Hebephrenic schizophrenia: diagnosis
Hebephrenic schizophrenia usually begins gradually between the ages of 15 and 25. However, it can also develop later. Speech and drive disorders and disorganized thinking are predominant. Concentration disorders and depesssions are often the first signs of the disorder as grades at school deteriorate. Those affected also become increasingly withdrawn and neglect friends, family and hobbies. In the early stages of hebephrenic schizophrenia, those affected are often noticeably shy and withdrawn.
According to the “International Statistical Classification of Diseases and Related Health Problems” (ICD-10), the following criteria apply to the diagnosis of “hebephrenic schizophrenia” (this form is no longer included in the new ICD-11):
- The general criteria for schizophrenia are present.
- Emotions are permanently flattened or superficial or inappropriate (e.g. laughing at a funeral).
- Behavior is aimless and incoherent; speech is incoherent and disjointed.
- Hallucinations and delusions are absent or only present in mild form.
Hebephrenic schizophrenia: altered emotions
Hebephrenic schizophrenia: disorganized behaviour and speech
Hebephrenic schizophrenia patients behave inappropriately, unpredictably and irresponsibly. For example, in a sad situation they may suddenly start making faces or making other “faxes”. This inappropriate behavior appears childish and silly to observers. Uninhibited and aloof behavior is also often observed.
It is also typical for hebephrenic schizophrenia patients to complain about fears of illness (hypochondriacal complaints). Their speech is also severely impaired. They often form meaningless sentences or repeat words. Their thoughts are incoherent.
Movements or actions can also appear bizarre if they are performed repeatedly or in a strange way (mannerisms). Hebephrenic schizophrenia patients do not show any intention in their behavior. As the illness progresses, those affected become increasingly withdrawn. They no longer pursue any interests and no longer care about their outward appearance.
In contrast to paranoid schizophrenia, patients with hebephrenic schizophrenia rarely suffer from delusions and hallucinations.
Hebephrenic schizophrenia: prognosis
Those affected are treated with certain antipsychotic drugs (atypical neuroleptics) as well as socio- and psychotherapy. However, the medication is often not effective enough for hebephrenic schizophrenia. Many sufferers therefore require long-term treatment in a clinic. There, patients learn how to deal with hebephrenic schizophrenia. If they are able to do so, they are encouraged to organize their day independently within the clinic.
