Schizophrenia is an overwhelming condition. And the fact that there are multiple subtypes of schizophrenia only makes it more overwhelming.

Each of these has its own set of symptoms and treatment options. One of the most overlooked of these subtypes is disorganized schizophrenia.

What is Disorganized Schizophrenia?

Disorganized schizophrenia is marked by disorganized speech, behavior, and a flat or inappropriate affect. It differs from other types of schizophrenia because you’re unlikely to experience auditory or visual hallucinations. Instead, you’ll struggle with a particular set of symptoms requiring specialized treatment. ¹ These include:

Disorganized Speech

Sometimes referred to as “word salads,” disorganized speech is the most common symptom of this condition. It may resemble the following: ²

• Inconsistent connections within sentences or sentence structure
• Repetitious thoughts, ideas, concepts, or phrases.
• Rhyming words or phrases or using speech that has a rhythmic nature to it
• Speech patterns that are almost unintelligible or lack consistency or coherence (in severe cases)
• Words that aren’t based in reality, usually made up by the speaker

Disorganized Behaviors

You may also struggle with tasks, both big and small. This is a product of disorganized behavior and can look like the following: ³

• A breakdown in normal everyday functions (i.e. bathing, changing clothes, and eating meals routinely)
• Distortion of time, reality, and personal reactions to one’s own environment or surroundings
• Performing actions that have a fundamental lack of purpose or seem strange to others
• Wide range of emotional states that shift suddenly and unexpectedly

Inappropriate Affects

Disorganized schizophrenia can also present what’s known as flat responses, meaning that they commonly don’t have much in the way of physical expressions.

A flat response is when you don’t express yourself through facial reactions or vocal inflections. In other words, a person appears to have a “flat” mood when speaking to someone. With flat responses, it can be difficult to try and decipher a person’s emotional state and understand the help they need. ⁴

Disorganized Schizophrenia Diagnosis

Since disorganized schizophrenia mirrors other mental health conditions, it can be difficult to diagnose. When it comes to diagnosis, a mental health professional will address the following: ⁵

• Your medical and mental health history, which may include family histories
• Your symptoms and their severity
• The safety complications and functionality in your daily life

To confirm a disorganized schizophrenia diagnosis, other pathology examinations may be done: ⁶

• A blood test showing blood count, chemical biomarkers, and thyroid levels
• Brain scans like MRI or CT
• Speech evaluation by a speech pathologist

To have a diagnosis of disorganized schizophrenia, you must exhibit two or more of the symptoms over a month. If you show signs of schizophrenia, you’ll be closely monitored by follow-up appointments to ensure symptoms improve rather than deteriorate.

How Does Disorganized Schizophrenia Develop?

Scientists still aren’t 100% sure what causes disorganized or other types of schizophrenia. However, there is statistical data that can assist in deciphering the developmental age and background of those who have disorganized schizophrenia.

It’s common for people to develop disorganized schizophrenia in adolescence or early adulthood (between the ages of 15 and 25). This is because the brain goes through the most physiological changes and growth during this period.

Risk Factors

When we discuss risk factors, we look at several categories, including:

• A family history of mental illness, including schizophrenia as well as psychoactive disorders. ⁷
• Exposure to viral infections (especially those that attack the brain and its structures). ⁸
• Have been subjected to harsh chemicals or irritants such as lead or gasoline. ⁹
• Imbibed in neurochemicals or continual use of illicit street drugs. ¹⁰

Disorganized Schizophrenia Treatment

Since disorganized schizophrenia is difficult to diagnose, it can also be difficult to treat. Due to this, the most common way to treat all forms of schizophrenia is through a mixture of medication and therapy.

Medication

Most of the medications for disorganized schizophrenia are also utilized for other forms of schizophrenia. These are primarily antipsychotics. You may also be prescribed anti-anxiety meds, mood stabilizers, and anti-depressants. ¹¹

It’s worth noting that some patients have also found relief from incorporating certain vitamins into their diet and other all-natural supplementations.

Therapies

Alongside medication, there are multiple approaches to therapy. The most common route is individual talk therapy where you’ll discuss your psychological state with a psychologist. More specifically, these therapies address negative thought patterns and aim to change them through coping mechanisms. The most common of these is cognitive behavior therapy (CBT). ¹²

Your healthcare provider may also recommend cognitive enhancement therapy (CET). This allows you to identify and reduce triggers or stressors. In one study, it was shown that CET was effective in the management of various forms of schizophrenia, including disorganized schizophrenia. ¹³

Furthermore, social skills training, speech therapies, and social rehabilitation options can further assist you.

Disorganized Schizophrenia Test

Wonder if you have disorganized schizophrenia? Not sure where to start. Many online tests ask questions regarding your symptoms and how common they are. While you cannot use these tests to diagnose schizophrenia, they can help in putting you on the track for the proper treatment.

If you want to identify whether or not you struggle with disorganized schizophrenia, consider the following:

• Do you see or hear things that others don’t?
  • Yes
  • Sometimes
  • No

• Do you feel like you don’t have things in common with others?
  • Yes
  • Sometimes
  • No

• Do you fear that you are not in touch with reality at times?
  • Yes
  • Sometimes
  • No

• Do you have special powers or secret abilities that others do not comprehend?
  • Yes
  • Sometimes
  • No

• Do you have issues completing normal, everyday tasks (ie. showering, brushing your teeth, changing your clothes, doing laundry)?
  • Yes
  • Sometimes
  • No

• Do you struggle to organize your thoughts, actions, or personal items?
  • Yes
  • Sometimes
  • No

• Do others struggle to read your facial features to understand your emotional state?
  • Yes
  • Sometimes
  • No

• Do you fear that there may be someone out to get you or watching what you do?
  • Yes
  • Sometimes
  • No

• Do you struggle to complete assignments at work or school?
  • Yes
  • Sometimes
  • No

• Do others have difficulty understanding what you’re saying?
  • Yes
  • Sometimes
  • No

If you have answered “yes” to multiple questions, you may want to reach out to a mental health professional.

DISCLAIMER: This is a sample self-administered examination. Any results that this test yields aren’t to be taken as a diagnosis or a confirmation that you or others have disorganized schizophrenia or other mental health conditions.

References

¹ Uhlhaas PJ, Phillips WA, Mitchell G, Silverstein SM. Perceptual grouping in disorganized schizophrenia. Psychiatry Res. 2006 Dec 7;145(2-3):105-17. doi: 10.1016/j.psychres.2005.10.016. Epub 2006 Nov 1. PMID: 17081620.

² Kuperberg GR. Language in schizophrenia Part 1: an Introduction. Lang Linguist Compass. 2010 Aug;4(8):576-589. doi: 10.1111/j.1749-818X.2010.00216.x. PMID: 20936080; PMCID: PMC2950318.

³ Ventura J, Thames AD, Wood RC, Guzik LH, Hellemann GS. Disorganization and reality distortion in schizophrenia: a meta-analysis of the relationship between positive symptoms and neurocognitive deficits. Schizophr Res. 2010 Aug;121(1-3):1-14. doi: 10.1016/j.schres.2010.05.033. Epub 2010 Jun 25. PMID: 20579855; PMCID: PMC3160271.

⁴ Gur RE, Kohler CG, Ragland JD, Siegel SJ, Lesko K, Bilker WB, Gur RC. Flat affect in schizophrenia: relation to emotion processing and neurocognitive measures. Schizophr Bull. 2006 Apr;32(2):279-87. doi: 10.1093/schbul/sbj041. Epub 2006 Feb 1. PMID: 16452608; PMCID: PMC2632232.

⁵ Andreasen NC. The diagnosis of schizophrenia. Schizophr Bull. 1987;13(1):9-22. doi: 10.1093/schbul/13.1.9. PMID: 3496659.

⁶ Marder SR. Clinical instruments to evaluate and guide treatment in schizophrenia. Handb Exp Pharmacol. 2012;(213):1-10. doi: 10.1007/978-3-642-25758-2_1. PMID: 23027410.

⁷ Salleh MR. The genetics of schizophrenia. Malays J Med Sci. 2004 Jul;11(2):3-11. PMID: 22973121; PMCID: PMC3433970.

⁸ van den Pol AN. Viral infection leading to brain dysfunction: more prevalent than appreciated? Neuron. 2009 Oct 15;64(1):17-20. doi: 10.1016/j.neuron.2009.09.023. PMID: 19840542; PMCID: PMC2782954.

⁹ Modabbernia A, Velthorst E, Gennings C, De Haan L, Austin C, Sutterland A, Mollon J, Frangou S, Wright R, Arora M, Reichenberg A. Early-life metal exposure and schizophrenia: A proof-of-concept study using novel tooth-matrix biomarkers. Eur Psychiatry. 2016 Aug;36:1-6. doi: 10.1016/j.eurpsy.2016.03.006. Epub 2016 Jun 14. PMID: 27311101; PMCID: PMC5300790.

¹⁰ Steeds H, Carhart-Harris RL, Stone JM. Drug models of schizophrenia. Ther Adv Psychopharmacol. 2015 Feb;5(1):43-58. doi: 10.1177/2045125314557797. PMID: 25653831; PMCID: PMC4315669.

¹¹ Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options. P T. 2014 Sep;39(9):638-45. PMID: 25210417; PMCID: PMC4159061.

¹² Rathod S, Phiri P, Kingdon D. Cognitive behavioral therapy for schizophrenia. Psychiatr Clin North Am. 2010 Sep;33(3):527-36. doi: 10.1016/j.psc.2010.04.009. PMID: 20599131.