This isn’t only disturbing for the impacted individual—it can also create distress for concerned family and friends. Without treatment, it isn’t uncommon for this disorder to become debilitating. However, medical professionals can treat this illness, and daily functioning can be restored with proper treatment. In 2013, our understanding of schizophrenia was forever changed due to shifts in the DSM-5. The DSM-5 is a tool used to diagnose mental health disorders, outlining the criteria for hundreds of illnesses. Revisions to diagnostic information for a mental health disorder significantly impact research and treatment. It also affects how those experiencing the disorder understand their condition. The criteria to receive a diagnosis of schizophrenia changed when previously existing schizophrenia subtypes were eliminated.
Schizophrenia Diagnostic Criteria: Then and Now
The symptoms of schizophrenia remained the same in the DSM-IV and the DSM-5. These symptoms are delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Negative symptoms do not mean they are bad; instead, it means there is an absence of expression. An example of a negative symptom is limited emotional expression. Two of these symptoms must have occurred for at least one month unless treated. In the DSM-IV, it could be any of those symptoms. However, in the DSM-5, it was clarified that those two symptoms must be either a delusion, hallucination or disorganized speech. Treatment was not significantly impacted since most folks experiencing this illness present with delusions, hallucinations, or disorganized speech.
What Were the Schizophrenia Subtypes?
The schizophrenia subtypes were:
Paranoid Disorganized Catatonic Undifferentiated Residual
Paranoia
Extreme and persistent suspicion is the hallmark trait of the paranoid subtype. This suspicion also presents itself in the form of delusions, as well. However, the paranoia is typically unfounded and generally responds well to medical treatment.
Disorganized Schizophrenia
Disorganized schizophrenia, also referred to as hebephrenic schizophrenia, is a combination of disorganized speech, disorganized behavior, and flat affect. Let’s explore these symptoms a bit further. First, disorganized speech is marked by incoherent speech patterns. Examples of this include language that doesn’t make sense, jumbled words, rapid jumps from topic to topic, and answering questions in a nonsensical manner. Disorganized behavior is similar, frequently presenting with laughter in inappropriate situations, talking to oneself, unprovoked agitation, or regressing to a childlike state.
Catatonic Schizophrenia
The catatonic subtype of schizophrenia is when someone is no longer mobile, meaning they may become frozen in stiff positions and avoid movement by any means necessary. Another presentation of catatonic schizophrenia is when an individual has excessive, unusual behavior, for example, mimicking the words and movements of others or engaging in physical tics like constant rocking.
Undifferentiated Schizophrenia
Undifferentiated schizophrenia is a category for folks who don’t align with the paranoid, disorganized, or catatonic subtypes. Those in this category will experience some of the previously mentioned symptoms, but their presentation won’t fit neatly into one of the subtypes.
Residual Schizophrenia
Those experiencing residual schizophrenia are no longer experiencing the prominent behaviors described in the above subtypes. However, they will still experience at least two of the symptoms from any of the subtypes while also displaying key symptoms from the main diagnostic criteria.
The Decision to Eliminate Types of Schizophrenia
Mental health professionals found the schizophrenia subtypes unreliable in the diagnostic process. Aside from being inconsistent, clinicians found them ultimately unhelpful. Another effort made to facilitate efficient treatment was clarifying the diagnostic criteria of schizoaffective disorder. Schizoaffective disorder is a condition that has schizophrenic features alongside mood disorder symptoms. The schizoaffective disorder criteria shifted to include that indicators of a manic or depressive episode are consistently present for the duration of the illness. People looking to learn more about schizophrenia may appreciate learning about the subtypes. While they are no longer used, they can provide deeper insight into how this illness has presented throughout the years.
How Is Schizophrenia Treated?
Schizophrenia is a condition that is dependent upon treatment. Traditional schizophrenia treatment plans include a combination of psychotherapy and medication. Cognitive-behavioral therapy (CBT) is the preferred psychotherapy treatment. It challenges negative thought patterns, creates tactics for managing emotional responses, and can help facilitate healthy relationships. Antipsychotic medications help manage symptoms. It is important to remember that medication in conjunction with psychotherapy is critical for optimal treatment. By dropping the schizophrenia subtypes, doctors were able to clarify symptoms, leading to more efficient medication management.
The Impact of Eliminating Schizophrenia Subtypes
With the elimination of the schizophrenia subtypes came a more reliable treatment framework. This helps those in pain access support more efficiently, minimizing the suffering that occurs with this illness. It also contributed to the constantly evolving research on schizophrenia, sparking studies that the elimination of the subtypes was a welcome change.
A Word From Verywell
Experiencing schizophrenia can be challenging and painful. The symptoms are debilitating and navigating life without treatment can be nearly impossible. However, this condition can be managed with proper treatment. Many folks experiencing schizophrenia attend school, have families and maintain employment in fields they love. If you or a loved one are experiencing any of the symptoms outlined in this article, help is available. Seeking a mental health professional is a great start. For more mental health resources, see our National Helpline Database.
