associated with unusual expressions or
perceptions of reality. It can lead to significant
social or occupational dysfunction.
It can feature auditory hallucinations, or hearing things
that are not there. Less commonly, the person may
experience visual hallucinations, in which they see
things that do not exist.
There may be bizarre or paranoid delusions, and
disorganized speech and thinking.
Schizophrenia is normally diagnosed in early adulthood.
The United States (U.S.) Centers for Disease Control
and Prevention (CDC), estimate that schizophrenia
affects between between 0.6 and 1 percent of the
global population.
Classification and diagnosis
Schizophrenia is a serious mental health issue.
In the past, there were different subtypes of
schizophrenia, including:
paranoid schizophrenia
disorganized, or hebephrenic schizophrenia
catatonic schizophrenia
childhood schizophrenia
schizoaffective disorder
In 2013 the Diagnostic and Statistical Manual of
Mental Disorders 5th edition (DSM-V) changed the
method of classification to bring all these categories
under a single heading: schizophrenia.
According to the American Psychiatric Association
(APA), the decision to eliminate these various subtypes
was based on the conclusion they had "limited
diagnostic stability, low reliability, and poor validity." It
was concluded that they did not help to provide better
treatment or to predict how patients would respond to
treatment.
Two other important changes were made to the
diagnostic criteria in 2013.
One was the removal of the requirement for a person
to experience bizarre delusions and to hear two or
more voices talking during an auditory hallucination to
receive a positive diagnosis.
The second was that, to receive a diagnosis, a person
must have at least one of the following symptoms:
hallucinations
delusions
disorganized speech
Click here for a more comprehensive article on
schizophrenia.
Subtypes
The following used to be subtypes of schizophrenia.
Find out what has changed in the use of these
categories.
Schizoaffective Disorder
A person with schizoaffective disorder experiences a
combination of schizophrenia symptoms, such as
hallucinations and delusions, and mood disorder
symptoms, such as mania or depression .
In the past, the person had to have both sets of
symptoms at the same time to receive a diagnosis of
schizoaffective disorder.
The DSM-V update in 2013 now says that to be
diagnosed with schizoaffective disorder, a person must
have experienced mood disorders for most of the time
they have also had the psychotic symptoms of
schizophrenia, from when they first started having
symptoms up to the present.
Catatonia
Catatonia includes extremes of behavior:
Catatonia can include excessive and peculiar motor
behaviors, sometimes referred to as catatonic
excitement
Catatonia can also include decreased motor
activity and engagement. For example, people in a
catatonic stupor demonstrate a dramatic reduction
in activity, where the patient cannot speak, move
or respond. Virtually all movements stop.
Catatonia can occur with schizophrenia and a range of
other conditions including bipolar disorder . For this
reason, it is now considered a specifier for
schizophrenia and other mood disorders, rather than a
type of schizophrenia.
Childhood onset schizophrenia
The symptoms of schizophrenia normally appear during
early adulthood, but they can sometimes emerge
during childhood, at the age of 10 years or earlier. It is
extremely rare, with an incidence of less than 0.04
percent .
If schizophrenia occurs in a child, it is very serious, and
treatment is needed.
However, healthy children can experience
hallucinations, so if this happens, it does not mean
that a child has schizophrenia.
Disorganized schizophrenia, or
hebephrenia
Disorganized thinking and behavior are features of
schizophrenia. The person may have incoherent and
illogical thoughts and speech.
This can make it difficult to perform daily activities,
such as preparing meals and taking care of personal
hygiene, or washing. People may not be able to
understand what the patient is saying. This can lead to
frustration and agitation.
While disorganization is a feature of schizophrenia, it is
no longer considered a separate subtype.
Paranoid Schizophrenia
A person with schizophrenia may have false beliefs, or
delusions, that an individual or group of people are
conspiring to harm them or members of their family.
They may spend time thinking about ways to protect
themselves from the people they believe are
persecuting them.
While delusions can still be key to a diagnosis of
schizophrenia, this is no longer considered a separate
subtype of the disorder.
Credit: Medical News Today
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