Diaries of Adolescent Schizophrenics (Hebephrenics)

Psychoanalytic investigations of the schizophrenic psychoses have been focused almost entirely on those manifestations which Fenichel (4) grouped under the productive, restitutive signs, namely on delusions and hallucinations. In hebephrenia, a variety of schizophrenia which manifests itself earlier and which is more characteristic of adolescence than the catatonic or paranoid form of schizophrenia, delusions and hallucinations are "inconsiderable" (8). While the psychotic with delusions and hallucinations may display a rich inner life, the delusions sometimes being highly systematized, the content of the hebephrenic's mental processes appears to be fluctuating and incoherent and is difficult to define. It has so far been impossible to find motives for typical hebephrenic activities such as blind rage, inappropriate laughter and silly behavior, as the psychiatric description in terms such as "inappropriate" or "silly" suggests. To what psychic content or aim they may be related can only be a subject for speculation; Mayer-Gross (9) considers them a discharge of surplus impulse. Why a surplus of impulse expresses itself in these typical hebephrenic activities is a problem which has so far remained unsolved. Psychoanalysts may be inclined to compare these activities with compulsive neuroses; but here compulsive acting occurs within an organized personality which one is reluctant to attribute to the hebephrenic psychotic whose ego is more dissimilar than similar to that of the obsessional.

While then the hebephrenic's personality or what is left of it still remains obscure one cannot hope to throw much light on it by studying the fully developed cases encountered in the psychiatric wards. The necessity for an early study has been repeatedly stressed, but Mayer-Gross says that the early stages are rarely seen by psychiatrists. Katan (7) has recently emphasized the necessity for a close study of