What Are The Subtypes Of Schizophrenia?

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 12/28/2020

According to the American Psychiatric Association, schizophrenia is a chronic brain disorder. It affects less than one percent of the population in the United States. The main symptoms that everyone typically associates with schizophrenia are hallucinations and delusions, but there are many more.

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The Signs and Symptoms of Schizophrenia

If you suspect you may have schizophrenia, you can take a free online test that can help you determine whether you may need to see a professional. Many of the signs of schizophrenia can be described as negative, positive, and cognitive. These are some of the most commonly reported symptoms.

Negative symptoms can mimic depressive disorders. Some of these include:

  • Not Showing Any Signs of Emotion. Seeming to have no interest in life as a whole.
  • Having A Poor Appearance due to not bathing or caring for themselves.
  • Talking in A Flat, Toneless Voice that is void of emotions.
  • Trouble Keeping Lasting Relationships. The disinterest in others and wanting to be alone causes people with schizophrenia to avoid or ignore loved ones.

The word positive in the positive symptoms does not mean good. It means they are characteristics that the individual has that others do not. Some of these include:

  • Hallucinations, which may include seeing things that others do not see. Hearing, feeling, or smelling things that are not there. Many people with schizophrenia hear voices, which are often threatening, which is the most common symptom.
  • Delusions include having strong ideas that are not considered to be real such as believing they are a god or that they are being watched or followed.
  • Thought Disorders include not understanding others when they speak and not being able to speak clearly. Those with schizophrenia may invent their own language or speak in a different tongue altogether.
  • Involuntary Movements may be repetitive or fast movements like tapping the foot or fingers after sitting still for a long time. They typically do not even know they are doing it.

Cognitive symptoms are those that affect a person’s overall functioning, such as:

  • Loss of Memory, including losing objects, forgetting something they just learned, or even forgetting who they are.
  • Inattention is observed as a general lack of interest or being unable to concentrate or focus.
  • Decision-Making Skills may be lacking. They may not be able to decide what to wear, so they just wear the same thing every day. Or they do not eat because they cannot decide what they want.
  • Inability to Comprehend or Recognize Things such as new but simple tasks or even everyday objects or situations.

The Subtypes of Schizophrenia

In addition to there being different types of symptoms, there were once ‘subtypes’ of schizophrenia based on the type of symptoms that a patient presented with.

These subtypes of schizophrenia included paranoid, catatonic, disorganized, residual, and undifferentiated types. At one point the Diagnostic and Statistical Manual, published by the American Psychiatric Association recognized these five subtypes of schizophrenia, but in the latest publication of the manual, no longer considers subtypes. The use of subtypes for diagnostic purposes resulted in poor diagnostic precision. Although clinicians no longer use the subtypes, here they are discussed to describe presentations of schizophrenia.

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Paranoid Schizophrenia

This subtype of schizophrenia was defined by paranoia. The person with this type of schizophrenia often has hallucinations and delusions that cause them to believe that someone is conspiring against them, watching or talking to them.

Disorganized Schizophrenia

This subtype was characterized by incoherence, not speaking clearly, lack of attention, no eye contact, and being generally disorganized.

Catatonic Schizophrenia

Those with catatonic schizophrenia seem to be stuck in one position and will not move.

Residual Schizophrenia

Residual schizophrenia was a subtype used to describe a person who has schizophrenia but is not experiencing any major symptoms like hallucinations or delusions. However, they must still be experiencing two of the common symptoms of schizophrenia to a lesser degree. These symptoms include lack of concentration, apathy, isolating themselves, not speaking clearly, and not thinking clearly.

Undifferentiated Schizophrenia

This subtype was reserved for those who did not fit into any of the other four subtypes. Those with undifferentiated schizophrenia have other symptoms such as disorganization, hallucinations, delusions, and even mild catatonia. But since the symptoms overlap, it cannot be classed as any of the other four subtypes.

The blurry lines between “types” of schizophrenia and the frequency with which symptoms from one “type” often appeared in another, often resulted in disagreement between clinicians about what type of schizophrenia a person had. For this reason, the American Psychiatric Association discontinued the use of subtyping.

Causes and Risks of Schizophrenia

Now that you know all of the types and subtypes of schizophrenia, you may want to know how it may develop. Although mental health experts and researchers are still unsure of the exact cause of schizophrenia, there are possible risk factors you should be aware of, such as:

Age ofthe Mother

Although it is still unclear why studies found that children born to older or younger parents may be more at risk for developing schizophrenia. This was only a factor in the first-born child and only included parents under 25 years of age or over 30 years of age.

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Genetics

Certain genes are present in those who have schizophrenia. Some of these genes include:

  • NRG3rs1074882
  • SETD1a
  • MIR137
  • DRD2
  • DGCR8
  • DGCR2
  • COMT
  • C4a
  • AKT1

To date, there is no solid evidence of any particular ‘schizophrenia’ gene, nor that the presence of any one gene alone determines whether or not a person develops schizophrenia.

Family History

Having an immediate family member with schizophrenia, psychosis, or any other kind of neurological brain disorder, indicates increased likelihood to develop schizophrenia.

Brain Damage or Chemical Imbalance

Brain structural abnormalities and chemical imbalances may be related to schizophrenia.

Prenatal Virus

Some studieshave found that schizophrenia is linked to particular virus antibodies in the mother during pregnancy.

Malnutrition During Pregnancy

In cases where the mother did not eat healthily or take the vitamins needed for the developing fetus, the risk of schizophrenia was higher. Studies are still being done but are finding that poor nutrition during pregnancy increases the chance of the baby developing schizophrenia.

Stressful Early Life

Interestingly, having a lot of stress during the early years of development can also be a risk factor for schizophrenia. In studies done by researchers, there is an increased chance of developing schizophrenia in those who have an unnatural amount of stress and anxiety in the first five years of life.

Drug Usage

According to the National Alliance on Mental Illness (NAMI), many studies found that those who took mind-altering drugs during their teenage years were at an increased risk of developing schizophrenia.

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Schizophrenia Can Be Treated

Being diagnosed with schizophrenia does not have to change your life as much as you may think. There are many types of medications that provide symptom relief. Also, psychotherapy is a way to help relieve symptoms and learn to live with schizophrenia.

  • Cognitive-Behavioral Therapy, or CBT, is a popular form of psychotherapy that helps you learn to see the relationship between your thoughts, feelings, and behaviors. The therapist can show you how changing your unhealthy thought patterns can improve your feelings and behaviors. CBT may include role-playing, journaling, worksheets, and possibly even group therapy.
  • Dialectical Behavioral Therapy, or DBT, is another form of psychotherapy that can help schizophrenia and other mental illnesses. This therapy is similar to CBT, but it concentrates on accepting your troubling feelings, behaviors, and thoughts rather than trying to get rid of them.
  • Interpersonal Therapy helps you learn to communicate with others better and build social skills. The therapist guides you through these skill-building sessions by encouraging you to evaluate your own way of interacting with others. This includes social inclusion, interacting with others, learning to trust your personal skills, and building your self-esteem.

Online Psychotherapy

Regardless of whether you have schizophrenia or someone you know is struggling with it,it is good to know about the disorder's symptoms. Those who are closest to the person with schizophrenia are better able to see the differences in the symptoms that doctors may not see when diagnosing the disease. Talking to a therapist, whether in person or online, is one of the best ways to get support while helping a loved one face their diagnosis, or to obtain support in your own diagnosis. If you or a loved one have symptoms of schizophrenia and want to know more, take this online test today.