Schizophrenia is a group of serious psychiatric disorders that, contrary to what many people think, don’t have to look like each other.

The types of schizophrenia are what have long served to determine the mental health of patients who present the symptoms , although knowing how to recognize and distinguish them is not easy.

In addition, the debate about whether there is a greater need to differentiate between types of schizophrenia or instead to address the phenomenon of schizophrenia globally has cast doubt on the appropriateness of using different subtypes based on separate diagnostic criteria.

Subtypes of schizophrenia or schizophrenia at all?

From the discussion about whether to consider types of schizophrenia or to talk about schizophrenia in general has come 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 still do. Depending on the categorization of symptoms and the emphasis placed on the variations and different forms in which schizophrenia can appear, either a single concept will be used to explain all cases of this disease, or various labels will be used to make it more specific: there is no objective criterion that will allow this question to be resolved.

As knowledge is power, here you can find a description of the characteristics of the types of schizophrenia that have been excluded from the DSMs in recent years.

1.Catatonic schizophrenia

This type of schizophrenia is characterized by the serious 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 so that they look like a wax figure (hence the name of the symptom), the inability to speak and the adoption of strange postures when standing or on the floor.

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 catatonic schizophrenia is presented, 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 impairment. Among these signs of disturbance in psychic functions is persecutory mania , that is, the belief that other people have want to harm us in the present or in the future.

It is also common in this type of schizophrenia to have auditory hallucinations and delusions (in the latter, no strange elements are perceived through the senses, but the thought is so altered that strange narratives are constructed about reality).

The delusions of grandeur, classic 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 person’s proactive behavior and initiatives) but rather negative symptoms (that is, characterized by the absence of basic psychological processes and with the lack of will and motivation). In other words, this type of schizophrenia is characterized by mental processes that are diminished, rather than by unusual excesses of mental activity.

People with this type of schizophrenia had many forms of inhibition, emotional flattening, poor verbal and non-verbal communication, etc.

Unlike the other types of schizophrenia we will see here, this one 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 in the present the positive symptoms are very moderate and of low intensity, while what is most striking is the “leftover” 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 the existence of behaviors that in themselves are a sign of pathology (such as the adoption of a totally rigid posture), the disease is expressed through the way in which the person’s actions are organized and follow one another . That is, its main characteristic is the disordered way in which the actions appear, compared to the rest.

Their behavior is chaotic and is not organized around themes that remain in time, that is to say, they do not construct a more or less coherent narrative that gives rise to persecution mania or hallucinations, for example. The person shows disorganization in their emotional states, in what they say and/or in the way they move.

6. Undifferentiated schizophrenia

This is a “drawer” category to be able to classify those cases that do not fit the diagnostic criteria of the rest of the types of schizophrenia. Therefore, it cannot be considered a consistent type of schizophrenia.

Bibliographic references:

  • 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 L.B., 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.