Schizophrenia is a chronic brain disorder that makes it hard for a person to differ between what is real and what is fake.  It can cause someone to have trouble thinking clearly, managing emotions, relating to others, and even cause them to struggle to function normally. 

Schizophrenia affects about 1 in every 100 people.  It can affect men and women equally.  Symptoms usually start between the teen years and early adulthood.  Early warning signs of this condition can be present for many years leading up to the first episode where hallucinations or delusions occur.  Schizophrenia has many different types and spectrums to the disease.  It is a chronic condition, meaning there is no cure, but there are treatment options to help with symptoms.  

The Diagnostic and Statistical Manual of Mental Disorders 5th edition, or DSM-5 no longer classifies schizophrenia into subgroups.  Instead it takes those subgroups and uses them as more of a spectrum.  Instead of labeling someone with paranoid schizophrenia they would be diagnosed saying that they have schizophrenia with paranoia. 

There has to be at least two symptoms of schizophrenia that are present and lasting for at least 6 months to be diagnosed with schizophrenia.  Other conditions share some of the same symptoms as schizophrenia so it can be tricky to be diagnosed right away.  


Schizophrenia Symptoms & Diagnosis

There are two types of symptoms that are present with schizophrenia. 

Positive symptoms which are traits, feelings, or behaviors that weren’t present before the condition.  Examples of positive symptoms are hallucinations, delusions, disorganized speech, or strange behaviors such as walking in circles. 

Negative symptoms are when a person has lost the capability to do something because of the disorder.  This could be emotional withdrawal, lack of motivation, or emotional flatness. 

There are some symptoms that are very common with schizophrenia that a psychiatrist will be looking for during their total psych evaluation. 

  • Hallucinations are seeing or hearing things that aren’t there. 
  • Delusions are having firm beliefs that something is true even when it can be disproven easily. 
  • Disorganized speech is when words or sentences are said and don’t make any sense. 
  • Strange behavior such as walking in circles or sitting still for hours. 
  • Withdrawal or lifelessness such as no emotions or no motivation. 

Symptoms of schizophrenia can cross between subgroups. 


Schizophrenia Subgroups

The main five subgroups of schizophrenia are paranoid, hebephrenic, undifferentiated, residual, and catatonic. 

Paranoid Schizophrenia

The most common one, or well known subgroup is paranoid schizophrenia.  It is usually what people think of when someone says something about schizophrenia.  Paranoid schizophrenia has mostly positive symptoms.  Including delusions and hallucinations being the most popular.  Hallucinations are usually auditory, like voices talking to you in your head.  Someone with paranoid schizophrenia may also have disorganized speech or trouble concentrating.  

Hebephrenic Schizophrenia or Disorganized Schizophrenia

Hebephrenic schizophrenia or disorganized schizophrenia does not cause delusions or hallucinations.  The main symptoms of this subgroup is disorganized behavior and speech.  It can also cause a flat affect.  This is when there are little to no emotions in facial expressions, tone of voice, or mannerisms. 

This type of schizophrenia can cause difficulty with routine tasks such as personal hygiene.  It can also cause trouble with inappropriate emotional responses to other people, as well as communication. 

Hebephrenic schizophrenia can cause the misuse of words, forgetfulness, trouble understanding everyday things, lack of impulse control.  It can also cause you to repeat things over and over.  Symptoms usually present around age 15-25.  

Residual Schizophrenia

Residual schizophrenia is when you have a history of psychosis but you currently aren’t experiencing any symptoms.  The symptoms have lessened in intensity.  With this subgroup symptoms are usually negative.  It can cause poor hygiene, slowed speech, flat affect, poor memory, and slow movement. 

Undifferentiated Schizophrenia

Undifferentiated schizophrenia is when a variety of symptoms are present.  This could be when symptoms from multiple subgroups are present at the same time.  Catatonic symptoms as well as hallucinations or delusions.  Doctors group these patients into undifferentiated schizophrenia since there is so much crossover in the spectrum. 

Catatonic Schizophrenia

Catatonic schizophrenia is the fifth subgrouping.  Catatonia is a behavioral syndrome marked by the inability to move normally.  It doesn’t always happen with just schizophrenia.  It can be present in other conditions.  If you have catatonic schizophrenia you have other symptoms that diagnose you with schizophrenia and then have catatonia as well.  Catatonia affects both speech and behavior.  It can cause excessive movement, or decreased movement. 

Symptoms are catalepsy, waxy flexibility, stupor, mutism, and posturing.  Stereotyped movements such as rocking can be a symptom.  As well as prominent grimacing.  Echolalia is repeating what others say and echopraxia is imitating movements of others both can be symptoms of catatonic schizophrenia.  


Schizophrenia is complex.  It can be hard to diagnose.  Everyone who has schizophrenia will experience symptoms different than anyone else with the condition.  Though people are not diagnosed into subgroups anymore, they are important to understand when it comes to the treatment process of schizophrenia.  




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