The specific symptoms experienced by a person, such as hallucinations, disordered thinking, or a disinterest in daily life, distinguish the different types of schizophrenia. Since the clinical manifestations can change over time, it is quite possible for an individual to have more than one type of schizophrenia during his or her lifetime. The different important types of schizophrenia are namely; paranoid schizophrenia, disorganized or hebephrenic schizophrenia, and catatonic schizophrenia. Besides these, there are four subtypes, named childhood schizophrenia, schizoaffective disorder, undifferentiated schizophrenia, and residual schizophrenia.
The defining features of paranoid schizophrenia: These include ridiculous or suspicious fantasies and beliefs, which classically revolve around a logical, organized idea or story which remains constant over a period. Although the most frequent fantasies are delusions of persecution, but delusions of grandeur are also common. As indicated by the name, individuals with this type of schizophrenia usually have a history of increasing paranoia, that is a feeling of fear and suspicion; and hence find difficulties in maintaining relationships with others. These individuals may even spend a great deal of time thinking about the various possible ways to protect themselves, and their family members from the imaginary persecutor. Generally, the performance of these individuals is better than other subtypes. In fact, their thoughts and behaviour is less disorganized, and they have a better prognosis.
Classical manifestations of disorganized schizophrenia: Disorganized schizophrenia is also referred to as hebephrenic schizophrenia, or Hebephrenia. Compared with other types of schizophrenia, disorganized schizophrenia generally appears at an earlier age; and has a gradual onset, with the individual gradually receeding into his or her own world of fantasies. The remarkable characteristics of this type include, an extreme expression of incompetence, disordered speech with impaired communication skills, disordered behaviour, and inexpressive or inapt emotions, such as laughter at a funeral. The speech of the individual might be mesed up and incoherent; and thus may be hard to follow. The patient uses made-up words or phrases the meaning of which is known only to him/her; and this is known as neologisms.
Other speech abnormalities include; saying the same words or statements repeatedly, known as perseveration; use of meaningless rhyming words such as, “I went up the bill, got the hill, still, to kill the pill”, known as clang. People with this type of schizophrenia also face problem carrying out their daily activities, such as inability to perform simple tasks like preparing meals; and care of personal hygiene like bathing and washing. It is important to understand that, especially individuals very close to the patient, that this lack of self-drive is mainly due to the disorder, and that this has got nothing to do with sluggishness. Apart from these, the individual also suffers from certain problems such as the dearth of speech, known as alogia; inability to experience enjoyment and happiness, known as anhedonia; absence of wish to form relationships, known as asociality; and absence of motivation , known as avolition. In fact, this type of psychosis is often associated with extensive withdrawal of interest from other people and the external world, thereby resulting in social maladjustment, and dysfunction. Though individuals with this type of schizophrenia suffer sometimes from hallucinations and delusions, but the difference from the paranoid subtype, is the absence of those being consistent or organized.
Definitive characteristics of catatonic schizophrenia: In fact, with the latest development of medical science, catatonic schizophrenia is extremely rare nowadays. As nothing is possible excepting medication and waiting for the response, this form of schizophrenia is really pathetic. This type of schizophrenia is characterized by the presence of extremes of behaviour. These include:
a. Catatonic excitement: This is manifested by hyperactivity or overexcitement in which the individual may imitate sounds, known as echolalia; or movements known as achopraxia around them, thus making them highly impressionable. Sometimes, they may even shout, talk swiftly, move to and fro rapidly, spin, whirl, or make peculiar senseless noises. Sometimes, they might act out in violence, either toward themselves or others.
b. Catatonic stupor: This is characterized by a marked decrease in activity, and the individual remains mute, and does not move or respond. Practically speaking, all movements come to a standstill. They may be extremely resistant to any alteration in his or her posture, and it might sometimes also happen that, he or she might have to hold an embarrassed, uncomfortable posture even for hours. It is important to understand that, though the individual appears absolutely blank and emotionless, having no idea about what is going on, the patient is actually experiencing extreme fear and anxiety. Sometimes the individual with catatonic schizophrenia might also manifest bizarre limb movements or facial expressions. They may suddenly frown or twitch.
1. Schizo-affective disorder: In this subtype, the individual experiences a combination of clinical manifestations both of schizophrenia, like hallucinations and delusions; as well as those of mood affective disorder such as, mania and depression. Nonetheless, it is still a matter of controversy amongst psychiatric experts that, whether this is a type of mood disorder, or a type of schizophrenia; and that whether it should be considered as a distinct condition.
2. Childhood schizophrenia: This subtype is also known as early-onset schizophrenia, or as childhood-onset schizophrenia. Though it is basically similar to schizophrenia, but the onset is at the age of ten, or earlier in life. The ability of the child to function properly is greatly affected by this type of schizophrenia.
3. Undifferentiated schizophrenia: As indicated by the name, in this type the patient displays obvious signs of schizophrenia, but not enough symptoms applicable to one specific type. Their symptoms often keep changing constantly. A sudden change in behaviour, disinterest along with social isolation, and extreme laziness are in fact, the first signs of this subtype.
4. Residual schizophrenia: As indicated by the name, in this type of schizophrenia, the patient whose symptoms have shown a marked improvement from one of the other types, experiences only the left over(residual) symptoms. Hence, the patient usually experiences lesser symptoms; and often show symptoms of schizophrenia during his/her remission.