出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/06 03:37:15」(JST)
| Hebephrenic schizophrenia | |
|---|---|
| Classification and external resources | |
| ICD-10 | F20.1 |
| ICD-9-CM | 295.1 |
| MeSH | D012562 |
Disorganized schizophrenia, also known as hebephrenia, is a subtype of schizophrenia, as defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV code 295.10.[1]
Disorganized schizophrenia is thought to be an extreme expression of the disorganization syndrome that has been hypothesized to be one aspect of a three-factor model of symptoms in schizophrenia,[2] the other factors being reality distortion (involving delusions and hallucinations) and psychomotor poverty (lack of speech, lack of spontaneous movement and various aspects of blunting of emotion).
The condition is also known as hebephrenia, named after the Greek term for "a boy" - hebeos, and possibly the ancient Greek goddess of youth, Hebe, daughter of Hera.[3] The term refers to the ostensibly more prominent appearance of the disorder in persons around puberty.[4]
The prominent characteristics of this form are disorganized behavior and speech (see formal thought disorder), including schizophasia and flat or inappropriate emotion and affect. In addition, psychiatrists must rule out any possible sign of catatonic schizophrenia.
The most prominent features of disorganized schizophrenia are not delusions and hallucinations, as they are in paranoid schizophrenia,[5][6] although fragmentary delusions and hallucinations may be present. A person with disorganized schizophrenia may also experience behavioral disorganization, which may impair his or her ability to carry out daily activities such as showering or eating.[7]
The emotional responses of such people often seem strange or inappropriate. Inappropriate facial responses may be common, and behavior is sometimes described as 'silly', such as inappropriate laughter. Sometimes there is a complete lack of emotion, including anhedonia (the lack of pleasure), and avolition (a lack of motivation). Some of these features are also present in other types of schizophrenia, but they are most prominent in disorganized schizophrenia.
This form of schizophrenia is typically associated with early onset (often between the ages of 15 and 25 years) and is thought to have a poor prognosis because of the rapid development of negative symptoms and decline in social functioning.[8]
Use of electroconvulsive therapy has been proposed;[9] however, the effectiveness after treatment is in question.
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| リンク元 | 「統合失調症」 |
| Ａ． | 特徴的症状：以下のうち2つ以上が1ヶ月以上の存在 |
| (1) 妄想 | |
| (2) 幻覚 | |
| (3) 解体した会話 | |
| (4) ひどく解体したまたは緊張病性の行動 | |
| (5) 陰性症状：感情平板化、思考貧困、意欲欠如 | |
| Ｂ． | 社会的または職業的機能の低下 |
| Ｃ． | 期間：少なくとも6ヶ月間存在 |
| Ｄ． | 失調感覚障害(統合失調感情障害)と気分障害を除外 |
| Ｅ． | 物質や一般身体疾患の除外 |
| Ｆ． | 広汎性発達障害との関係：自閉性障害や 他の広汎性発達障害の既往歴がある場合、 顕著な幻覚や妄想が少なくとも1ヶ月存在すること |
| (a) | 考想化声 thought echo、考想吹込 thought insertion、思考奪取 thought withdrawal、考想伝播 thought broadcasting | いずれか1つ |
| (b) | させられ体験 delusion of control、身体的被影響体験 delusion of influence、妄想知覚 delusional perception | |
| (c) | 注釈幻声、会話形式の幻聴 auditory hallucination | |
| (d) | 宗教的・政治的な身分や超人的な力や能力といった、文化的に不適切で実現不可能なことがらについての持続的な妄想（たとえば天候をコントロールできるとか、別世界の宇宙人と交信しているといったもの）。 | |
| (e) | 持続的な幻覚が、感傷的内容を持たない浮動性あるいは部分的な妄想や支配観念に伴って継続的に（数週から数ヶ月）現れる。 | いずれか2つ |
| (f) | 思考の流れに途絶や挿入があり(思考途絶)、その結果まとまりのない話しかたをしたり(連合弛緩)、言語新作が見られたりする。 | |
| (g) | 興奮、常同姿勢、蝋屈症、拒絶症、緘黙、昏迷などの緊張病性行動 catatonic behavior。 | |
| (h) | 著しい無気力、会話の貧困、情動的反応の鈍麻や不適切さのような、社会的引きこもりや、社会的能力の低下をもたらす陰性症状。 | |
| (i) | 関心喪失、目的欠如、無為、自分のことだけに没頭する態度、社会的引きこもりなど、個人的行動の質的変化。 |