Doctors used to divide schizophrenia into five main types based on which symptoms a person had. Because the symptoms of schizophrenia often vary from person to person, classifying this mental health condition into subtypes helped doctors predict how schizophrenia might affect someone.
In recent decades, it’s become clear that these classic schizophrenia subtypes often aren’t helpful. You may not fit perfectly within one of these categories, and you may switch between different types of schizophrenia over the course of your life.
However, you may still find it helpful to learn about the different groups of symptoms that are part of schizophrenia. This may help you better understand your own or a loved one’s condition.
Mental health experts use a guide called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to define and diagnose various conditions. Past versions of the DSM have categorized schizophrenia into five types. You can read more about the five classic types below, but know that these labels are now considered outdated in the current version of the DSM and by most health care providers.
Paranoid schizophrenia has two key symptoms — paranoia (being suspicious of others or feeling like you can’t trust them) and delusions (false beliefs). This type of schizophrenia is typically treated with antipsychotic medications and talk therapy such as cognitive behavioral therapy (CBT). Electroconvulsive therapy (ECT), a treatment in which a mild electrical current is delivered to the brain, may also help.
Sometimes called hebephrenic schizophrenia, disorganized schizophrenia commonly leads to three key symptoms:
Experts used to consider the disorganized subtype as the most severe form of schizophrenia, and it often develops earlier in life, in your second or third decade. This type can be treated with typical schizophrenia therapies, including medications, talk therapy, and ECT.
The term “catatonia” refers to multiple symptoms in which you behave unusually and can’t properly control the way your muscles move. People with catatonic schizophrenia may:
Catatonic behavior is often treated with ECT or benzodiazepines — calming medications used to treat seizures or anxiety.
In the past, a person would receive a diagnosis of undifferentiated schizophrenia if they had a couple of general schizophrenia symptoms — like delusions, hallucinations, unusual speech patterns, or atypical behaviors — but didn’t meet the criteria to be diagnosed with the paranoid, disorganized, or catatonic subtypes.
A diagnosis of residual schizophrenia used to mean that a person has had typical schizophrenia symptoms in the past but no longer experiences them. They also often experience negative symptoms — the absence of usual behaviors or habits. Negative symptoms of schizophrenia may include speaking infrequently, having few or no facial expressions, withdrawing from other people or activities, or having very low motivation levels.
In general, mental health care providers can reliably diagnose schizophrenia — if you have certain characteristic symptoms, multiple doctors will give you the same schizophrenia diagnosis. This diagnosis can then be used to recommend useful treatments.
However, the same can’t be said for the traditional schizophrenia subtypes. Different providers may each tell you that you have a different subtype.
Additionally, the subtypes are not stable over time. In other words, you may meet the criteria for one subtype when you are first diagnosed, but a year later you may have symptoms that more closely resemble a different subtype.
There are also other issues with the classic schizophrenia types. While schizophrenia can run in families, different family members often have different subtypes, indicating that genetics may not determine which type you have. They’re also not useful in the sense that they don’t often tell doctors which treatments may be most helpful or what your prognosis (outlook) is likely to be.
Overall, dividing cases of schizophrenia into subtypes isn’t that helpful when it comes to diagnosing the condition or coming up with an appropriate treatment plan.
Experts released the fifth edition of the DSM, called the DSM-5, in 2013. This guide no longer includes definitions for different subtypes of schizophrenia. In the same year, the American Psychiatric Association determined these traditional classifications were outdated, and most health care providers no longer use these terms.
The DSM-5 uses other ways of describing schizophrenia. Now, experts categorize schizophrenia based on how the condition has progressed over time and how it is currently affecting you.
Schizophrenia often leads to episodes in which symptoms of psychosis become much worse. After some time, the episode may end, and you may experience few or no symptoms until you have another episode. Currently, experts classify cases of schizophrenia based on whether you have experienced a single episode or multiple.
Health care providers also classify schizophrenia based on whether you are currently in the middle of an episode, are in partial remission (your symptoms are improving but still present), or are in full remission (you are currently not experiencing any schizophrenia symptoms).
Now, experts may say your schizophrenia falls into one of the following groups:
You need to have been living with schizophrenia for one year or more before a doctor can accurately diagnose you with one of these classifications. Your classification may also change over time. This information helps your doctor understand how your schizophrenia has affected you in the past, as well as what types of treatments you may currently need.
If you have symptoms of catatonia, your doctor may specify that you have schizophrenia with catatonia, since these symptoms are often treated with different types of medications.
Your doctor may also measure how severe your schizophrenia is. To do this, they may work with you or your loved ones to rate the severity of each main schizophrenia symptom.
Other related conditions also fall under the general schizophrenia umbrella. These schizophrenia spectrum disorders include:
If you or a loved one is living with schizophrenia, speak with a health care provider. Your doctor can help you better understand what types of schizophrenia symptoms you or your friend or family member may have. They can also recommend a treatment plan and help you understand how to better live with schizophrenia.
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