Question

Which of the following types of schizophrenia carries a bad prognosis?

• A. Paranoid
• B. Catatonic
• C. Hebephrenic
• D. Undifferentiated

Hint:

Think of the subtype with early onset and disorganised behaviour.

Answer 1

The Correct Option is C

The question is comparing the outlook of four schizophrenia subtypes and asking which one is known for a poor prognosis.

1. Paranoid: tends to start later in life, with reasonably preserved personality and functioning, and is dominated by delusions and hallucinations. This subtype has a comparatively favourable prognosis.
2. Catatonic: shows striking motor symptoms like stupor or excitement, but usually responds well to treatments such as benzodiazepines or ECT, so the outcome is generally decent.
3. Hebephrenic: begins early, develops gradually, and shows disorganised speech, behaviour and flattened affect, with poor functioning even before the illness starts. This combination of features is linked to a poor long term outcome.
4. Undifferentiated: a catch all category for presentations that do not fit the other patterns clearly, with an outcome usually considered in between, not specifically poor.

Hebephrenic schizophrenia stands out because of its early onset, disorganisation and weak premorbid functioning, all of which point toward a worse prognosis than the other subtypes.

Let's summarize:

• Later onset and preserved functioning, as in paranoid or catatonic types, favour a better outcome.
• Early onset with disorganised behaviour and poor premorbid adjustment, as in hebephrenic schizophrenia, points to a poor prognosis.

So hebephrenic schizophrenia is the subtype with the bad prognosis.