Behavior patterns of patients with hebephrenic schizophrenia when they attempt academic study

Direct assistance with academic study was given to 16 subjects who had hebephrenic schizophrenia (HS) and problems with school attendance, with the aim of helping the subjects to reaching their desired level of academic achievement. The subjects exhibited nine behavior patterns when they reached an impasse in their study: (i) difficulty understanding the degree of importance; (ii) difficulty integrating multiple concepts; (iii) difficulty understanding abstract concepts; (iv) difficulty developing an overview; (v) difficulty with applied problems; (vi) attempting to achieve complete understanding; (vii) becoming labile prior to exams; (viii) excess cramming leading to breakdown; and (ix) extreme reactions. These patterns were compared with those of 10 healthy junior high school students (normal group). In the HS group, patterns (i-v) were seen in at least a moderate degree in all subjects, but were significantly stronger than in the normal group and, even with study advice, improvement was temporary. Wide individual variations were seen in patterns (vi-ix) in the HS group, but again they were significantly stronger than in the normal group. The behavior patterns were influenced by the prospects of academic success, and were more prominent in subjects with higher expectations. Cognitive dysfunction was the root cause of these behavior patterns, with the additional involvement of psychological factors.