What Are The Symptoms Of Disorganized Schizophrenia?

Disorganized schizophrenia, also known as hebephrenia, is one of five schizophrenia subtypes. The disorder is characterized by disorganized speech and behavior, and it also comes with disturbances in emotional expression. Disorganized schizophrenia patients tend to have less pronounced delusions and hallucinations, but there's still strong evidence these symptoms occur.

The disorder is best managed if diagnosed and treated early. It tends to have earlier ages of onset than several other kinds of schizophrenia, with the first symptoms appearing between fifteen and twenty-five years old. The earlier the age of onset, the more difficult it is for the patient to have a normal quality of life, though diagnosis and treatment can help in any case. There are several different symptoms, most of which relate to an individual's communication and emotional processing.

Schizophasia

Schizophasia is a type of language often called 'word salad' in the mental health field. This language is confused and often repetitive. It can be a symptom of several mental illnesses, including disorganized schizophrenia. The biggest characterization of schizophasia is a confusing word usage of words that don't appear to have any relationship or meaning.

Experts believe when it occurs like this, it's a sign of a formal thought disorder. In the DSM-V, schizophasia is not considered a medical condition of its own, but is instead treated as a symptom of an overarching mental health condition. The intentional production of nonsense isn't the same as schizophrenia. For example, an individual who speaks exclusively in codes or makes up palindromes isn't exhibiting the disorganized thought patterns and speech inherent in schizophasia.

Disorganized Behavior

Disorganized behavior is another hallmark trait of disorganized schizophrenia. This type of behavior can also present in the other types of schizophrenia, but it's less of a central trait. Schizophrenia has a negative impact on goal-directed behavior, which means patients may struggle with executive dysfunction. Executive function is the part of the brain that helps with time management, starting tasks, and meeting goals. Schizophrenia patients may struggle to begin tasks like making meals, or they might have trouble focusing well enough to follow a task through to completion, making it particularly difficult to engage in independent functioning.

There are several ways disorganized behavior can be expressed. One is a steady decline in the ability to function from day to day. Another is inappropriate or unpredictable emotional responses to different stimuli. Patients may engage in behaviors that seem strange or don't have any purpose, and they may struggle with impulse control. Following routines and keeping up with things like brushing teeth, dressing, and bathing can be difficult or impossible.

Inappropriate Or Strange Emotional Responses

Disorganized schizophrenia will often present with inappropriate or strange emotional responses. The way an individual responds emotionally to situations is also called their affect. There are two main components of affect: internal and external. The internal component is how a situation makes them feel on the inside. The external component is how they express those feelings on the outside. Disorganized schizophrenia patients will typically exhibit flat affect when emoting, which means there are few to zero emotions shown in their mannerisms, vocal tone, or facial expressions. Their responses to situations might be inappropriate.

For example, they might laugh at something sad. On top of lacking emotional expression, it's common for those with disorganized schizophrenia to experience further negative symptoms. Negative symptoms are related to a lack of affect, emotional expression, or communication present in neurotypical individuals. Disorganized schizophrenia patients might have blunt facial expressions and fail to make eye contact with others even while engaged in conversation with them. Problems with appropriate emotional response can be the result of other disorders as well.

Loose Associations

Loose associations are a type of thought disorder that happens in schizophrenia. When an individual's thinking becomes severely disordered, their thoughts become disjointed and disconnected because they lack connections to each other. The lack of logical progression in thinking is called loose association or derailment. A patient might jump from one concept to another without any apparent link between them. They might express thoughts they believe make total sense, but those viewing them from outside will be unable to decipher what they mean. Rather than focusing on one core thought, they might move from one idea to the next very quickly.

One type of loose association is clang association, which occurs when the individual picks the words based on how they sound through puns or rhyming, rather than what the words mean. Most clang associations tie in with schizophasia. Some of the nonsensical words might be completely made up. When the thought disorder is severe enough, the structure of the words remains preserved, but an outsider will not be able to see any connection between them.

Fragmented Hallucinations

Regardless of the subtype, schizophrenia is a disorder that can cause varying forms of psychosis, including both delusions and hallucinations. Fragmented hallucinations can be a part of disorganized schizophrenia. One of the most serious ways schizophrenia affects individuals is by causing fragmentation in identity and making self-recognition almost impossible. This can make it difficult for schizophrenia patients to determine what is part of their mind and what isn't.

While some individuals with this condition can recognize when they're experiencing delusions or hallucinations, this ability isn't present in everyone. Some disorganized schizophrenia patients also say they feel like they've been separated from their sense of self, as though they no longer have an identity that fits them. They may feel as if they've become removed from the experience of humanity as a whole, and they can no longer relate to others.