This category includes the most psychotic and difficult to treat patients. Once called hebephrenia, disorganized schizophrenia typically appears at a younger age than the paranoid form of the disease. An untreated person with this subtype generally has poor hygiene and an unkempt appearance, which makes him seem clearly disturbed. Deterioration can be steady and quick without treatment.
A Patient with Disorganized Schizophrenia
Meets the general criteria for schizophrenia
Has disorganized speech
Demonstrates disorganized behavior
Shows inappropriate or little emotion
Shows no signs of catatonic behavior
Adapted from the DSM-IV.
A person with disorganized schizophrenia may intersperse speech with laughter or silliness. The humor is called inappropriate by psychiatrists because it has no connection to the topic of conversation, if conversation is even possible. The speech itself will be disorganized. Behavioral disorganization will be so severe that bathing, grooming, and nutritional intake suffer.
If hallucinations and/or delusions are present, they are not as organized, elaborate, and consistent as they are in other forms of the disease, such as paranoid schizophrenia. In keeping with the disorganized nature of this subtype, psychotic symptoms, when present, are disconnected and patchy.