Heboid syndrome - an explosive mixture of schizophrenia, psychopathy and antimorality

Heboid syndrome can be conditionally classified as a syndrome of distorted (disharmonious) development. This can be explained by the relatively late manifestation of the pathology - most often during puberty.

The syndrome is characterized by pronounced manifestations of distortions, destruction or loss of certain personality components, which brings it closer to psychopathic states and distinguishes it from psychopathic syndromes. The occurrence of this disease and the role of mental development in its origin have not been sufficiently studied.

Thus, according to information from BiB.social, heboid syndrome is a system of symptoms characterized by painful sharpening and distortion of emotional-volitional personal qualities, characteristic mainly of adolescence. The syndrome was first described in 1890 by K. Kahlbaum, who designated it with the term “heboidophrenia” in connection with symptoms similar to hebophrenia.

How does the syndrome manifest itself?

Pronounced psychopathological features of heboid syndrome:

• disinhibited state, perversion of primitive drives, especially sexual;
• disappearance or distortion of moral principles (the concept of good and evil, legal and behavioral) and a tendency in this regard to antisocial and illegal actions;
• dulling of emotions with the absence or decline of such higher emotional manifestations as feelings of pity, empathy, compassion;
• increased emotional excitability with a tendency to aggressive behavior;
• pronounced egocentrism and the desire to satisfy the lowest needs, criticism with a special desire to resist accepted social attitudes and behavioral norms;
• loss of interest in any work activity, especially learning.

Many scientists have been studying heboid syndrome, its psychopathology and its manifestations in various diseases. The dynamics of development are little described, mainly in schizophrenia in adolescents and young adults.

Childhood and syndrome

How does heboid syndrome manifest itself in children?

Research shows that the syndrome is often preceded by behavioral disorders in childhood, especially a sadistic perversion of sexual desire, a desire to mock loved ones, harm other adults and children, abuse animals, experiencing pleasure, desire for everything that can cause disgust or disgust in many people. Children enjoy playing with worms, caterpillars, spiders, and spend hours rummaging through trash cans and landfills.

They have a special attitude to different emotions, to negative events and incidents (road accidents, quarrels, fighting, murder, fire). Psychopathology can also be expressed in a tendency to steal, leave home, act cruelly, and be gluttonous. Other components of this syndrome are often added to the disturbances of desire in children: incomprehensible stubbornness, a tendency to contradict adults, lack of pity for others.

Diagnosis and treatment of hebephrenia

Patients are excluded from pathologies such as frontal lobe tumors, Pick's disease, or Huntington's disease. Doctors are based on the characteristic symptoms of the disease:

• there is no purposefulness in actions;
• motor-volitional changes (foolishness);
• disorganized speech;
• instinctive forms of behavior: eating inedible things, sloppiness;
• fragmentary delusions and hallucinations.

Patients are prescribed treatment in a neuropsychiatric hospital. The following medications are prescribed:

1. Neuroleptics: Aminazine, Haloperidol, Rispolet.
2. Tranquilizers.
3. Vitamins.

For maintenance therapy, long-acting forms of antipsychotics and lithium preparations are indicated. Antipsychotic drugs significantly improve the condition of patients. With adequate treatment, delusions, hallucinations, and aggressive behavior are eliminated.

The conditions for successful therapy are:

1. Constant long-term use of medications.
2. Strict adherence to the regimen and dosage of medications.
3. The dosage of antipsychotics is selected strictly individually, slowly increased until effective and very slowly withdrawn.

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Early diagnosis and treatment of hebephrenia significantly improves the prognosis and outcome of the disease. Among the recommended methods, doctors include cognitive behavioral therapy and the help of a psychotherapist if patients have experienced at least one stable remission.

The most common manifestations of the syndrome

With the manifestation of heboid syndrome in adolescence, as in cases of earlier occurrence of such disorders, the pathology of drives comes to the fore in the form of their intensification and perversion. Teenagers' sexuality increases, they masturbate vigorously, often without even hiding it, they talk about sex with pleasure, become cynical, often use indecent expressions, strive to have sex, and sometimes show various sexual perversions.

In addition, they exhibit distinctive signs of a perversion of sexual desire, often sadistic, which at first is directed mainly against relatives, especially against the mother. Teenagers try everything all the time to be angry, bully, terrorize and beat up their family members. Perversion of instincts includes increased aggressiveness, lack of disgust, refusal of hygiene, and untidiness.

Dissocial aspect

One patient was expelled from the university because of her obvious immoral behavior. The hostel administration considered her to be depraved. In reality, all her antics were aimed at shocking other undergraduate and graduate students. She inserted various objects into her vagina and imitated pleasure from anal sex toys. And all this was done in front of a crowd of people. The main goal is to act differently from everyone else. Such oddities sometimes increase the degree of risk. Not all people can calmly react to non-standard and provocative behavior.

In hospitals, such patients rarely go unnoticed. They can do many undesirable things - try to disorganize the treatment process of all other patients, make noise, and can become the initiators of drinking alcohol and running away. If a person is also prone to cruelty, then he may mock other patients or try to do so.

Sometimes they deliberately create the illusion of having some super-valuable idea. It can be a symbiosis of fragments of the teachings of various religions, philosophical systems and scraps from science fiction. One patient sat on his bed almost every night, hugging his pillow and looking out the window with sparkling eyes. At the same time, he talked about how everything is light and this light can be realized. These thoughts brought him into unusual excitement and he began to walk, wave his arms and talk about how all this was a dance of light and shadow.

Worth seeing: Psychopathic-like schizophrenia

Differences from other forms of pathologies

A comparative age-related analysis of heboid disorders in children, performed in different periods of adolescence, indicates that the main component of the described syndrome is behavioral disorders that increase with age.

The dynamics of heboid syndrome vary depending on the form in which it occurs. In borderline disorders, in particular psychopathy and organic psychopathic states, such manifestations can often be smoothed out by the end of adolescence or during adolescence. In schizophrenia, heboid symptoms persist for 15-20 years.

Heboid syndrome is especially characteristic in its most common form in the continuous sluggish course of schizophrenia and the initiation of other forms with manifestation in adolescence. It has also been suggested that some long-term heboid states are an atypical manifestation of schizophrenia. According to some authors, the syndrome can also be noticeable at the initial stage of paranoid and retrograde schizophrenia.

Diagnosis of the disorder

In this pathological condition, manifestations such as delusions, hallucinations, and emotional coldness, inherent in more common forms of schizophrenia, are erased, so a comprehensive psychiatric and neurological examination is required to make an accurate diagnosis. To exclude brain tumors, injuries and epilepsy, which may be accompanied by similar symptoms, the following studies are carried out:

• NMR;
• EchoEG;
• EEG;
• CT.

To clarify the diagnosis, a number of tests are performed to assess the psychological and mental state. The doctor pays attention to the patient’s behavioral characteristics. In addition, conversations are held with parents and teachers who had contact with the teenager.

What are the causes of pathology?

The causes of heboid syndrome are not fully understood. It is described in psychopathy and psychopathic states caused by brain infections and trauma. However, psychopathic individuals with heboid manifestations are often included in the group of so-called asocial or emotionally stupid. Due to age-related changes, the separation of heboid states with different classification forms is very difficult. In differentiated diagnosis, in most cases, one has to look not so much at the classification differences of the syndrome, but at the associated symptoms and the clinical picture of the disease as a whole, including the dynamics described above.

Forms, types and types of schizophrenia in ICD-11

The new International Classification of Diseases (ICD-11), introduced by the World Health Organization (WHO) in June 2018, includes changes regarding, in particular, the diagnosis of schizophrenia. For example, subtypes of schizophrenia (paranoid, catatonic, hebephrenic, etc.) were completely eliminated, diagnostic criteria were revised, variants of the course were introduced (first episode, multiple episodes, continuous course) and stages of endogenous psychosis (acute episode, partial remission and complete remission) . Instead of forms of schizophrenia, ICD-11 introduced dimensions, leading symptoms - positive, negative, depressive, manic, psychomotor, cognitive.

Schizophrenia and heboid syndrome

They often walk side by side. In schizophrenia, the syndrome manifests itself in a particularly pronounced perversion of sexual desire with strong sadistic actions and emotional coldness. Autistic behavior, various thought disorders, unreasonable mood swings with attacks of fear and anxiety, alternation of anger and irritation with strange jokes, mannerisms, grimaces (similar to manifestations of heboidophrenia), autistic components of fantasies, rudimentary productive symptoms (delusions, episodic ideas of relationships) are also noted . In the case of the stage of adolescent retrograde schizophrenia, the appearance of heboid disorders is preceded by pronounced negative symptoms.

Knowledge of the syndrome

The features of heboid syndrome in psychopathy have been little studied. Manifestations of heboids are associated with age, and, according to statistics, most often such deviations are observed in males. At the same time, literary data indicate the possibility of more or less pronounced heboid states as a method of sexual decompensation in some developing psychopathy (mainly in the group of excitable and hyperthymic ones). In such cases, there are mainly pathologies of exacerbation and mild distortion of adolescent personality shifts, mainly emotional and volitional, which were described earlier.

In the described developmental system, not only sadistic and perverted inclinations predominate, but also increased drives. Rudeness, sharpness, affective outbursts, and aggression arise under the influence of various situations, as manifestations of pathological protest reactions, unfounded or for an insignificant reason, and not against an emotionally cold background. Opposition to parents is associated with reactions of independence with a painful and intensified desire for independence and does not have the nature of constant actions, physical and moral bullying, characteristic of a patient with schizophrenia and with this syndrome.

We need your bestial morality - from lantern to lantern!

Or, to use poetic language: fly wherever the wind of passion blows.
Passion is almost material due to its tangible reality. A feature of this pathology, also called “moral insanity” in psychiatric works, is a gross disregard for existing social moral norms for the sake of one’s ego.

A striking illustration of the behavior and life of a heboid is the hippie movement that swept America in the recent past.

Adults, only outwardly young boys and girls, suddenly left their homes (for the most part, the homes of wealthy parents) to indulge in all kinds of hard things - giving themselves up to vagrancy, theft, drug intoxication, indulge in unrestrained sex and brutal fights.

And this was not a herd of brainless cattle - many already had a university education and a prestigious job or its prospects.

The massive spread of the hip movement was led by the condemnation of parents who lead a lifestyle of either “wolves” or “lambs” that is equally hated by rebellious youth. “Your bestial morality is for us - from lantern to lantern!” - a line from Vysotsky, piercingly revealing the extent of this condemnation.

Heboid hippies did not offer anything in return for the already established way of life - they were driven solely by stubborn protest and intoxication with freedom, falsely understood as doing nothing, unbridled sex, spurred on by marijuana, and continuous self-affirmation among their own kind.

Meaningless transitions and moving from place to place are not at all the same as the search for a better life and happiness in a foreign land. No attempt is made to make money as a mattoid; everything is obtained exclusively through theft and disguised begging.

Due to the peculiarities of the psyche, which does not reach a mature level and does not allow one to see oneself with an unbiased look, and an unhealthy lifestyle, heboids become the worst enemies not only of society, which they blame for all their troubles, but also of themselves and their own kind.

Possessing a sufficiently developed mind and imagination, patients often satisfy their vanity by mentally playing out scenes of sadistic content, where parents are assigned the roles of victims. In some cases, they realize their subconscious intentions by mutilating and killing animals and mocking the defenseless and weak.

Hippies are bright representatives of mattoids:

According to the definition of French psychiatrists, heboid teenagers who have not run away from home and torment loved ones with their senseless antics are “home executioners.”

The end of the life of such individuals is often sad: having cut off all family ties, they are not able to create full-fledged families. Those who have not taken their own lives die from diseases of the AIDS category and the consequences of alcoholism, homo- and bisexuality, become prisoners in prisons and regulars in psychiatric clinics, because every next crime requires another examination - heboids do not go for voluntary treatment due to non-recognition of the flawed state of their psyche.

Deviant behavior

Forms of antisocial behavior - vagrancy, sexual promiscuity, alcohol abuse, theft - appear in connection with increased drives and a special tendency to imitate reactions. They are more common in antisocial groups of adolescents. This behavior is formed under the influence of negative society, observed in the illegal or criminal actions of adolescents with schizophrenia.

Often, heboid syndrome in adolescents with emerging psychopathy does not imply the development of a tendency to isolation, thought disorder, complex pathological fantasy, rudimentary perception and delusional disorders, episodes of anxiety and fear, characteristic of a patient with schizophrenia with the described syndrome. This condition in severe psychopathy usually does not extend beyond adolescence.

With stable antisocial and delinquent behavior, the result of such states is, as a rule, safe and does not leave defects in the emotional-volitional sphere.

Forecast

In hebephrenic schizophrenia, the prognosis for a favorable treatment outcome is minimal. The disease is constantly progressing and has irreversible consequences for the patient’s personality. The situation is complicated by large dosages of drugs that the patient must take regularly. Some of them have side effects that negatively affect the general physical condition of the patient.

If the patient has reached the stage of remission, this is already a great success. But, as a rule, this period is unstable and short-lived. Over time, the disease “gains momentum.” By the end of life, a person completely loses self-care skills, becomes apathetic and passive. In this condition, the patient needs constant monitoring and care. If, due to various circumstances, you do not have the opportunity to look after a relative around the clock, contact the mental health center “Balance” by phone +7 (499) 495-45-03. We will take care of your loved one and provide them with high-quality medical supervision.

Defect of high personality traits

Heboid syndrome is characterized in situations of psychopathological conditions by an initially obvious defect in higher personal qualities:

• lack of criticism,
• lack of feeling of distance,
• gross violation of higher emotions (including moral and intellectual),
• sharp disinhibition of lower drives in the form of undisguised masturbation,
• gluttony.

Antisocial actions in such patients are usually impulsive or committed under external influence.

There may be other signs: mood swings from euphoria to irritability, exhaustion, mental inertia. Autonomic disorders can often occur: endocrine pathology (obesity, hypertrichosis), hydrocephalus with hypertension.

The difference between heboid syndrome and schizophrenia is the absence of acute behavior, special thought disorders, lower pathological fantasies or other symptoms.

Individual manifestations of the heboid, associated with the disinhibition of drives and the exacerbation of certain features of the teenage psyche, may occur in children with rapid puberty of an organic nature. These include clinical disorders, increased aggressiveness, a tendency to vagrancy and some other antisocial behavior (petty theft, alcohol consumption) in boys and emotionality combined with very high sexual desire with sexual promiscuity in girls. However, these manifestations are only a separate component of the heboid syndrome, not associated with a specific pathological picture.

Main symptoms

Hebephrenic schizophrenia is characterized by symptoms that negatively affect a person’s behavior and its adequacy.

• Tomfoolery, clowning and grimacing are the most striking hallmarks of the disease. The patient behaves like a child, regardless of his age. He is capricious, plays around, plays pranks, grimaces, makes terrible faces, laughs for no reason, and does ridiculous things.
• Violation of the volitional sphere. A patient suffering from hebephrenic schizophrenia is characterized by carelessness. He is not capable of volitional efforts to achieve his goal. He cannot subordinate his behavior to the norms and rules accepted in society, and does not have a sense of duty.
• Problems in communication - cannot establish contact with his peers, is shy, withdraws into himself, avoids society. The patient creates the impression of himself as a timid and shy person.
• Speech impairment - it contains feigned intonations, statements are devoid of logic and integrity. When speaking, active gestures are observed.
• Hypersexuality. The patient is able to be completely naked in a public place, in full view of everyone, to relieve his physical needs.
• Sudden mood swings - from causeless euphoria to severe irritability and aggression.
• Sloppiness - a person stops caring about his appearance, looks unkempt and unkempt.
• Loss of appetite - begins to eat food in large quantities.
• Problems with thinking and thinking abilities affect the learning process. A person has no desire to learn something new. If the patient is a child, he finds it difficult to study and has difficulty completing his homework.
• Passion for religion, occultism and mysticism.

If you notice one or more of the above symptoms in your loved one, we strongly recommend that you consult a psychiatrist. A person with such a disease needs constant monitoring by specialists. The Balance Clinic provides inpatient and outpatient treatment services. We also provide emergency medical care, which is especially important in case of severe symptoms of the disease.

Pathology therapy

Treatment of heboid syndrome is symptomatic. It does not exclude the use of tranquilizers and sedatives. The prognosis of treatment depends on the dynamics of the underlying disease. In a severe, low-progressing form of schizophrenia with the end of adolescence, a noticeable decrease in the syndrome may be observed, and social and work adaptation may be restored. Heboid syndrome usually does not recur, but in those who have suffered it, one can observe a distortion of personality with obvious signs of developmental delay, the appearance of the strangest individual properties and emotional-volitional qualities.

Treatment of hebephrenic schizophrenia

With this disease, the patient requires complex drug treatment to reduce the severity of existing symptomatic manifestations. At the initial stage of development of this form of schizophrenia, the patient can live at home and be under the control of relatives, but in the future, if aggressiveness increases, treatment in a hospital may be required, since medications cannot eliminate all symptoms and the person may pose a danger to others. When treating this disorder, the following are often prescribed:

• tranquilizers;
• sedatives;
• neuroleptics;
• lithium preparations.

A course of insulin therapy may be indicated. Patients are often prescribed vitamin complexes. In some cases, temporary improvement is achieved through electroconvulsive therapy. In the final stages, the patient’s personality and emotional state are destroyed so much that conversations with a psychoanalyst and attempts to socialize the patient do not bring any results.