Today, clinicians typically view schizophrenia as a spectrum of symptoms. Until fairly recently, though, there were distinct diagnoses for several different types of schizophrenia.
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What Is Schizophrenia?
Schizophrenia is a chronic mental health disorder that can undermine a person’s ability to accurately perceive their environment, express their thoughts, and interact with others.
Depending on the type and intensity of a person’s symptoms, it may be extremely difficult for them to complete school, get and keep a job, and establish an independent lifestyle.
Highlighting the dramatic negative impact that schizophrenia can have, an April 2017 meta-analysis in the journal Lancet Psychiatry found that the weighted average life expectancy among people with this condition is about 14.5 years shorter than it is among the general public.
Symptoms
As established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), schizophrenia is characterized by five types of symptoms:
- Hallucinations: Auditory and visual hallucinations are most common, but it’s possible for hallucinations to also involve the senses of smell, taste, and touch.
- Delusions: These are rigidly held beliefs that can be easily disproved (such as claims that a person is in a romantic relationship with a celebrity they’ve never met) or have no basis in reality (such as believing they have supernatural powers).
- Disorganized speech: This can involve using words for their sound or rhyming pattern instead of their meaning, jumping from topic to topic with no logical progression or connection, or speaking in an incomprehensible manner.
- Grossly disorganized or catatonic behavior: Examples of this symptom include unpredictable agitation, childish behaviors, purposeless movements, and maintaining an odd or bizarre posture.
- Negative symptoms: People with this symptom type may exhibit diminished facial expressiveness, speak in a flat or monotone voice, or have little to no motivation for engaging in purposeful activities.
To be accurately diagnosed with schizophrenia, a person must have at least two of the symptoms listed above. At least one of the symptoms must be hallucinations, delusions, or disorganized speech.
Causes
Schizophrenia has not been linked with a single cause. Instead, experts have identified a range of factors that can increase a person’s risk for developing this condition.
Risk factors enumerated in the DSM-5 include older parental age, oxygen deprivation during birth, and several genetic variations.
According to an April 2016 review in the journal Neuroscience & Biobehavioral Reviews, other potential risk factors and vulnerabilities include:
- Maternal malnutrition before and during pregnancy
- Vitamin D deficiency in utero and during infancy
- Cannabis use during adolescence
- Physical, psychological, and/or sexual abuse during childhood
- Infection with human endogenous retroviruses (HERVs)
- Tobacco use
- Being a member of a marginalized and excluded social or ethnic group
What Are the Different Types of Schizophrenia?
The DSM-4 included criteria for five sub-types of schizophrenia: paranoid, catatonic, disorganized, residual, and undifferentiated.
These different types of schizophrenia were eliminated when the DSM-5 was published in 2013. However, reviewing their descriptions can still be valuable for many reasons, including:
- To emphasize the many ways that this condition can manifest
- To ensure that people receive the treatment that best aligns with the type and severity of their symptoms
- To see how experts’ understanding of schizophrenia has evolved
Paranoid Schizophrenia
Paranoid schizophrenia was the most frequent diagnosis during the period when the different types of schizophrenia were official clinical designations. This type is also probably the closest version to what most people understand as “typical” schizophrenia.
The primary characteristics of paranoid schizophrenia are delusions and auditory hallucinations. As suggested by the name of this type, the delusions often cause the individual to believe that they are being spied on, targeted, or otherwise persecuted.
Catatonic Schizophrenia
People with catatonic schizophrenia are unlikely to experience hallucinations or delusions. Instead, dysfunctional speech patterns, negative symptoms, and abnormal behaviors are dominant.
This type of schizophrenia is associated with symptoms such as:
- Flat affect, including minimal facial expressions or speech variations
- Diminished interest in goal-directed activities or interactions with other people
- Anhedonia, which is the inability to feel pleasure or experience joy
Disorganized Schizophrenia
Also often referred to as hebephrenia, disorganized schizophrenia primarily affects a person’s thought processes and speech patterns.
People who have this type of schizophrenia often exhibit symptoms such as:
- “Word salad,” or the use of what appear to be random, unconnected words and phrases
- Echolalia, or repeating words or sounds made by other people
- Tangentiality, or a tendency to veer far off-topic when speaking
- Neologisms, which are made-up words that have no apparent meaning to others
Residual Schizophrenia
Residual schizophrenia referred to cases in which people had previously experienced powerful hallucinations and delusions, but those symptoms had mostly subsided. However, other effects – primarily negative symptoms – remained present.
Undifferentiated Schizophrenia
This was the “catch-all” category for people whose schizophrenia symptoms did not match up with the criteria for one of the other four types.
How Is Schizophrenia Treated?
Treatment for schizophrenia typically involves medication, therapy, education, and ongoing support.
The medication component of schizophrenia treatment may include an array of prescription drugs, including:
- First-generation antipsychotics such as chlorpromazine (Thorazine)
- Second-generation antipsychotics such as aripiprazole (Abilify)
- Mood stabilizers such as lithium or valproic acid
- Antidepressants such as fluoxetine (Prozac)
Therapies and support services that can be beneficial for people with schizophrenia include:
- Family therapy and education
- Group therapy
- Cognitive behavioral therapy (CBT)
- Cognitive enhancement therapy (CET)
- Social skills instruction
- Psychosocial therapies
- Expressive arts therapy
The most effective elements of care can vary from person to the next, influenced by factors such as the nature of their symptoms, the impact that these symptoms have had on their life, and if they have developed any co-occurring medical or mental health concerns.
Learn More About Schizophrenia Treatment in Tampa Bay
Tampa Bay Recovery Center is a trusted source of personalized outpatient care for adults who have schizophrenia, other mental health concerns, and co-occurring addictions. Treatment options at our center in Tampa Bay, FL, include a partial hospitalization program (PHP), an intensive outpatient program (IOP), and a virtual (online) program.
We will be happy to discuss the features and benefits of each of these options with you and identify the ones that best align with your loved one’s unique needs.
To learn more about how we can help, or to schedule a free assessment, please visit our Contact page or call us today.
