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IOWA 500: THE CLINICAL AND GENETIC DISTINCTION OF HEBEPHRENIC AND PARANOID SCHIZOPHRENIA

Consecutively admitted hebephrenics (N = 115) and paranoid schizophrenics (N = 62) were studied. Clinically the two groups differ in that the hebephrenics have more changes in affect, have more tangential thinking, block more, and are more delusional. Hallucinations were equal between both groups. Paranoids were admitted at an older age and were older at the age of onset. The paranoids show less disruption of family life. A blind family history assessment revealed that hebephrenic probands had over three times as many schizophrenic relatives as the paranoid probands. The literature on schizophrenia was evaluated and many studies indicate a significant increase in schizophrenic relatives in hebephrenic probands as compared to paranoid probands. Furthermore, both children and other secondary cases of schizophrenia in the families of hebephrenics are more likely to be hebephrenic than paranoid. The children and other secondary cases of schizophrenia of paranoid probands are more likely to be paranoid than hebephrenic. These familial data indicate a high probability that process schizophrenia is not a unitary (homogeneous) illness. It is possible that there are two types of schizophrenia, one of which may manifest itself mostly as hebephrenia but occasionally as paranoid schizophrenia. The second type would be paranoid schizophrenia in which there is a paucity of schizophrenic relatives. In paranoid schizophrenia, an affected relative, should he exist, would have only paranoid schizophrenia. Thus, there may be only one type of hebephrenic schizophrenia but two types of paranoid schizophrenia, one related genetically or familially to hebephrenic schizophrenia.