What Are The Different Types Of Schizophrenia?

Medically reviewed by Julie Dodson, MA, LCSW
Updated October 16, 2024by BetterHelp Editorial Team

Schizophrenia is a mental illness that can cause delusions, hallucinations, and psychosis. In the past, it was divided into different types, each with its own criteria. In recent years, mental health experts have done away with these old types in favor of a single, broader title: the schizophrenia spectrum. 

To understand this spectrum, it may be helpful to explore how specialists once defined the different types of schizophrenia. You can also investigate other conditions that, while related to schizophrenia, continue to be separate diagnoses. 

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Understanding schizophrenia

Schizophrenia symptoms often arise during early adulthood. It causes changes in the ways people think, feel, and behave, which can have significant impacts on their daily lives.

Symptoms of schizophrenia are often related to a broader state or episode called psychosis. Psychosis is a state where a person becomes disconnected from reality. A “psychotic episode” can occur frequently in individuals with schizophrenia. In addition, someone with this condition may cycle in and out of psychosis multiple times during their life. 

It isn’t known what exactly causes schizophrenia. However, it’s thought that genetics and environmental factors may make a person more likely to develop it. It has also been found that schizophrenia often occurs alongside other mental illnesses. Common comorbidities include major depressive disorder, anxiety, and substance use disorders.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. 

What are the symptoms of schizophrenia?

The symptoms of schizophrenia are divided into two categories: positive and negative. 

Positive symptoms of schizophrenia: What are they and how do they affect people with schizophrenia?

Positive symptoms are ways of thinking and acting that are present in people with schizophrenia but absent in people without it. These symptoms tend to be more intense during a psychotic episode. Examples may include:

  • Hallucinations: Hallucinating is the perception of sensory experiences that are not genuinely occurring. In people with schizophrenia, hearing voices or seeing people that aren’t there may occur.  
  • Delusions: Delusions are false beliefs that cannot be dispelled with evidence or logic. For example, you might be convinced you're dating a celebrity or part of a government conspiracy. 
  • Disorganized thoughts: Disorganized thinking is thinking that doesn’t follow logic. For example, a person might make connections between unrelated ideas, mix up different concepts, or jump randomly from thought to thought. 
  • Disorganized speech: In people with schizophrenia, disorganized thinking may cause disorganized speech. This symptom may involve going on an unrelated tangent, making up words, or speaking in ways others can’t understand. 

Negative symptoms of schizophrenia: What are they and how do they affect mental health?

Negative symptoms are ways of thinking and acting that are absent in people with schizophrenia but present in people who don’t have it. These symptoms may be more likely to continue between psychotic episodes. Examples of these symptoms may include:

  • Lack of pleasure: Schizophrenia may cause people to lose interest in what used to make them happy, like hobbies, favorite foods, or spending time with loved ones.
  • Lack of motivation: People with schizophrenia may lose motivation to do tasks. This symptom can cause them to stop bathing, working, or cleaning their living space.
  • Lack of socialization: It can be common for people with schizophrenia to withdraw socially. They might stop leaving the house, become disconnected from their community, or lose touch with their friends and family. 
  • Lack of expressiveness: Schizophrenia may cause changes in the ways people show emotion. Some might stop making facial expressions or using hand gestures to communicate. Others might speak in a flat tone of voice or stop altogether.

Understanding these symptoms may make it easier to understand the different types of schizophrenia that have been proposed in the past. 

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Are there different types of schizophrenia?

In the past, doctors divided schizophrenia into different types. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4), published by the American Psychiatric Association, these included:

Different types of schizophrenia: Understanding the subtypes

  • Paranoid schizophrenia: The paranoid schizophrenia type was diagnosed based on delusions and hallucinations. It did not include symptoms of speech, movement, or emotional expression. 
  • Catatonic schizophrenia: This diagnosis centered around movement. Symptoms often included excessive movement or stillness or unusual postures or gestures. 
  • Disorganized schizophrenia: This diagnosis was sometimes also called “hebephrenic schizophrenia.” It featured symptoms like disorganized speech and behavior but without the unusual movement patterns of the catatonic type. 
  • Residual schizophrenia: This diagnosis was made when a person showed ongoing negative symptoms but with absent or less severe positive symptoms. 
  • Undifferentiated schizophrenia: A person might also receive an “undifferentiated” schizophrenia diagnosis if they show some symptoms of schizophrenia without meeting all the criteria for a specific type. 
Since the publication of the more recent version of the DSM, the DSM-5, schizophrenia is considered a “spectrum disorder.” Psychologists understand that schizophrenia can look different in different people. Not everyone may experience the same symptoms; when they do, those symptoms can vary significantly from person to person.

Other psychotic disorders

There are disorders besides schizophrenia that feature psychotic symptoms but are considered separate conditions. These conditions include the following. 

Schizoaffective disorder

Schizoaffective disorder features symptoms of schizophrenia, like hallucinations and delusions, with additional mood-related symptoms. For example, a person with schizoaffective disorder might also experience a depressed mood or manic episodes. For this reason, it may sometimes be mistaken for bipolar disorder, which can cause similar symptoms. 

Delusional disorder

To be diagnosed with delusional disorder, a person must experience delusions for at least one month without showing any other symptoms of schizophrenia, like hallucinations or changes in speech or movement.

Brief psychotic disorder

Brief psychotic disorder may be diagnosed when an individual experiences psychotic symptoms that last longer than a day but less than a month. The symptoms often disappear on their own, although they may come back from time to time. 

Schizophreniform disorder

Schizophreniform disorder is similar to brief psychotic disorder in that it causes psychotic symptoms that resolve on their own. However, they may last up to six months instead of lasting up to one month. If symptoms continue past six months, the person may be diagnosed with schizophrenia. 

Schizotypal personality disorder

Schizotypal personality disorder can cause unusual behavior, paranoia, and challenges in relationships. However, it does not often cause delusions or hallucinations like schizophrenia does. 

It may be worth remembering that even though these conditions aren’t specific types of schizophrenia, they are listed under the umbrella of “Schizophrenia Spectrum and Other Psychotic Disorders” in the DSM-5. 

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Support for schizophrenia and related disorders

Schizophrenia is a lifelong condition, but it is often treatable. Other related disorders can often be treated, too. This process tends to involve a combination of medication, therapy, and other treatments as needed. Therapy, in particular, may help individuals manage symptoms and improve negative thought patterns. 

How online therapy can help people with schizophrenia and other mental illness

If you’re living with schizophrenia, commuting to in-person therapy may be challenging due to symptoms like low motivation. In these cases, online therapy through a platform like BetterHelp may be more accessible. Online platforms allow clients to attend therapy from the comfort of home via phone, video, or live chat sessions. 

Research has found that online therapy can effectively improve symptoms of mental illnesses that often occur alongside schizophrenia. In a 2017 review, researchers looked at over 300 studies of internet-based therapy for conditions like depression, anxiety, OCD, and PTSD. They found that online therapy was a valuable and cost-effective treatment, with results similar to those of in-person studies. 

Takeaway

Schizophrenia is a severe mental illness. It can cause changes in a person’s behavior and ways of thinking. This can lead to symptoms like hallucinations, delusions, social withdrawal, or a loss of touch with reality. 

Schizophrenia used to be divided into specific types based on symptoms. Nowadays, experts use a single term, “the schizophrenia spectrum,” to capture the different ways it can affect people. However, there are other disorders, like brief psychotic disorder, that continue to be separate diagnoses despite sharing specific symptoms with schizophrenia. If you think you are experiencing schizophrenia symptoms, reach out to a therapist online or in your area for support.

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