Schizophrenia spectrum (A brief guide)

In this guide, we will discuss what it is considered as the schizophrenia spectrum, types of schizophrenia, symptoms, causes and treatment options.

The Schizophrenia Spectrum

The schizophrenia spectrum is included within the spectrum of psychotic disorders alongside schizoaffective disorder, delusional disorder, schizotypal personality disorder, borderline schizophrenia, schizophreniform disorder, brief psychotic disorder, as well as psychosis associated with substance use or medical conditions ( 

According to WebMD, about 3.5 million people in the United States are diagnosed with schizophrenia and it is said to affect about 1.1% of the world’s population.

Schizophrenia and the other psychotic disorder are considered the most impairing mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). They have been associated with a profound negative effect on an individual’s normal functioning and day to day activities. 

Additionally, they are said to start manifesting in the transition from adolescence to adulthood, usually after puberty and most people get diagnosed in their late teens to early 30s. However, there is also a possibility of presenting the symptoms during childhood, also known as “childhood schizophrenia”, but it is considered rare. 

Also, it is thought that men and women can get the disorder in the same proportion, however, men tend to get diagnosed earlier in life (late teens to early 20s) than women do (late 20s to early 30s). 

The indicates how we may have probably encountered or met people suffering from schizophrenia but we may have only thought they were acting in an odd or atypical way. 

They indicate how “they may have been dressed in an unusual way, perhaps disheveled or wearing an unusual collection of clothes, makeup, or jewelry that did not seem to fit any particular group or subculture. They may have been talking to themselves or yelling at someone you could not see. If you tried to speak to them, they may have been difficult to follow or understand, or they may have acted paranoid or started telling a bizarre story about the people who were plotting against them”.

Schizoaffective disorder

This disorder is characterized by an individual’s abnormal thought processing and dysregulated emotions. Someone with schizoaffective disorder can have mixed symptoms from schizophrenia and mood disorders, usually bipolar or depression, but won’t specifically meet the full criteria for either disorder. 

Bipolar disorder can be identified due to symptoms related to mania, hypomania or mixed episodes while the depressive subtype can be identified through symptoms related to depression. 

Symptoms related to schizoaffective disorder include hallucinations, paranoid delusions, and disorganized speech and thinking. 

Delusional Disorder

In this disorder, the individual manifests delusions but hallucinations, thought disorders or mood disorders are not present. Someone with delusional disorder can still lead a normal life and can continue to socialize as usual, where their behavior may not be classed as odd or bizarre as it happens with other forms of schizophrenia. 

According to Lumen Learning, there are 7 subtypes of delusional disorder and they are: 

  1. Erotomanic type (erotomania): Delusion that another person, often a prominent public figure, is in love with the individual.
  2. Grandiose type: Delusion of inflated worth, power, knowledge, or identity.
  3. Jealous type: Delusion that the individual’s sexual partner is unfaithful when such is not the case.
  4. Persecutory type: Delusion that the person (or someone the person is close to) is being treated badly or malevolently.
  5. Somatic type: Delusion that the person has some physical defect or medical condition.
  6. Mixed type: Delusions with characteristics of more than one of the above types but with no single predominant theme.
  7. Unspecified type: Delusions that cannot be clearly classified into any of the subcategories.

To fulfill the diagnostic criteria of a delusional disorder, the individual must have delusions that last for at least 1 month and can not be explained due to the effects of medications, drugs or any other medical condition. 

Are there different types of schizophrenia?

Not so long ago, schizophrenia was divided into different subtypes such as catatonic, disorganized, paranoid, residual and undifferentiated. However, the concept and understanding of this mental disorder have been “reorganized” and now mental health professionals conceive schizophrenia as a spectrum disorder that actually includes the previous types. 

Symptoms of the schizophrenia spectrum

According to WebMD, you could have the following symptoms:

  • Hallucinations. You hear voices or see or smell things that others say aren’t there. The voices might criticize or threaten you. They might tell you to do things you otherwise wouldn’t.
  • Delusions. You believe things that aren’t true, even when others show you proof or share facts that explain why your beliefs are wrong. Delusions can seem bizarre to others.
  • For example, you might think that the TV is sending you special messages or that the radio is broadcasting your thoughts for everyone to hear. You might also feel paranoid and believe that others are trying to harm you.
  • Thought disorders. You might have trouble organizing your thoughts, and you might speak in a way that’s hard for others to understand. Perhaps you stop talking in the middle of a thought because you feel like it’s been taken out of your head. This is called thought withdrawal. Another type of disordered thinking, called thought blocking, happens when someone has a sudden stopping of their flow of thinking and as a consequence, they may become silent until a new thought enters their mind.
  • Movement disorders. You might move your body over and over again as if you’re upset, or you might stop moving and responding. Doctors call this catatonia.
  • Negative symptoms. Maybe you speak in a dull, flat tone, have trouble following through, lack interest in your daily life, and find it hard to keep up relationships. You might appear to be depressed. But while sadness, tearfulness, and other symptoms point to depression, so-called negative symptoms more likely point to a problem with the way the brain works.

To be diagnosed with schizophrenia according to the DSM-5, it is necessary to have at least two of the symptoms for at least 6 months. One of them must be hallucinations, delusions or disorganized speech. Additionally, symptoms may be present at different times and they may get worse or better, but it is still considered as schizophrenia. 

So, what makes schizophrenia different from other psychotic disorders? Well, there is actually a “how long you have had the symptoms” factor or whether you actually have the symptoms of a mood disorder. 

Positive symptoms

Positive symptoms refer to “disorders of commission, meaning they are something that individuals do or think. Examples include hallucinations, delusions, and bizarre or disorganized behavior” (Lumen Learning).

Additionally, Positive symptoms describe the behavior and individual has that indicates loss of contact with the world. These types of symptoms are the easiest to recognize. 

Negative Symptoms

Negative symptoms refer to disorders of omission, meaning they are things that the individual does not do. For instance, related symptoms include lack of speech, flat affect or a lack of emotional response, loss of interest in activities the individual used to enjoy, loss of interest in social contact and lack of motivation.

These types of symptoms tend to get confused with depression symptoms and even laziness.

Causes of schizophrenia

Researchers have suggested that there is a clear genetic predisposition to developing the disease, however, manifesting this condition cant only be blamed on genetic factors. Scientists suggest that most likely, the combination between genes and the environment is what causes the disease to be triggered. 

Others have suggested that being exposed to infections or viruses or if your mother was malnourished before giving birth, could have contributed to an increased chance of developing the disease. 

Brain changes and chemistry are also accounted for the manifestation of schizophrenia. Some scientists even believe it can be caused by abnormal development in an area of the brain called the frontal cortex.  Others believe it has to do with having too many connections between neurons as they are being eliminated when the brain is maturing. 

Another theory suggests that hormonal changes during puberty can also be related to developing schizophrenia, suggesting that women develop schizophrenia later in life due to hormone estrogen “protecting” them somehow. 

Treatment for schizophrenia

The first line of treatment for schizophrenia is the prescription of antipsychotic medications, often combined with psychotherapy and social support. Some of the psychological interventions include family therapy, skills training, and even psychotherapy for substance abuse. It becomes fundamental for family members and loved ones to be educated about the disease, preventing relapses and increases in the frequency of hospitalizations.

Additionally, hospitalization may be common after having severe psychotic episodes and an individual may be hospitalized voluntarily or involuntarily, depending on the type of legislation. 

Other services such as community-based services such as drop-in centers, visits by members of a community mental health team, supported employment, and support groups are also common

Exercise has been suggested as having a positive impact on physical and mental health wellbeing for people with schizophrenia.

Why is this blog about schizophrenia spectrum important?

We have discussed how schizophrenia has gone through a series of changes in the latest DSM version. Now, schizophrenia is conceived as a spectrum instead of talking about subtypes or categories. 

Additionally, we have seen how debilitating this condition is, but fortunately, there are treatment options available. Also, we have talked about the possible causes or risks of developing schizophrenia.

There is still a lot to understand about schizophrenia and a lot of research is still needed on this topic. If you have a friend or a relative with schizophrenia, remember that supporting them is vital for therapeutic success and major life improvements. 

Feel free to comment in the comments section below!

Frequently Asked Questions (FAQs) about the Schizophrenia spectrum

What is the unspecified schizophrenia spectrum?

Unspecified schizophrenia is used to diagnose someone that has symptoms that cause a lot of distress in their day to day functioning but does not meet the full criteria for any of the disorders under the schizophrenia spectrum and other psychotic disorders classification.

Is schizophrenia on the autism spectrum?

The schizophrenia spectrum and the autism spectrum are two separate disorders with a different presentation of symptoms and onset. However, a rare and severe form of schizophrenia during childhood (childhood-onset schizophrenia) frequently gets confused with autism due to neurodevelopmental difficulties. 

What are the schizophrenia spectrum and other psychotic disorders?

The schizophrenia spectrum and other psychotic disorders refer to symptoms that are typical of a schizophrenia spectrum or other psychotic disorder (eg, delusions, hallucinations, disorganized thinking, and speech, catatonic behavior), that can cause substantial distress in an individual’s life and can impair them from living a normal life.

What are the five types of schizophrenia?

In a previous version of the DSM, there were different subtypes of schizophrenia considered as:

paranoid schizophrenia.
disorganized, or hebephrenic schizophrenia.
catatonic schizophrenia.
childhood schizophrenia.
schizoaffective disorder.

What is the chemical imbalance that causes schizophrenia?

The chemical imbalance suggested by researches to contribute to developing schizophrenia is related to neurotransmitters dopamine, glutamate and serotonin.