Types of Schizophrenia

March 4, 2024

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Despite a formal shift away from classifying schizophrenia into distinct subtypes, the five traditional subtypes – paranoid, hebephrenic, undifferentiated, residual, and catatonic – were once recognized to categorize various manifestations of the condition. Schizophrenia remains a long-term mental health disorder that impacts an individual’s emotional well-being, their capacity for clear and logical thought, and their ability to engage with and understand others. Fortunately, all forms of schizophrenia are treatable with the right combination of therapies.

What Are Schizophrenic Disorders?

Schizophrenia is a mental disorder that alters your thoughts, actions, and feelings, potentially disrupting everyday life, academic and occupational performance, and interpersonal relationships. Even with treatment, about one-third of those with schizophrenia continue to experience significant challenges with their symptoms.

These are the characteristics of schizophrenia:

  1. Negative symptoms, which involve a reduction or loss in functions and abilities, such as lack of motivation, limited speech, and diminished thinking capabilities.
  2. Positive symptoms, which refer to the presence of unusual perceptions or beliefs, such as hallucinations and delusions, that are not typically experienced by others.
  3. Cognitive symptoms, which impact mental processes including focus, memory, and the capacity for attention, impairing the ability to manage daily activities.

For a diagnosis of schizophrenia, a mental health specialist will perform a thorough evaluation and tests to exclude other neurological or psychiatric conditions. This assessment may also involve discussions with family, friends, or other healthcare providers to gather additional information that aids in evaluating the nature and duration of symptoms.

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A diagnosis generally requires that symptoms have been present for at least six months.

How Many Types of Schizophrenia Are There?

The categorization of schizophrenia underwent significant revisions with the 2013 update to DSM (Diagnostic and Statistical Manual of Mental Disorders), the manual utilized by mental health professionals for diagnosing mental disorders. The prior edition, DSM-IV, identified five different types of schizophrenia– more on these below.

With the introduction of DSM-5, these categories were eliminated. Although symptoms such as paranoia, disorganized speech and behavior, and catatonia remain integral to diagnosing schizophrenia, they are no longer considered separate subtypes. The decision to revise the schizophrenia classification in the DSM stemmed from the overlap in symptoms among subtypes and the challenges in diagnosing with precision.

In 2022, APA (American Psychiatric Association) released DSM-5-TR, an updated version of the DSM-5 manual. This revision did not introduce significant changes to how schizophrenia is classified.

The 5 Types of Schizophrenia

What are the types of schizophrenia, then? Although subtypes no longer recognized as distinct clinical disorders, they continue to be useful for specifying particular symptom patterns and guiding treatment strategies. The five classical subtypes are:

  1. Paranoid schizophrenia
  2. Hebephrenic (or disorganized) schizophrenia
  3. Undifferentiated schizophrenia
  4. Residual schizophrenia
  5. Catatonic schizophrenia

1) Paranoid schizophrenia

Previously the most frequently diagnosed form of schizophrenia, paranoid schizophrenia was reclassified in 2013 by APA. It was determined that paranoia is a positive symptom of schizophrenia, leading to the removal of paranoid schizophrenia as a separate category and its symptoms being integrated into the broader diagnosis of schizophrenia. Core symptoms of this pattern include delusions, hallucinations, disorganized speech, difficulty concentrating, behavioral issues, and flat affect.

2) Hebephrenic (disorganized) schizophrenia

Although removed from DSM-5, hebephrenic or disorganized schizophrenia is still acknowledged in ICD (International Statistical Classification of Diseases and Related Health Problems), a diagnostic tool used in many countries worldwide. This form is characterized by a lack of hallucinations and delusions, instead manifesting through disorganized behavior and speech, flat affect, speech disturbances, disorganized thinking, inappropriate emotional responses, and difficulties in performing daily activities.

3) Undifferentiated schizophrenia

This diagnosis was applied to individuals displaying symptoms that spanned several different schizophrenia types, such as a mix of catatonic behavior with delusions or hallucinations. Under current diagnostic guidelines, this classification simply indicates the presence of a broad spectrum of symptoms.

4) Residual schizophrenia

Residual schizophrenia referred to cases where individuals, previously diagnosed with schizophrenia, exhibit diminished symptoms. This subtype often involves more negative symptoms like reduced emotional expression, psychomotor issues, slowed speech, and neglect of personal hygiene. Given the fluctuating nature of schizophrenia symptoms, the use of this category has decreased.

5) Catatonic schizophrenia

Catatonic schizophrenia, recognized in earlier DSM editions, has been proposed to function better as a specifier due to its occurrence across various psychiatric and medical conditions. Symptoms can range from immobility and mutism to mimicking behaviors and a stupor-like state, indicating a complex presentation that transcends a single disorder classification.

FAQs

Is schizophrenia a disease?

Schizophrenia is a chronic brain disorder characterized by symptoms such as delusions, hallucinations, disorganized speech, and significant impairment in daily functioning. It is considered a complex psychiatric condition rather than a disease in the conventional sense, as it involves a combination of genetic, biological, and environmental factors.

Are there different levels of schizophrenia?

Schizophrenia is not categorized by levels, but it can vary in severity and type. The symptoms and their intensity can fluctuate over time, leading to periods of improvement and episodes of worsening. Treatment plans are tailored to individual needs, reflecting the condition’s complexity and variability.

What is the most dangerous type of schizophrenia?

The perception of schizophrenia as inherently dangerous is largely a stigma. No specific type of schizophrenia is considered the most dangerous. That said, individuals with untreated schizophrenia may experience severe symptoms that can lead to distress or risky behaviors, primarily towards themselves rather than others. With appropriate treatment and support, the risk of harm significantly decreases.

Get Treatment for Schizophrenia at Connections

Although schizophrenia can be a remarkably demanding and aggravating condition to deal with, it’s also treatable with the right personalized care. At Connections in Southern California, we can help you overcome any obstacles related to mental health disorders, even severe ones like schizophrenia, even if you have previously found treatment to be ineffective.

Accurate diagnosis and assessment is essential to create an individualized treatment plan for schizophrenia. Over the course of a month or more, you can access a blend of holistic and science-backed therapies that may include medications.

Call 844-759-0999 if you or someone that you care about needs help addressing mental health issues related to schizophrenia.

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