Understanding the Different Types of Schizophrenia

Understanding the Different Types of Schizophrenia
Written By: Clinical Psychologist
Reviewed By: Counselling Psychologist
MA Psychology Pennsylvania State University, USA
Last Updated: 22-11-2023

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What is Schizophrenia?

Schizophrenia is a severe and disabling mental health condition, that affects how an individual thinks, feels, and behaves. Such individuals experience psychosis, that is, a loss of contact with reality. Their ability to perceive and respond to others becomes so disturbed that they may not be able to complete daily chores at home, fulfil assigned duties at work or maintain interpersonal relationships.

Although schizophrenia is discussed as if it were a single illness, it is probably encompassing in the group of diseases with heterogeneous aetiology and includes patients with clinical disease presentations, response to treatment and course of the disease are different. Symptoms and signs are variable and include changes in perception, emotion, thinking and behaviour.  

The manifestation of these symptoms varies between patients and over time, but the effects of the disease are always severe and usually long-lasting. The psychopathology of schizophrenia generally begins before the age of 25, lasts a lifetime and affects all kinds of people and classes. Both patients and their families often suffer from poor care and social exclusion disorder due to widespread ignorance.

Schizophrenia is one of the most common type of disorder among severe mental health disorders, but the nature of which has not yet been explained; therefore, it is sometimes referred to as a syndrome, a group of schizophrenias, or as mentioned in Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Fifth Edition, schizophrenia spectrum.

Doctors should understand the diagnosis of schizophrenia based entirely on psychiatric history and mental status examination. There is no laboratory test for Schizophrenia.

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The Different Types of Schizophrenia

Paranoid Type: Frequent auditory hallucinations or obsession with one or more delusions are hallmarks of the paranoid form of schizophrenia. Delusions of grandeur or persecution are the main characteristic of the paranoid kind of schizophrenia, according to conventional wisdom. Compared to individuals with catatonic or disorganized schizophrenia, patients with paranoid schizophrenia typically experience their first episode of the disease at a later age. Individuals with schizophrenia who develop in their late 20s or early 30s typically have a social network that supports them during their disease, and paranoid patients typically have larger ego resources than catatonic and disorganized patients. Compared to people with other forms of schizophrenia, those with paranoid schizophrenia have less regression in their mental abilities, emotional responses and conduct. 

While paranoid schizophrenia patients are generally tense, distrustful, guarded, reserved and occasionally violent or aggressive, they can also behave appropriately in social circumstances on occasion. When their psychosis isn t there, their IQ usually stays intact.

Disorganized Type: The absence of symptoms that match the criteria for the catatonic form of schizophrenia and a noticeable relapse to primitive, disinhibited and chaotic behaviour are characteristics of the disorganized kind of disorder. This subtype typically manifests before the age of twenty-five. Patients with disorganization are typically active but in a pointless, unproductive way. They have severe thinking problems and have little sense of reality. They have an untidy personal appearance, poor social behaviour, and inappropriate emotional responses.

Often they would laugh out loud for no apparent reason. These patients frequently exhibit odd smiles and grimacing; their actions are best characterized as foolish or pretentious.

Catatonic Type: In North America and Europe, the catatonic form of schizophrenia, which was prevalent a few decades ago, is now uncommon. A notable disruption in motor function, involving posturing, excitation, rigidity, negativism, or stupor is the hallmark of the catatonic type.

The patient may occasionally exhibit sudden swings between extremes of exhilaration and lethargy. Waxy flexibility, mannerisms, and stereotypes are associated traits. Mutism is especially prevalent. Patients require close supervision during catatonic excitation to keep them from harming others or themselves. It may be necessary to seek medical attention due to malnourishment, fatigue, elevated body temperature or self-harm.

Undifferentiated Type: Frequently, patients who clearly have schizophrenia cannot easily fit into one type or another. These patients are classified as having schizophrenia of the undifferentiated type.

Residual Type: The persistent schizophrenic disturbance in the absence of all active symptoms or just enough symptoms to rule out another type of schizophrenia is what defines the residual type of schizophrenia. The residual type is characterized by emotional blunting, social withdrawal, eccentric behaviour, illogical thinking, and mild loosening of associations. When hallucinations or delusions do arise, they are not dramatic or intensely felt.

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  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  2. Kay, S. R. (1991). Positive and negative symptoms in schizophrenia: Bleuler, Freud, and the future. British Journal of Psychiatry, 159(6), 565-577. doi: 10.1192/bjp.159.6.565

  3. Kendler, K. S., & Lieberman, J. A. (2014). The search for psychosis: Nature, nurture, and neuroscience. Oxford University Press.

  4. Lewis-Holmes, E., & Murray, R. M. (2005). Disordered salience and the symptomatic core of schizophrenia. Psychological Medicine, 35(9), 1377-1389. doi: 10.1017/S0033291705006278

  5. National Institute of Mental Health. (2023). Schizophrenia. https://www.nimh.nih.gov/health/publications/schizophrenia

  6. Owen, M. J., Sawa, A., & Krystal, J. H. (2016). Neurotransmitter systems and circuits in schizophrenia. Neuron, 88(1), 77-97. doi: 10.1016/j.neuron.2015.11.008

  7. Taylor, D. M., & Andreasen, N. C. (2000). Converging evidence for a neurodevelopmental model of schizophrenia. European Archive of Psychiatry and Clinical Neuroscience, 210(3), 150-165. doi: 10.1007/s004060000079

  8. Walker, E., & Davis, M. (2008). Illuminating the path: The history of schizophrenia. Oxford University Press.

  9. Andreasen, N. C., & Fenton, W. E. (2008). Understanding schizophrenia: A very short introduction. Oxford University Press.

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