Schizophrenia is a mental health condition that affects a person’s thoughts and behaviors. The classifications and types of schizophrenia have changed over the years.

Thought- and behavior-related symptoms, such as delusions and hallucinations, determine the classification of the different types of schizophrenia.

Schizophrenia typically involves psychosis, which is a loss of connection with reality in some form. This may include hearing voices or holding false beliefs that may lead to paranoia.

This condition affects less than 1% of people in the United States. People usually receive their diagnosis between their late teens and early 30s.

This article explores the different types of schizophrenia and their current and past classification. It also looks at how a doctor diagnoses schizophrenia and the available treatment options.

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The classification of schizophrenia types changed with the 2013 update of the manual that mental health professionals use to diagnose mental health conditions. This is called the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The previous version, the DSM-4, described the following five types of schizophrenia:

  • paranoid type
  • disorganized type
  • catatonic type
  • undifferentiated type
  • residual type

The updated version, DSM-5, no longer uses these categories. The features of these types — including paranoia, disorganized speech and behavior, and catatonia — are still features of a schizophrenia diagnosis, but experts no longer consider them distinct subtypes.

Overlapping subtype symptoms and low diagnostic precision were among the reasons for updating the DSM classification of schizophrenia.

In 2022, the American Psychiatric Association published an updated version of the DSM-5 manual, DSM-5-TR. However, this version does not significantly change the classification of schizophrenia.

The DSM-5-TR helps mental health professionals diagnose schizophrenia by describing the key symptoms of the condition.

Under the DSM-5-TR classification, a person must display at least two of the following symptoms for a significant length of time over 1 month to receive a diagnosis of schizophrenia:

At least one of the symptoms must be either delusions, hallucinations, or disorganized speech. The symptoms must significantly affect a person’s occupation, social life, or personal relationships and must persist for at least 6 months, being present for at least 1 month in total.

The severity of a person’s schizophrenia will depend on the frequency and severity of each of these symptoms.

If the individual experiences catatonia, they may receive a diagnosis of schizophrenia with catatonia.

Mental health professionals use the same criteria to diagnose schizophrenia in adults and children.

However, schizophrenia is very rare in children. People may refer to this as childhood-onset schizophrenia or early onset schizophrenia.

Learn more about schizophrenia in childhood.

Schizophrenia is the most well-known condition of its type, but a range of conditions involve psychosis and other schizophrenia-like symptoms.

The DSM-5-TR lists schizophrenia alongside several other conditions that it groups under “schizophrenia spectrum and other psychotic disorders.” These conditions include:

  • Schizotypal personality disorder: This involves discomfort in close relationships, disturbances in cognition or perceptions, and eccentric behavior.
  • Delusional disorder: This involves the person having delusions for 1 month but no other psychotic symptoms.
  • Brief psychotic disorder: This occurs when symptoms of psychosis last for longer than a day but less than a month.
  • Schizophreniform disorder: This occurs when symptoms of schizophrenia last for less than 6 months.
  • Schizoaffective disorder: This mainly involves symptoms of schizophrenia, but a person may also have significant mood symptoms, such as mania or depression.
  • Substance- or medication-induced psychotic disorder: Psychotic symptoms can arise from the use of alcohol, cannabis, hallucinogen, or sedatives. They may also appear after taking certain medications, such as anesthetics, anticonvulsants, heart medications, chemotherapy drugs, or antidepressants.
  • Psychotic disorder due to another medical condition: There are various possible causes of psychosis, including untreated endocrine, metabolic, or autoimmune conditions and temporal lobe epilepsy.

The symptoms of schizophrenia may overlap with those of bipolar disorder, which is a condition that causes changes in mood, energy, activity, and behavior.

Learn how the symptoms of schizophrenia compare with those of bipolar disorder.

The DSM-4 classified the following types of schizophrenia as separate conditions, but experts have not recognized them as diagnostic categories since the publication of the DSM-5 in 2013.

Paranoid type

Experts previously characterized a person with paranoid schizophrenia as meeting the following criteria:

  • a preoccupation with one or more delusions or frequent auditory hallucinations
  • certain symptoms — disorganized speech, disorganized or catatonic behavior, and a lack of or inappropriate emotional response — are not prominent

Delusions and hallucinations are still elements of a schizophrenia diagnosis, but experts no longer consider paranoid schizophrenia a distinct subtype.

Learn more about paranoia and schizophrenia.

Disorganized type

For a person to receive a diagnosis of disorganized schizophrenia, they had to display disorganized speech and behavior, as well as flat or inappropriate emotional expression. They also could not meet the criteria for catatonic schizophrenia.

Although experts no longer consider disorganized schizophrenia a distinct subtype, disorganized speech and thought are still elements of a schizophrenia diagnosis.

Learn more about disorganization in schizophrenia.

Catatonic type

Catatonia is a crucial component of catatonic schizophrenia. Catatonia is a type of syndrome that causes a person to have abnormal physical movements, behaviors, and withdrawal.

A person may appear excited or withdrawn. They may also display other symptoms, such as:

  • mutism, which is being unable to speak
  • echolalia, or repeating other people’s words
  • echopraxia, which refers to mimicking other people’s actions
  • depression, mania, or psychosis

A person must have at least two symptoms of catatonia to receive a diagnosis of catatonic schizophrenia.

Catatonia can occur with schizophrenia and various other conditions, including bipolar disorder. For this reason, mental health professionals now consider it a specifier for schizophrenia and other mood disorders rather than a type of schizophrenia.

Learn more about catatonic symptoms and schizophrenia.

Undifferentiated type

Undifferentiated schizophrenia involved symptoms that did not fit into the paranoid, disorganized, or catatonic types of schizophrenia.

Learn more about undifferentiated schizophrenia.

Residual type

For a diagnosis of residual schizophrenia, experts used to refer to these criteria:

  • the absence of prominent delusions, hallucinations, disorganization, or catatonic behavior
  • continuing disturbance, with the presence of two or more symptoms that may be mild, such as odd beliefs or unusual perceptions

Learn more about residual schizophrenia.

People with schizophrenia may have another mental health condition or comorbidity. For example, a 2020 study found that people with schizophrenia may have other comorbidities, such as:

The same study found that the average prevalence of comorbidities in people with schizophrenia was 23%, with the comorbidity rate in the range of 4–50%.

A person with schizophrenia may have an increased risk of other conditions, such as cardiovascular disease and respiratory disease. This is due to a higher incidence of smoking and decreased engagement in health-promoting behaviors.

The typical age range for receiving a diagnosis of schizophrenia is 16–30 years.

A person will need to see a doctor to receive a diagnosis of schizophrenia. No single physical or lab test can confirm schizophrenia.

Instead, a doctor will ask a person about their symptoms and how long they have been experiencing them. They may also ask the person whether they have a family history of mental health conditions and whether the symptoms have worsened over time.

For a diagnosis of schizophrenia, a person must have at least two of the following symptoms for a significant length of time over 1 month:

  • delusions
  • hallucinations
  • disorganized speech
  • disorganized or catatonic behavior
  • negative symptoms

A person must also be experiencing social or occupational disruption, which must last for at least 6 months and include at least 1 month of symptoms.

A doctor may conduct a full psychiatric history and order blood and urine tests to rule out other possible causes of the symptoms.

There is no cure for schizophrenia. The current treatment options focus on helping people with schizophrenia manage their symptoms and maintain their day-to-day routine.

Antipsychotic medications

A person with schizophrenia will likely receive medication to help with their psychotic symptoms. These medications may be in pill, liquid, or tablet form. Some people may receive the medication as an injection once or twice a month.

Antipsychotic medications include:

Learn more about antipsychotic medications.

A person may also receive benzodiazepines to help with anxiety symptoms and behavioral disturbances. These medications include:

Cognitive behavioral therapy (CBT)

CBT is a goal-oriented form of therapy that helps a person identify unhelpful behaviors and thoughts. It also provides the person with strategies to combat them.

CBT and other forms of therapy, such as art or drama therapies, may help a person with the negative symptoms of schizophrenia and help prevent relapse.

Learn more about CBT and how it works.

Clozapine

Clozapine is a type of antipsychotic drug that doctors may prescribe for a person who is resistant to other antipsychotic medications. Healthcare professionals typically prescribe clozapine if a person does not respond well to at least two different antipsychotic medications.

A doctor will monitor a person taking clozapine, and the person will need to undergo blood tests due to the increased risk of agranulocytosis. This occurs when the body is unable to make enough white blood cells.

A person with schizophrenia has an increased risk of premature death. According to the World Health Organization (WHO), a person with schizophrenia is two to three times more likely to die early than the general population.

The average potential life loss for people with schizophrenia in the U.S. is 28.5 years.

Approximately 4.9% of people with schizophrenia die by suicide. This rate is significantly higher than it is among the general population. However, treatment and therapy may lower this risk in a person.

According to the WHO, at least one-third of people with schizophrenia experience complete remission of their symptoms.

Schizophrenia is a mental health condition that affects a person’s thoughts and behaviors.

The current classification system for the classification of schizophrenia is in the DSM-5-TR. Mental health professionals no longer use the terms paranoid schizophrenia, disorganized schizophrenia, and catatonic schizophrenia. Instead, they use the umbrella term schizophrenia to describe the condition as a whole and note which specific symptoms an individual is experiencing.

Schizophrenia is a complex condition, and many related conditions have similar symptoms. A person with schizophrenia may also experience comorbidities, such as depression, cardiovascular disease, or respiratory disease.

A person will only receive a diagnosis of schizophrenia if they display at least two symptoms of schizophrenia for a significant period.

The treatment options include antipsychotic medications and therapy, such as CBT.

If a person is concerned about the symptoms that they or a loved one is experiencing, they can find more resources from the National Institute of Mental Health or look for mental health services on the Substance Abuse and Mental Health Services Administration website.

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