Are There Different Types of Schizophrenia?

Doctors who specialize in mental health used to divide schizophrenia into different subtypes. But that system didn’t work well.

Now, experts talk about schizophrenia as a spectrum disorder. It's a group of related mental disorders that share some symptoms. They're like variations on a theme in music. They affect your sense of what's real. They change how you think, feel, and act.

The main disorder is schizophrenia. It includes all the previous subtypes: catatonic, disorganized, paranoid, residual, and undifferentiated.

It's a psychosis, which means that what seems real to you isn't. It can look like:

Hallucinations : Seeing or hearing things that aren't there.

Delusions: Mistaken but firmly held beliefs that are easy to prove wrong, like thinking you have superpowers, are a famous person, or people are out to get you.

Disorganized speech: Using words and sentences that don't make sense to others.

Strange behavior: Acting in an odd or repetitive way, like walking in circles or writing all the time, or sitting perfectly still and quiet for hours on end.

Withdrawn and lifeless: Showing no feelings or motivation, or lacking interest in normal daily activities.

People with schizophrenia have at least two of these symptoms for at least 6 months. One of them must be hallucinations, delusions, or disorganized speech. A single voice that offers ongoing comments about your thoughts and actions, or voices that talk to each other, is enough.

There could have been times when you didn't have any symptoms, but the first one would have started at least 6 months ago. And you must have had them for at least a month continuously.

You may have different symptoms at different times, and they may get worse or better -- and it's still schizophrenia.

Doctors may categorize your schizophrenia according to your main symptom to make a diagnosis clearer. But rather than saying you have "paranoid schizophrenia," they would say you have "schizophrenia with paranoia,” for example.

Related Disorders

What makes schizophrenia different from some similar disorders in the spectrum is how long you've had symptoms and whether you also have signs of a mood disorder.

When you've had psychotic symptoms for at least a month but less than 6 months, doctors call it schizophreniform. Many people with this disorder go on to have schizophrenia. In other words, schizophreniform is often early schizophrenia.

But for about one-third of people, the symptoms just go away.

With schizoaffective disorder, you'll have a combination of psychotic symptoms along with depression (major depressive disorder) or bipolar disorder. You could feel very down, or swing between super high-energy or highly irritable and very low, too.

In schizoaffective disorder, the psychotic symptoms have to sometimes happen even when your mood is OK. This is a rare, serious, lifelong illness.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on May 30, 2016

Sources

SOURCES:

American Psychiatric Association: "Schizophrenia," "DSM-5 Overview: The Future Manual."

Tandon, R. Schizophrenia Research, October 2013.

NAMI: "Diagnostic Criteria for Schizophrenia."

Cleveland Clinic: "Schizophreniform Disorder," "Schizoaffective Disorder."

Malaspina, D. Schizophrenia Research, October 2013.

Pelizza, L. Acta Biomedica, September 2010.

William T. Carpenter, MD, professor of psychiatry and pharmacy, University of Maryland School of Medicine and Maryland Psychiatric Research Center, Baltimore, MD.

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