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.
The classification of schizophrenia types
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
- disorganized speech
- very disorganized or catatonic behavior
- negative symptoms, such as reduced emotional expression
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
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.
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.
- 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.
For a person to receive a diagnosis of disorganized schizophrenia, they had to
Although experts no longer consider disorganized schizophrenia a distinct subtype, disorganized speech and thought are still elements of a schizophrenia diagnosis.
Catatonia is a crucial component of catatonic schizophrenia. Catatonia is a type of syndrome that causes a person to have
A person may appear excited or withdrawn. They may also display other symptoms,
- 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
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.
Undifferentiated schizophrenia involved symptoms that
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
People with schizophrenia may have another mental health condition or comorbidity. For example, a
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,
The typical age range for receiving a diagnosis of schizophrenia is
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
- 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
A person with schizophrenia will likely
A person may also receive benzodiazepines to help with anxiety symptoms and behavioral disturbances. These medications include:
Cognitive behavioral therapy (CBT)
CBT is a
Clozapine is a type of antipsychotic drug that doctors may prescribe for a person who is
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
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