Positive negative and disorganized symptoms of schizophrenia

Schizophrenia is a complex and chronic disorder of the brain that affects about 1 percent of the U.S. population.

Characterized by multiple symptoms such as distorted thinking, behavioral difficulties, or altered perceptions of reality, schizophrenia may be described based on these symptoms.

While no longer an official diagnosis, the term hebephrenic, or disorganized, schizophrenia is still used to describe a group of symptoms.

Disorganized or hebephrenic schizophrenia describes a person with schizophrenia who has symptoms including:

• disorganized thinking
• unusual speech patterns
• flat affect
• emotions that don’t fit the situation
• incongruent facial reactions
• difficulty performing daily activities

An individual with schizophrenia who is described as hebephrenic does not have hallucinations or delusions but instead has disorganized behavior and speech.

Once considered a diagnosis, in the newest version of the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5), the official manual that psychiatrists and other mental health professionals use, hebephrenic schizophrenia is no longer an official diagnosis.

However, the term is still considered a diagnosis in another manual, the International Classification of Diseases and Related Health Problems (ICD-10), healthcare professionals use to categorize medical conditions.

What was previously a group of subtypes is now used to describe one main overarching diagnosis and help mental health professionals plan and provide care.

Read this article for more information about subtypes and schizophrenia.

Symptoms of schizophrenia may include:

• hallucinations: hearing, seeing, or feeling things that aren’t there
• delusions: false beliefs or suspicions not shared by others, even in the face of contradictory evidence
• negative symptoms: emotionally flat, no relationships, dull or disconnected speaking voice, apathy
• cognitive issues or disorganized thinking: struggle to complete tasks or thoughts, lack of insight
• abnormal behavior: laughing to self, self-neglect or unkempt appearance, wandering aimlessly

While people with schizophrenia described as disorganized don’t have hallucinations and delusions, they usually have several other symptoms in addition to negative symptoms and disorganized thinking.

Diagnosing schizophrenia can be difficult. There is no specific lab test or physical exam that can diagnose it.

To diagnose it, a doctor or healthcare professional must see symptoms for at least 6 months. Other options need to be ruled out, such as brain tumor, other mental illness, substance-induced psychosis, or other medical conditions.

A diagnosis of schizophrenia means that a person has at least two of the following symptoms consistently, along with reduced functioning:

• delusions
• hallucinations
• disorganized behavior
• catatonia
• negative symptoms

Symptoms that could be considered disorganized schizophrenia include:

• flat affect
• speech disturbances
• disorganized thinking
• inappropriate emotions
• facial expressions that don’t fit the situation
• difficulty with daily activities

Related conditions that may need to be ruled out before a diagnosis can be made include:

• schizoaffective disorder
• psychosis
• bipolar disorder
• schizophreniform disorder
• delusional disorder
• substance use

The exact cause of schizophrenia is unknown. Researchers think there are several contributing factors:

• biological factors
• genetics
• environmental factors
• substance use

Many of these variables are thought to interact with each other in some way to cause schizophrenia. It is also thought that different factors cause different types of schizophrenia.

Risk factors and causes often overlap, since the exact cause of schizophrenia is unknown.

Having a risk factor for a disease or condition does not mean that an individual will definitively develop that condition, but they are at higher risk.

Risk factors for schizophrenia include:

• genetics
• substance use
• environment

There’s no one gene for schizophrenia, but there is thought to be an interaction between genetics and environment. Individuals with a close relative with schizophrenia, like a parent or sibling, are more than six times more likely to develop it as well.

Mind-altering drugs used during adolescence may increase the risk of developing schizophrenia. The younger an individual is and the more frequent the substance use occurs, the higher the risk.

Exposure to viruses or malnutrition in utero, especially in the first and second trimesters, has been shown to increase the risk of later developing schizophrenia.

Treatment goals for schizophrenia include:

• targeting symptoms
• preventing relapse
• increasing adaptive functioning so the person can be in the community

This is usually done with both medications and other treatments.

Treatment options

Treatment options can include:

• psychotherapy
  • cognitive-behavioral therapy (CBT)
  • individual therapy
  • group therapy
• pharmacological therapy
  • antipsychotic medications are the first-line treatments
• assertive community treatment
  • a multidisciplinary therapeutic team approach
  • help reduce hospitalizations and homelessness

Depending on the specific symptoms, sometimes a combination of medications may be used. Medication and therapy are often used together since support systems help increase the likelihood of sticking to a medication routine. Job training and social skills training may also be part of psychotherapy or social supports.

While there are no treatments specific to hebephrenic schizophrenia, CBT can help address disorganized thinking and behaviors and help provide support.

Schizophrenia is a chronic illness, and there is no cure. There are treatments, and sticking to a treatment plan is a good way to help manage these symptoms.

Above-average financial, social, and health concerns may be associated with a schizophrenia diagnosis due to:

• limited access to a nutrient-dense, balanced diet
• increased likelihood of being a smoker and having substance use disorder
• limited access to medical care
• increased risk of suicidal thoughts and attempts
• increased likelihood for treatment-related negative effects
• approximately half of all people with schizophrenia also having other mental health disorders

Combined, these factors can contribute to a higher risk of death for those diagnosed with this disorder.

Treatment with medications, behavioral therapy, and social support are important in helping to manage symptoms of schizophrenia. Treatment may change over time due to medication side effects or if symptoms change. An individual’s doctor can adjust or change medications if a specific drug causes side effects.

For people with hebephrenic schizophrenia, negative symptoms can be associated with higher risks because of the disturbance to behavior and emotions. This is why having a treatment plan and plenty of social supports is essential for management.

Schizophrenia is a complex, serious, and chronic mental health illness. While hebephrenic schizophrenia is no longer its own separate diagnosis through the DSM-5, the features of the illness still remain.

While there is no cure for schizophrenia, there are treatments available that may help manage symptoms and improve quality of life.