What Are the Different Types of Schizophrenia?

Medically reviewed by Kathleen Daly, MDMedically reviewed by Kathleen Daly, MD

Schizophrenia is a mental health condition that affects your thoughts, emotions, behaviors, and ability to communicate, plan, and relate to others. Generally, the condition is pretty rare and affects less than 1% of the U.S. population. Most people with this condition typically start showing symptoms in their late teens, 20s, and early 30s.

In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), schizophrenia is not categorized into different types. The previous edition (the DSM-4), however, organized schizophrenia into five types: paranoid, catatonic, disorganized, undifferentiated, and residual schizophrenia. Some researchers still refer to these types during the diagnostic process, though.

Paranoid Schizophrenia

Paranoid schizophrenia typically causes psychotic (or psychosis-related) symptoms such as delusions and hallucinations. Delusions are false beliefs that you might have even though there's evidence to a contrary belief, whereas hallucinations occur when you see, hear, smell, taste, or feel things that aren’t actually there—such as voices or visual images.

For people with paranoid schizophrenia, delusions and hallucinations are often grandiose, meaning that they involve an inflated sense of self-importance. They can also be persecutory, which refers to believing that someone or something is “out to get you.” For example, a person with paranoid schizophrenia may think they hear voices threatening them or people chasing them. They may also believe that a person or organization is spying on them, even if they don't have proof of that claim.

Catatonic Schizophrenia

Catatonic schizophrenia (or schizophrenia with catatonia) affects the way a person moves their body, responds to stimuli, and relates to the world around them. A person with this type may exhibit signs of either catatonic stupor (which involves moving very little and appearing withdrawn) or catatonic excitement (which refers to agitated, restless, and excessive movements).

People with catatonic schizophrenia may also often be unresponsive when others try to interact with them. Some also experience echolalia (repeating the same words or phrases over and over) or echopraxia (repetitive movements).

Disorganized Schizophrenia

Disorganized schizophrenia involves severe cognitive, behavioral, and emotional symptoms. People with disorganized schizophrenia typically experience disorganized thinking, which means that they may have racing or illogical thoughts or make connections between unrelated ideas. They also tend to express their thoughts and emotions in ways that others find confusing, bizarre, or unsettling, such as speaking in unusual patterns and laughing or scowling at inappropriate times.

This type of schizophrenia is often considered the most serious type, as it typically affects daily functioning to the greatest extent.

Undifferentiated Schizophrenia

Undifferentiated schizophrenia historically referred to a condition that caused symptoms of another type of schizophrenia (such as psychotic or disorganized schizophrenia), but a person with these symptoms didn't meet the full diagnostic criteria for a specific type of schizophrenia. This term has since been considered outdated, and most healthcare providers use the term "schizophrenia spectrum disorder" to highlight how symptoms of schizophrenia can vary across a spectrum.

Residual Schizophrenia

Someone may be diagnosed with residual schizophrenia if they have had at least some positive symptoms of schizophrenia (which refer to symptoms like hallucinations or disorganized thinking) but now only have negative symptoms. In schizophrenia terms, negative symptoms are related to your emotions and how you interact with others. Some negative symptoms include speaking very little, lack of motivation, social withdrawal, and depression.

In other words, people with residual schizophrenia may still have beliefs and behaviors that others might consider eccentric, but they no longer experience severe or positive symptoms associated with the condition.

Other Related Conditions

Symptoms of mental health conditions tend to overlap. There are several other conditions that share certain symptoms with schizophrenia, including:

• Schizoaffective disorder: Causes symptoms of both schizophrenia and a mood disorder (such as bipolar disorder or depression) at the same time

• Schizophreniform disorder: Causes the same symptoms of schizophrenia, such as delusions, hallucinations, negative symptoms, and disorganized speech—but these are short-term and only last between one and six months

• Delusional disorder: Causes persistent delusions for a month or more, with no additional symptoms

• Brief psychotic disorder: Causes psychotic symptoms for a short period, usually between a day to a month

• Schizotypal personality disorder: Causes symptoms like reclusiveness, disorganized speech patterns, bizarre and distorted thinking, and difficulty forming meaningful relationships with others—but these symptoms tend to be less severe than schizophrenia

• Substance-induced psychotic disorder: Causes psychosis as a side effect of a drug, like hallucinogens or certain prescription medications

• Psychotic disorder due to another medical condition: Causes symptoms of psychosis due to underlying conditions like brain tumors, Parkinson’s disease, Alzheimer’s disease, fever, and hypoglycemia (extremely low blood sugar levels)
  

Diagnosis

If you or a loved one are experiencing signs of schizophrenia, seeing a healthcare provider about your symptoms is important. The earlier you receive a diagnosis for your condition, the sooner you can get started on treatment that helps you improve your symptoms and quality of life. Getting mental health support can feel worrisome or scary, but it's important to know that support is out there. Knowing what to expect during the diagnostic process can also help ease any anxiety.

When you go in for an appointment, your primary healthcare provider will ask about your symptoms, conduct a physical exam, and often refer you to a mental health provider such as a psychiatrist or psychologist. Your mental health provider will then evaluate your symptoms and behavior on an ongoing basis—generally lasting around six months. They may also order other tests to rule out other conditions that may cause similar symptoms, such as a brain tumor or substance use disorder.

After they complete the necessary testing and evaluation period, your provider can determine whether or not you meet the criteria for schizophrenia, according to the DSM-5. Should you receive a diagnosis for schizophrenia, your provider will work with you to find the best treatment options for your individual needs.

Treatment Options for Schizophrenia

While there is no cure for schizophrenia at this time, several treatments can help keep symptoms at bay and boost your quality of life significantly. The goal of treatment is to improve your daily life so you can meet your goals, form healthy relationships, participate in your community, and attain educational or career outcomes if you desire them. Your exact treatment plan will likely involve a combination of these treatment options:

• Medication: Using antipsychotic medications, benzodiazepines, antidepressants, or anti-seizure medications

• Coordinated specialty care (CSC) programs: Includes in-patient care, out-patient care, or a mix of both to help you improve symptoms and work with trained professionals (like case managers, psychotherapists, and social workers) to help you perform daily activities well

• Psychosocial intervention: Incorporates a variety of interventions such as individual therapy, group therapy, family education, support groups, behavioral skills training, vocational rehabilitation, educational counseling, psychoeducation, and cognitive remediation

• Drug and alcohol counseling: Offers healthier coping mechanisms to help you manage symptoms, especially because people with schizophrenia have higher-than-average rates of substance use disorder

In some cases, healthcare providers may recommend electroconvulsive therapy (ECT) to treat schizophrenia. ECT places electrodes on specific points of your head to send electric shock signals to induce a seizure and improve brain activity. This treatment is particularly effective for treating catatonic schizophrenia. If you think this treatment may be a good option for you, consider talking to your provider for advice.

When to Contact a Healthcare Provider

If you think you may have signs of schizophrenia, it's better to see a healthcare provider sooner rather than later. They can refer you to a mental health provider and offer in-patient care if necessary. You can also find local resources for yourself or a loved one through the Substance Abuse and Mental Health Services Administration (SAMHSA).

Family members, friends, and partners of people with schizophrenia should also gently encourage their loved ones to seek treatment and help them find resources if possible. Family education programs may help you understand the condition in more detail, while support groups can offer compassion, help, and advice as you navigate this journey.

A Quick Review

According to the DSM-5, schizophrenia is no longer divided into separate subtypes. However, the DSM-4, which was released before the fifth edition, recognized five types of schizophrenia: paranoid, catatonic, disorganized, undifferentiated, and residual. Some healthcare providers still use subtype classification during diagnosis, while others do not. Regardless of which type you have, schizophrenia can significantly affect your life, so getting support and treatment is essential to living well.

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