A psychiatric disorder that can be subdivided into six different types.
Schizophrenia is a group of serious psychiatric disorders that, contrary to what many people believe, do not have to resemble each other.
The types of schizophrenia are what have long served to determine the mental health of patients with symptoms, although knowing how to recognize and distinguish them is not easy.
Furthermore, the debate about whether it is more necessary to differentiate between types of schizophrenia or, on the contrary, the phenomenon of schizophrenia must be approached globally, has raised doubts about the appropriateness of using different subtypes based on separate diagnostic criteria.
Subtypes of schizophrenia or just schizophrenia?
From the discussion about whether to consider types of schizophrenia or to speak of schizophrenia in general has had an important consequence: recently, the DSM-V diagnostic manual has stopped differentiating according to subtypes of schizophrenia, although that does not mean that this decision has received good levels of acceptance by psychiatrists in general.
In short, it is not at all clear whether or not to distinguish between types of schizophrenia, but many specialists in the medical field continue to do so. Depending on the categorization of the symptoms and the emphasis placed on the variations and different forms in which schizophrenia can appear, a single concept will be used to explain all cases of this disease or different labels will be used to specify more: no there is an objective criterion that allows to resolve this question.
As knowledge is power, here you can find a description of the characteristics of the types of schizophrenia that have been excluded from the DSM in recent years.
1. Catatonic schizophrenia
This type of schizophrenia is characterized by the severe psychomotor disorders that the patient presents. These pathological alterations are not always the same, although the main ones are immobility and waxy rigidity, in which the person keeps the muscles tense in a way that looks like a wax figure (hence the name of the symptom), the inability to speak and adopting strange postures while standing or on the ground.
During the phases in which catatonia occurs, alterations in consciousness and other alterations such as mutism, stupor and staring also appear, alternating these negative symptoms with others such as agitation. However, it must be taken into account that there can be a lot of variability in the way in which catatonic schizophrenia presents, and most patients do not present all the symptoms associated with it at the same time.
Finally, it is necessary to point out that in addition to the discussion about whether there are types of schizophrenia or a single clinical entity that expresses itself in different ways, there is a debate about whether catatonia is in fact one of the manifestations of schizophrenia or whether it is another independent phenomenon.
2. Paranoid schizophrenia
One of the best known types of schizophrenia, in this case the symptoms tend to be more psychic than motor ; in fact, people with this kind of schizophrenia do not have motor or speech impairments. Among these signs of alteration in psychic functions is persecution mania , that is, the belief that other people want to harm us in the present or in the future.
It is also frequent that in this type of schizophrenia there are auditory hallucinations and delusions (in the latter, strange elements are not perceived through the senses, but thought is so altered that strange narratives are constructed about reality).
The delusions of grandeur, classics of megalomaniacs, can also make their appearance here.
3. Simple schizophrenia
This has been a category to designate a possible type of schizophrenia in which there are not so many positive symptoms (that is, those that define the proactive behavior and initiatives of the person) and there are negative symptoms (that is, characterized by the absence of basic psychological processes and with a lack of will and motivation). In other words, this type of schizophrenia is characterized by mental processes that are diminished, and not so much by unusual excesses of mental activity.
People with this type of schizophrenia showed many forms of inhibition, affective flattening, little verbal and non-verbal communication, etc.
Unlike the rest of the types of schizophrenia that we will see here, this did not appear in the DSM-IV, but has been a category proposed by the WHO.
4. Residual schizophrenia
This category was used as a type of schizophrenia that occurs when there has been an outbreak of schizophrenia in the past but at present the positive symptoms are very moderate and of low intensity, while what is most striking are the “remains” of negative symptoms that have remained. Therefore, to understand this type of schizophrenia it is very important to take into account the time factor and make comparisons between before and after.
5. Disorganized or hebephrenic schizophrenia
In this type of schizophrenia, more than there are behaviors that are in themselves a sign of pathology (such as the adoption of a totally rigid posture), the disease is expressed through the way in which the actions of the person. That is, its main characteristic is the disorderly way in which the actions appear, compared to the rest.
His behavior is chaotic and is not organized around themes that are maintained over time, that is, a more or less coherent narrative is not constructed that gives rise to the persecution mania or hallucinations that one has, for example. The person shows disorganization in their emotional states, in what they say and / or in their way of moving.
6. Undifferentiated schizophrenia
This is a “mixed bag” category to be able to classify those cases that do not fit the diagnostic criteria of the other types of schizophrenia. Therefore, it cannot be considered a consistent type of schizophrenia.
- Fink, M., Shorter, E., and Taylor, M. a. (2011). Catatonia is not schizophrenia: Kraepelin’s error and the need to recognize catatonia as an independent syndrome in medical nomenclature. Schizophrenia Bulletin, 36 (2), pp. 314-320.
- Jansson LB, Parnas J. (2007). Competing definitions of schizophrenia: what can be learned from polydiagnostic studies ?. Schizophrenia Bulletin 33 (5): pp. 1178-200.
- Wilson, M. (1993). “DSM-III and the transformation of American psychiatry: a history.” American Journal of Psychiatry 150 (3): pp. 399-410.