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What are the Different Types of Schizophrenia?

Schizophrenia is a mental illness that is associated with unusual expressions or perceptions of reality. This can lead to significant social or professional disruption.

It can include auditory hallucinations or hear things that are not there. Less often, the person may experience visual hallucinations in which they see things that do not exist.

There may be bizarre or paranoid delusions and disorganized speaking and thinking.

Schizophrenia is usually diagnosed in early adulthood. The United States Centers for Disease Control and Prevention (CDC) estimate that schizophrenia affects between 0.6 and 1 percent of the world's population.

Classification and diagnosis

There have been several subtypes of schizophrenia in the past including:

  • paranoid schizophrenia
  • disorganized or hepephrenic schizophrenia
  • catatonic schizophrenia
  • Childhood schizophrenia
  • schizoaffective disorder

In 2013, the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) changed the classification method to put all of these categories under a single heading: schizophrenia.

According to the American Psychiatric Association (APA), the decision to eliminate these various subtypes was based on the conclusion that they would have "limited diagnostic stability, poor reliability, and poor validity." It was concluded that they do not contribute to better treatment or predict how patients would react to treatment.

Two other important changes were made to the diagnostic criteria in 2013.

One of these was removing the requirement that a person experience bizarre delusions and speak two or more voices during an auditory hallucination in order to obtain a positive diagnosis.

The second was that in order to be diagnosed a person must have at least one of the following symptoms:

  • Hallucinations
  • Delusions
  • disorganized speech

Click here for a more complete article on schizophrenia.

Subtypes

The following were subtypes of schizophrenia. Find out what has changed when you used these categories.

Schizoaffective disorder

A person with schizoaffective disorder experiences a combination of symptoms of schizophrenia, such as hallucinations and delusions, and mood disorder symptoms, such as mania or depression.

In the past, the person had to have both symptoms at the same time to get a diagnosis of schizoaffective disorder.

The 2013 DSM-V update now states that a person diagnosed with schizoaffective disorder has had the most psychological symptoms of schizophrenia from the time they started having symptoms to this day.

catatonia

Catatonia involves extreme behaviors:

  • Catatonia can include excessive and peculiar motor behaviors sometimes called catatonic arousal
  • Catatonia can also include decreased motor activity and engagement. For example, people in catatonic drowsiness show a dramatic decrease in activity where the patient cannot speak, move, or react. Virtually all movements stop.

Catatonia can occur in schizophrenia and a number of other conditions including bipolar disorder. Because of this, it is now considered a specifier for schizophrenia and other mood disorders, rather than a type of schizophrenia.

Childhood schizophrenia

Symptoms of schizophrenia usually appear in early adulthood, but can sometimes appear by the age of 10 years or earlier. It is extremely rare, with an incidence less than 0.04 percent.

When schizophrenia occurs in a child, it is very serious and treatment is needed.

However, healthy children can experience hallucinations. If that happens, it doesn't mean a child has schizophrenia.

Disorganized schizophrenia or hebephrenia

Disorganized thinking and behavior are hallmarks of schizophrenia. The person may have incoherent and illogical thoughts and language.

This can make it difficult to perform daily activities such as preparing meals and maintaining personal hygiene or washing. People may not understand what the patient is saying. This can lead to frustration and agitation.

While disorganization is a feature of schizophrenia, it is no longer considered a separate subtype.

Paranoid schizophrenia

A person with schizophrenia may have the misconception or delusion that a person or group of people is conspiring to harm them or their family members. You may spend time thinking about ways to protect yourself from the people they believe will haunt them.

While delusional ideas can still be key to diagnosing schizophrenia, it is no longer considered a separate subtype of the disorder.