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 medical condition.

Classic Types of Schizophrenia

Mental health experts, like doctors of psychology and psychiatry, use a guide called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to help 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You can read more about the five classic types below, but know that these labels are now considered outdated in the current version of the DSM and by most health care providers.

1. Paranoid Schizophrenia

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.

2. Disorganized Schizophrenia

Sometimes called hebephrenic schizophrenia, disorganized schizophrenia commonly leads to three key symptoms:

• Disorganized speech — Problems communicating in a way others can understand, which may include repeating words, talking too quickly, making up new words, or jumping suddenly from one topic to another
• Disorganized behavior — Actions that are inappropriate or don’t make sense, such as acting like a child, wearing clothes that aren’t practical for the weather, or becoming unexpectedly agitated
• Flat or inappropriate affect — Showing very few signs of emotion or displaying emotion that doesn’t fit the situation, such as smiling during a serious situation or getting angry or sad for no clear reason

Health experts used to consider the disorganized subtype as the most severe form of schizophrenia. It often develops earlier in life, in a person’s 20s or 30s. This type can be treated with typical schizophrenia therapies, including medications, talk therapy, and ECT.

3. Catatonic Schizophrenia

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:

• Feel agitated for unclear reasons
• Speak very little
• Have unusual reactions to things that are happening around them
• Exaggerate their actions or mannerisms
• Hold the same facial expression for a long period of time
• Copy what others say or do

Catatonic behavior is often treated with ECT or benzodiazepines — calming medications used to treat seizures or anxiety.

4. Undifferentiated Schizophrenia

In the past, a person would receive a diagnosis of undifferentiated schizophrenia if they had a couple of general schizophrenia symptoms — like delusions, hallucinations (including auditory hallucinations), unusual speech patterns, or atypical behaviors — but didn’t meet the criteria to be diagnosed with the paranoid, disorganized, or catatonic subtypes.

5. Residual Schizophrenia

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. These exist in contrast to the positive symptoms, which are things people with schizophrenia experience that the general population doesn’t.

Why Experts Categorized Schizophrenia Into Types

In general, mental health professionals can reliably diagnose schizophrenia — if a person has certain characteristic symptoms, different doctors will give you the same diagnosis of schizophrenia. This diagnosis can then be used for coming up with a useful treatment plan, which may include medications, support groups, therapy, and more.

However, the same can’t be said for the traditional schizophrenia subtypes. Different providers may each tell you that you have a different subtype of schizophrenia.

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 a person has. Subtypes also aren’t useful in that they don’t often tell health care providers which treatments may be most helpful or what a person’s 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 Now Consider Schizophrenia a Spectrum Disorder

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.

Mental health care providers have moved from diagnosing someone with one type of schizophrenia to diagnosing them with a schizophrenic spectrum disorder. Then they use the types above, along with some other related disorders, to determine where on the spectrum a person is. This change is based on new research about schizophrenia, brain images, and genetic studies on the causes of schizophrenia.

The disorders that were once thought of as separate types of schizophrenia are now thought of as parts of one larger disorder that can show up in different ways. Some people may even experience a variety of types of schizophrenia over their lifetime.

New Schizophrenia Categories: Describing the Disease Course

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.

Psychotic Episodes

Schizophrenia often leads to episodes in which symptoms of psychosis become much worse. After some time, the episode may end, and the person may experience few or no symptoms until they have another episode. Currently, experts classify cases of schizophrenia based on whether a person has experienced a single episode or multiple.

Remission

Health care providers also classify schizophrenia based on whether a person is currently in the middle of an episode, is in partial remission (symptoms are improving but still present), or are in full remission (the person is currently not experiencing any schizophrenia symptoms).

Current Schizophrenia Classifications

Now, experts may say your schizophrenia falls into one of the following groups:

• First episode, in an acute episode — A person is experiencing schizophrenia symptoms for the first time and hasn’t gone through a period in which they have lessened.
• First episode, in partial remission — The person has had some psychotic symptoms that are now starting to disappear.
• First episode, in full remission — The individual had schizophrenia symptoms at one point in the past but don’t currently have any.
• Multiple episodes, in an acute episode — A person has had two or more episodes of schizophrenia and are currently experiencing symptoms.
• Multiple episodes, in partial remission — The individual has had two or more episodes of schizophrenia, but current episode symptoms are starting to disappear.
• Multiple episodes, in full remission — The person has had two or more episodes of schizophrenia but no current symptoms.
• Continuous — The individual’s schizophrenia symptoms are ongoing, and they don’t have periods of remission.

A person needs to have been living with schizophrenia for one year or more before a doctor can accurately diagnose them with one of these classifications. A person’s classification may also change over time. This information helps their doctor understand how their schizophrenia has affected them in the past, as well as what types of treatments they may currently need.

Other Ways of Classifying Schizophrenia

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 schizophrenia spectrum umbrella. These schizophrenia spectrum disorders include:

• Delusional disorder — A disorder characterized by the presence of one or more delusions (fixed false beliefs)
• Schizotypal personality disorder — A condition that leads to unusual behaviors, magical or odd beliefs, and social anxiety, but not usually hallucinations or delusions
• Brief psychotic disorder — A condition in which schizophrenia-like symptoms suddenly appear and then disappear within a short time
• Schizophreniform disorder — A condition in which a person experiences psychotic symptoms for less than six months

Ask Your Doctor About Your Schizophrenia

If you or a loved one are living with schizophrenia, speak with a health care provider. Your doctor can help you better understand what types of schizophrenia symptoms you or your loved one may have. They can also recommend a treatment plan and help you understand how to better live with schizophrenia.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression, or related mental illness, and their loved ones. On MyDepressionTeam, more than 146,000 members come together to ask questions, give advice, and share their stories with others who understand life with depression or schizophrenia.

Have you been diagnosed with schizophrenia? What was your diagnostic process like? Share your experience in the comments below, or start a conversation by posting on your Activities page.