganized schizophrenia can be particularly challenging, having extreme impacts on social and mental health and taking a big emotional toll on people in a sufferer’s support network.

Disorganized schizophrenia is a lifelong disorder. Recovery is possible, but treatment is lifelong too. Understanding what this type of schizophrenia actually is is an important place to start, whether you’re a sufferer or someone you care about is dealing with the disorder.

What is Disorganized Schizophrenia

Like the name suggests, disorganized schizophrenia is characterized by disorganized thoughts and behavior. People with schizophrenia of this type often have difficulty with thought processes, behavior, communication, and social interactions.

This mental health disorder is also known as disorganized hebephrenic schizophrenia, or hebephrenia, which is the Greek word for adolescence. This is because this type typically develops between 15 and 25 years of age. It shares some symptoms with childhood-onset schizophrenia, which typically shows signs as young as 13.

Signs generally appear at a young age, but they aren’t always easy to spot. Because they’re gradual, and because this stage of life is for many people about negotiating life and finding your place in the world, it isn’t always obvious at first.

The cause isn’t clear either, but research suggests it’s a brain disfunction influence by both biological and environmental factors.

Understanding the condition and its manifestation can go a long way to living with disorganized schizophrenia or supporting someone with the disorder.

Disorganized Schizophrenia Symptoms

There are five subtypes of schizophrenia (which we’ll touch on later). Two of the symptoms you’d typically think of – hallucinations and hearing voices – aren’t associated with disorganized schizophrenia. These are more typical of paranoid schizophrenia.

Disorganized thought

This mental health symptom is one of the biggest and is strongly linked to the other symptoms. A sufferer won’t be able to think clearly or logically. They struggle to structure or connect their thoughts.

Formal Thought Disorder is one official name for this, referring to the kind of disorganized thinking that a person with disorganized schizophrenia experiences. It shows itself especially in the way this person talks and behaves. Sometimes they’ll experience thought blocking, when they are unable to take an idea further as if they’ve come against a wall, or lose their train of thought entirely.

Disorganized speech

This is the result of illogical and nonsensical thought patterns. The lack of coherent thought comes through in speech. The person may struggle to hold a structured conversation, shifting from one topic to another. They could stop mid-sentence or answer questions in ways that don’t make sense.

They may not be able to find the words they’re looking for, or will even make up their own (known as neologism). In extreme cases they may speak nonsense that doesn’t even sound like language.

Disorganized behavior

Often someone with disorganized schizophrenia will have extreme behavior, linked again to disrupted thought patterns. Disorganized behavior symptoms may range from childlike actions to aggression and even violence, often unprovoked and without reason. At the other extreme they may be nearly catatonic, or unable to respond to instructions or conversation. They might behave inappropriately in social circumstances.

It’s often be a struggle to cope with the basics of life, like personal hygiene or preparing a meal. On a hot day, for example, someone showing this symptom might wear multiple layers of clothes. Self-care becomes a challenge or could be entirely neglected.

Inappropriate emotions and affect

An inability to express emotions properly or appropriately only makes it more difficult to manage social situations. “Affect” refers to facial expressions, which are key to social interactions. Two classic examples are smiling at inappropriate time or not expressing sympathy when it’s warranted.

Negative symptoms

These are symptoms that don’t directly respond to medical treatment. They are the wider implications of disorganized thought and behavior and the struggle to interact normally in social circumstances, like those given as examples above.

With appropriate treatment and support negative symptoms can improve.

Diagnosis and treatment

As with most psychotic disorders, diagnoses of schizophrenia disorders involves both medical and psychological tests.

This can include a physical examination (helping rule out any physiological causes to the symptoms), a blood count and examination of the thyroid function, and sometimes an MRI or CT scan to check for abnormalities in the brain.

Psychological evaluation is also a crucial step. Potential suffers will be asked about their thoughts, behavior patterns, and feelings.

The number of symptoms shown and their duration and intensity are part of diagnoses of the disorder. Those showing symptoms for a significant part of a one-month period but less than six months may be diagnosed with schizophreniform disorder. If someone is experiencing symptoms of schizophrenia as well as a mood disorder (like depression or bipolar disorder) they may be diagnosed with schizoaffective disorder.

Treatment of the disorder deals with both the “positive symptoms” that can respond to antipsychotic medications and the negative symptoms of the mental illness. Medication will usually be atypical antipsychotics like Invega Sustenna or second-generation antipsychotics. These types are less likely to have some of the side effects of typical medications.

It’s important to remember that even when symptoms are alleviated treatment shouldn’t be stopped or changed without consulting a doctor. It should also be integrated into standard men’s health and women’s health routines.

Psychotherapy, usually in conjunction with medication, will help to treat issues with mental health and the regulation of emotions and behavior. Cognitive-behavioral therapy helps to identify ways of thinking and find useful ways to deal with emotions. Vocational and social training support can also help someone with the disorder to live independently. It’s an important part of recovery.

Finally, support networks are crucial. It’s important for family and friends to have their own support as well to understand the symptoms and how to deal with them and their own concerns. Caring for someone with mental disorders can be a big commitment.

Other Types of Schizophrenia

There are four other types of schizophrenia, which share some psychotic symptoms with disorganized schizophrenia. As we mentioned earlier, in cases where a person shows the symptoms of mood (or affective) disorder as well they may be diagnosed with schizoaffective disorder.

Paranoid schizophrenia

This type of schizophrenia is characterized by unreasonable suspicions and symptoms that usually respond to medical treatment. At least one delusion typically preoccupies the sufferer. Other symptoms of schizophrenia, like the disorganized speech and flat affect associated with disorganized schizophrenia, tend to be less prominent or may not even be present.

Catatonic schizophrenia

Today this disorder is usually considered to be the result of untreated schizophrenia, so it’s a rare subtype. Early treatment and intervention is more common. Patients with schizophrenia of this type will be mostly immobile and resist attempts to be moved. In contrast, they may mimic the movements of other people (echopraxia) or repeat what they say (echolalia).

Undifferentiated schizophrenia

Those who don’t have disorganized schizophrenia or fit into the two previous disorder categories fall into this type. They’ll experience delusions, hallucinations, disorganized speech, and catatonic behavior.

Residual schizophrenia

This term describes those who may be experiencing two key positive symptoms to a lesser extent, but may still have negative symptoms (like difficulty with paying attention, apathy, social withdrawal, and problems with speech). Antipsychotic mediations will often help with positive symptoms like delusions and hallucinations, but negative symptoms may remain.

It’s down to the doctor whether a patient is classified as being simply in a residual phase or as having this subtype.

Living with Disorganized Schizophrenia

It’s a challenge to live with symptoms of psychosis that affect mental health and behavior the way that disorganized schizophrenia does. Untreated, the disorder can have a big impact on how a sufferer integrates with society, not to mention their own mental life.

 But with ongoing treatment, and support for both a sufferer and their support network, it’s possible to recover and live the life they might always have dreamed of.

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
Scroll to Top