Until the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, schizophrenia was officially recognized as having five distinct subtypes.

Because the symptoms of these subtypes were not felt to be reliable or consistently valid, the American Psychiatric Association determined that having distinct subtypes hindered diagnosis and removed them when they published the DSM-5.

Although they are no longer used for diagnostic categorization, some mental health professionals still find these subtypes useful for understanding the ways in which schizophrenia can present. This nuanced understanding can help determine the best ways to approach treatment plans.

As we look at the different subtypes of schizophrenia, it is important to keep in mind that the symptoms of these subtypes overlap with other disorders, and that to be diagnosed with schizophrenia, a person must meet the criteria outlined in the DSM-5.

Paranoid Schizophrenia

This schizophrenia subtype is the one most often depicted in the media, and most likely what comes to mind when people think of schizophrenia.

Delusions (fixed, false beliefs that conflict with reality) are a hallmark of paranoid schizophrenia. Hallucinations, particularly auditory (“hearing voices”), are also common.

Paranoid schizophrenia primarily involves positive symptoms, meaning the onset of traits, feelings, or behaviors that were not there before.

Symptoms

Paranoid schizophrenia primarily involves positive symptoms, meaning the onset of traits, feelings, or behaviors that were not there before. These include the following.

Preoccupation with one or more delusions Auditory hallucinations

The following are typically not present or prominent with paranoid schizophrenia:

Disorganized speechDisorganized or catatonic behaviorFlat or inappropriate affect

Hebephrenic Schizophrenia

Also know as disorganized schizophrenia, hebephrenic schizophrenia is marked by disorganized symptoms.

Symptoms

Disorganized speechDisorganized behaviorFlat or inappropriate affect

In practical terms, this means that people with hebephrenic schizophrenia may:

Have difficulty with routine tasks like personal hygiene and self-careHave emotional reactions that are incongruous or inappropriate to the situationHave difficulty communicatingMisuse words or place them in the wrong orderHave difficulty thinking clearly and responding appropriatelyExhibit neologism (the use of nonsense words or making up words)Move quickly between thoughts without logical connectionsForget or misplace thingsPace or walk in circlesHave difficulty understanding everyday thingsGive unrelated answers to questionsRepeat the same things over and overFind it difficult to complete tasks or achieve goalsLack impulse controlNot make eye contactExhibit childlike behaviorsWithdraw socially

Residual Schizophrenia

Residual schizophrenia, as a condition, is different than the residual phase of schizophrenia. The residual phase refers to a time in the course of schizophrenia where symptoms are not as acute. There may still be some negative symptoms (a previous trait or behavior ceasing, or the lack of a trait or behavior that should be there) remaining.

A person with residual schizophrenia does not currently exhibit prominent delusions, hallucinations, disorganized speech, or highly disorganized or catatonic behavior. They do have negative symptoms, and/or two or more diagnostic symptoms of schizophrenia, but in a milder form, such as odd beliefs or unusual perceptual experiences.

Symptoms

Blunted affect (difficulty expressing emotions, diminished facial expressions and expressive gestures)Odd beliefsUnusual perceptionsSocial withdrawal 

Catatonic Schizophrenia

A person with catatonic schizophrenia meets the criteria for a diagnosis of schizophrenia and also exhibits symptoms of catatonia.

Catatonia affects both speech and behavior and is defined by excessive movement (excited catatonia) or decreased movement (retarded catatonia).

Symptoms

Catalepsy: Muscular rigidity, lack of response to external stimuli Waxy flexibility: Limbs remain for an unusually long time in the position they are placed by another Stupor: Unresponsiveness to most stimuli Excessive motor activity: Apparently purposeless activity not influenced by external stimuli Extreme negativism: An apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved Mutism: Lack of speech Posturing: Voluntary assumption of inappropriate or bizarre postures Stereotyped movements: Involuntary, repetitive physical movements such as rocking Prominent grimacing: Distorting one’s face in an expression, usually of pain, disgust, or disapproval Echolalia: Repeating what others say Echopraxia: Imitating the movements of others

Undifferentiated Schizophrenia

A person with undifferentiated schizophrenia has symptoms that fit with a diagnosis of schizophrenia but do not give an overall picture of a paranoid type, catatonic type, or disorganized type.

Symptoms

There are no specific symptoms that indicate undifferentiated schizophrenia, but rather a person exhibits a myriad of symptoms that don’t meet the full criteria for a particular subtype.

Symptoms of undifferentiated schizophrenia include:

DelusionsHallucinationsParanoiaExaggerated or distorted perceptions, beliefs, and behaviorsUnusual or disorganized speechAgitation Neglect of personal hygiene  Social withdrawalExcessive sleeping or a lack of sleepDifficulty making plansProblems with emotions and emotional expressionTrouble with logical thinkingBizarre behaviorAbnormal movements

Schizoaffective Disorder

Schizoaffective disorder has features of schizophrenia and features of a mood disorder, either major depressive disorder or bipolar disorder.

Symptoms of schizoaffective disorder fall into the following three categories:

PsychoticDepressionMania

Delusional Disorder

Delusional disorder is a form of psychosis in which a person has fixed, false beliefs. For example, a person with delusion disorder may believe a celebrity is in love with them, that someone is spying on them or “out to get them,” that they have a great talent or importance, or hold other beliefs outside the realm of reality.

Brief Psychotic Disorder

Brief psychotic disorder is an episode of psychotic behavior with a sudden onset. It lasts less than a month. Afterward, the person goes into complete remission. However, it is possible to have another psychotic episode in the future.

Schizophreniform Disorder

With schizophreniform disorder, a person exhibits the symptoms of schizophrenia, but the condition lasts less than six months.

Schizotypal Personality Disorder

Schizotypal personality disorder involves someone having odd beliefs, perceptions, and behavior. They may be suspicious or paranoid of others and have limited relationships.

A Word From Verywell 

Schizophrenia is complex and doesn’t present the same way in everyone with the disorder. A diagnosis is personal and unique. While the subtypes of schizophrenia are no longer considered distinct diagnoses, knowing the different ways in which schizophrenia manifests can help you understand schizophrenia and, if necessary, make a personalized treatment plan with a healthcare provider.