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5 Types of Schizophrenia and Why They’ve Changed

Posted on April 14, 2023
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Medically reviewed by
Paul Ballas, D.O.
Article written by
Maureen McNulty

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.

Classic Types of Schizophrenia

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 You can read more about the five classic types below, but know that these labels are now considered outdated in the current version of the DSM and by most health care providers.

1. Paranoid Type

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 Type

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 kid, 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

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.

3. Catatonic Type

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 atypical 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 the things that others say or do

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

4. Undifferentiated Type

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.

5. Residual Type

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.

The Need for Different Schizophrenia Classifications

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.

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 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).

Current Schizophrenia Classifications

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

  • First episode, in an acute episode — You are experiencing schizophrenia symptoms for the first time, and haven’t gone through a period in which they have lessened.
  • First episode, in partial remission — You had some psychotic symptoms that are now starting to disappear.
  • First episode, in full remission — You had schizophrenia symptoms at one point in the past but don’t currently have any.
  • Multiple episodes, in an acute episode — You have had two or more episodes of schizophrenia and are currently experiencing symptoms.
  • Multiple episodes, in partial remission — You have had a few episodes but currently have only a few symptoms of the condition.
  • Multiple episodes, in full remission — You don’t have symptoms of schizophrenia at the moment but have had more than one period of increased symptoms in the past.
  • Continuous — Your schizophrenia symptoms are ongoing, and you don’t have periods of remission (times when your symptoms go away).

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.

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 general schizophrenia umbrella. These schizophrenia spectrum disorders include:

  • Delusional disorder — A disorder that leads to realistic delusions in which you can’t tell whether a situation occurred or not
  • 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 you experience psychotic symptoms for less than six months

Ask Your Doctor About Your Schizophrenia

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.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression, or related mental health conditions, and their loved ones. On MyDepressionTeam, more than 143,000 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.

    Posted on April 14, 2023
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    All updates must be accompanied by text or a picture.
    Paul Ballas, D.O. is an attending psychiatrist at Friends Hospital in Philadelphia, Pennsylvania. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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