In this blog, we will talk about the types of schizophrenia latest changes to the criteria, related symptoms, causes, risks, how it is diagnosed, treatment options, complications if left untreated and most common myths.
How many types of schizophrenia are there?
The types of schizophrenia described in the previous version of the Diagnostic and Statistical Manual of Mental Disorders were paranoid schizophrenia, hebephrenic schizophrenia, Catatonic schizophrenia, Undifferentiated schizophrenia, residual schizophrenia and unspecified schizophrenia or schizophrenia brain.
The DSM-5 removed the subtypes of Schizophrenia, undifferentiated schizophrenia among them, and instead, they changed the name of the category to Schizophrenia Spectrum and Other Psychotic Disorders, which still keeps the characteristic symptoms mentioned previously, plus a significant social and occupational dysfunction.
With the new DSM-5 criteria for schizophrenia changed in comparison to a later version, including in those changes the drop out of types of schizophrenia.
In contrast with the previous version the threshold now is set to include at least two of the related symptoms and must have been present for six months, including at least one month of active symptoms (American Psychiatric Association).
The main reason why the types of schizophrenia were removed was because many clinicians thought they were not helpful when diagnosing because the patient’s symptoms often changed from one subtype to the other (symptom overlap).
Previous types of Schizophrenia
- Paranoid schizophrenia
- Disorganized schizophrenia
- Catatonic schizophrenia
- Undifferentiated schizophrenia
- Residual schizophrenia
Criteria for previous types of schizophrenia
Here you will see the criteria for the previous used types of schizophrenia: Paranoid schizophrenia, Disorganized schizophrenia, Catatonic schizophrenia, Undifferentiated schizophrenia, Residual schizophrenia.
Needed to meet the following criteria to be diagnosed:
- Preoccupation with one or more delusions or frequent auditory hallucinations.
- Didn’t have any of the following as prominent behaviors: disorganized speech, disorganized or catatonic behavior, or inappropriate affect.
Disorganized Type (Hebephrenic)
Needed to meet the following criteria:
- All of the following are prominent behaviors:
- Disorganized speech
- Disorganized behavior
- Flat affect
- Won’t meet the criteria for the catatonic type
Needed to meet at least 2 of the following criteria:
- Stupor or mutism: meaning not responding to other people or the environment.
- Excitement or agitation
- Posturing: holding their body in an unusual position.
- Negativism: no response to instructions
- Rigidity: resisting people who try to adjust their body
- Waxy flexibility: staying in an immobile posture.
- Persisting in repeating the same words and phrases over and over
This term was used to describe people who were not experiencing the typical symptoms as predominantly as the other types.
They presented the symptoms but to a much lesser degree. Hence,
Additionally, this subtype was characterized by a “residual phase”, meaning that even after medication treatment was effective to treat the positive symptoms, the negative remained.
Hence, people who did not report having delusions or hallucinations were considered to be a residual phase of the condition.
Symptoms of Schizophrenia
Schizophrenia can make people have difficulties concentrating and sustaining a connection between thoughts, which can be evidenced when they speak.
They are normally perceived as incoherent when they attempt to answer questions and everything they say is unrelated to the question or is illogical.
Some signs of disorganized speech are:
- Perseveration, this means repeating the same word or phrase over and over again.
- They tend to create words that only have meaning to them.
- Loose associations or shifts quickly between subjects with no apparent connection.
- Use of rhyming words but without meaning.
- In severe cases, it can be nearly impossible to understand what the person is trying to say.
Here, goal-oriented behaviors are severely affected. Someone with Schizophrenia can have difficulties (or it can become nearly impossible) beginning and ending tasks, not only due to trouble understanding an order or the task but also forgetting things or losing them.
So, being independent is extremely difficult due to their disorganized behavior.
Some of the most common symptoms can be evidence as:
- An overall decline in daily life activities.
- Unpredictable emotional responses or showing no emotion at all. These responses may not be correlated with the current mood. Some examples can be evidenced as laughing at a funeral or providing monosyllabic responses when they are happy.
- Difficulties controlling impulses: related behaviors are drug abuse, extreme gambling and having eating disorders.
- Behaviors that might seem bizarre or lacking purpose.
- Severely impaired Daily life functioning in activities such as bathing, brushing teeth or dressing.
People with schizophrenia tend to have inappropriate emotional responses or how they express those emotions.
They tend to exhibit flat affect, which means that their facial expressions, tone of voice or mannerisms do not match their emotional states.
For instance, someone with Schizophrenia can be at a funeral and start laughing instead of crying.
Delusions are false beliefs of persecution, guilt or grandeur.
It is really common for people with Schizophrenia to describe how they have certain powers or how they think someone is stalking them or wants to harm them.
They are convinced this is real and sometimes can become really aggressive.
These can be visual, auditory, olfactory, tactile, gustatory and general somatic.
Here we describe what each of them relates to:
- Visual Hallucinations: here the person sees something that does not exist or sees something that exists but they are perceiving it in a different way.
- Auditory Hallucinations: this is the most common form in people with schizophrenia and it is related to the perception of sounds that are non-existent. They will often hear voices that are talking to them but they can also be heard as whistling or hissing.
- Olfactory Hallucinations: they involve smelling odors that are non-existent. They are characterized for being usually unpleasant such as throw up, urine, feces, smoke or rotting flesh. This condition is known by the name of phantosmia and can result from neurological damage (trauma, brain tumor exposure to toxic substances) to areas of the brain related to the olfactory system.
- Tactile Hallucinations: refers to when they feel they are being touched and they are actually not. One of the most common complaints involves bugs crawling over the skin.
- Gustatory Hallucinations: these are related to the sensation that they are tasting something sweet or salty when they are actually not.
- General Somatic Hallucinations: this type of hallucination refers to the person experiencing their body being harmed or hurt for example, through mutilation or disembowelment. Other people have described animals, such as snakes, trying to invade their bodies.
You can understand these symptoms and what schizophrenia exactly is by reading schizophrenia stories.
Complications of Schizophrenia
Some of the complications can include being depressed, having suicidal thoughts or even suicidal attempts, Malnutrition, Hygiene problems, substance abuse (which may include alcohol, prescription medications, and illegal drugs), Inability to find or maintain employment which in the end results in financial problems, poverty, being homeless, among others.
People with schizophrenia have reported that smoking actually helps them concentrate but it can interfere with the effectivity of drugs and can lead to other medical conditions.
It is important for the family, friends or partners to be involved in therapy and support them as much as possible for the treatment to be more effective as if they have to endure living with this condition on their own.
How is it diagnosed?
The general criteria for a diagnosis of Schizophrenia should apply (at least 2 of the symptoms) for at least one month, and they are:
- Disorganized or catatonic behavior
- Negative symptoms such as flat affect, alogia (brief and empty replies), and avolition (difficulty starting or ending tasks) should be present.
Studies suggest that genes can make a person more vulnerable to Schizophrenia, meaning, you are at a higher risk of developing this condition if you have a first-degree relative that has been diagnosed or had schizophrenia and was not properly diagnosed.
Additional research has suggested that there may be a correlation between stress-related environmental circumstances, pregnancy, early-stage development, and Schizophrenia.
Some of the most common stress-related factors that can cause major risks of developing Schizophrenia are:
- Prenatal exposure to viral infections.
- Hypoxia at birth: low levels of oxygen at birth from prolonged labor or premature birth.
- Exposure to viruses as a child.
- Early parental separation
- Traumatic experiences or sexual abuse during childhood.
Some of the most common treatment options that have been shown to be beneficial treating Schizophrenia are:
Medication or drug management
Drug intake can help reduce symptoms like hallucinations, delusions, paranoia, and disorganized thinking.
Doctors may recommend the best medication depending on the severity of the symptoms, especially because not everyone responds to medication the same way.
The most usually prescribed drugs are atypical antipsychotics or second-generation antipsychotics that are less likely to cause some of the side effects normally seen in typical medication.
The most recommended, to reduce certain symptoms and enhance functioning, is Cognitive Behavioral Therapy (CBT).
Though CBT they need to identify and target disruptive or dysfunctional behaviors in order to develop specific coping skills.
Supported employment service
People with Schizophrenia can benefit from getting trained in how to find and keep employment.
Family members, friends, relatives or partners, can get involved and they are usually educated in what Schizophrenia is, what it means to live with someone suffering from it and get trained in strategies on how to manage and support their loved one.
Additionally, it has been evidenced that involving the family in the treatment, increases the chances of therapeutic success.
Common Myths related to Schizophrenia…
- Schizophrenia is the same as “split personality” or having multiple personalities.
- Schizophrenia is a very rare and not so common condition.
- People with schizophrenia are extremely dangerous.
- People with schizophrenia can’t be treated.
Why is this blog post about types of Schizophrenia important?
It is important to understand what it is meant by the types of schizophrenia since some mental health professionals still use them to describe subtypes of schizophrenia-related to variations in symptomatology from one person to the other.
With this in mind, this guide about the types of schizophrenia is meant to be informative and bring awareness to what it means to live with this condition, understanding schizophrenia as one condition, the modified symptoms, treatment options, complications if left untreated, causes, risks, and some common myths to be aware of.
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What we recommend for Schizophrenia
If you have schizophrenia then ongoing professional counselling could be your ideal first point of call. Counselling will allow you to practice various habits that improve your overall quality of life.
Frequently Asked Questions (FAQs) about types of schizophrenia
Can schizophrenia go away?
Schizophrenia won’t go away, it is considered a life-long condition and until today there is no cure for it.
However, symptoms of schizophrenia can be treated with psychotherapy and medication.
What are the 5 types of schizophrenia?
What is the most common type of schizophrenia?
The most common type of schizophrenia from the previous classification was Paranoid schizophrenia.
How do you test for schizophrenia?
There are no laboratory tests specifically for schizophrenia, however, diagnosis can be based on fMRI and CT scans, blood test and behavioral observation.
- Schizophrenia Spectrum and Other Psychotic Disorders: Dsm-5(r) Selections
- Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness
- The Book of Woe: The DSM and the Unmaking of Psychiatry
- Pocket Psychiatry (Pocket Notebook Series)
- Schizophrenia Is a Misdiagnosis: Implications for the DSM-5 and the ICD-11