Psychiatrist in Pune – Dr. Niket Kasar
Five Different Types of Schizophrenia
Types of Schizophrenia
The nature of symptoms taken into account while determining the disease of schizophrenia varies greatly with the progression of the disease. Since the 5 types of schizophrenia sub-types are defined in accordance with the most prominent characteristics, the same person may be analyzed with different types of schizophrenia as the illness proceeds. The types of schizophrenia are:
Paranoid sub-type schizophrenia
The paranoid type of schizophrenia is marked by thoughts of conspiracy or prosecution, (which are prominent, but delusional in mind) or auditory hallucinations. The patients, however, are more capable of working and are better at relationships than those having the other 4 types of schizophrenia. The life lead is much more normal, especially if they can manage the disease. Though the reason is unknown, it could probably be leading from the fact that those suffering from this schizophrenic type begin to show their symptoms during the later part of life, and have thus already managed to grasp better functioning before the illness could settle.
The patients may be hesitant in discussing their illness, and need not categorically look unusual or odd. Their delusions and hallucinations circle around particular themes which do not change frequently. In schizophrenia paranoid type the overall behavior and temperament depend on the nature of their thoughts. For instance, somebody who imagines being unjustly persecuted could become hostile easily or short-tempered. These indications are generally understood by professionals when extra stress triggers the symptoms. It is precisely in such situations that the patient might realize the requirement for help. They may take such steps that might attract attention.
However, as the features are barely visible, it becomes important for the patient to discuss their thought reflections openly. This could be difficult where paranoia or suspicions are high.
There can be variations over the same time period, in regard with its severity and nature. The thought process may get disorganized when the condition is on the path of worsening or exacerbation. During such phases, the patient may find it tougher to remember even the recent events or might speak incoherently, behaving in an irrational or in a disorganized pattern. Since these are features prominently characteristic to other sub-types, based on the state of their illness, the given symptoms may vary in several degrees in paranoid sub-type patients. Family and friends should be supportive, encouraging the patient to seek help from a professional.
Disorganized Sub-type schizophrenia
As evident from its very name, this type of schizophrenia is marked by disorganized thought patterns, with less of delusion and hallucination difficulties. The ability to normal functioning of regular living might get seriously impaired, and might include trouble in performing routine activities such as brushing, bathing, etc.
This is one of those sub-types of schizophrenia where emotional impairment may be observed. For instance, the patient’s emotions may fluctuate greatly or might be unjustified in a given circumstance, with unordinary responses of emotions (flat or blunted affect). The patient is unusually giddy or jocular, like one who chuckles at a solemn occasion like a funeral.
The communication ability might get impaired, with a practically incomprehensible speech, owing to disorganized thought patterns. It is important to look out for speech which is marked with difficulties in forming of sentences with correct word order than difficulties arising form articulation or enunciation. ‘Hebephrenic’ was the term used in the past for this sub-type.
Catatonic Sub-type Schizophrenia
Here the schizophrenia type’s symptoms that are predominant are movement imbalances. It may be catatonic excitement, (hyperactivity), or catatonic stupor, (reduction in performance of activity).
Other movement imbalances could include what is termed as stereotypic behavior. This is basically doing the same task repetitively, generally resulting from not having anything productive to do.
Immobility or resistance to change in appearance may be noticed. The patient may stay immovable, preferring to stay in the same poise as placed in by another person, for a prolonged time, (waxy flexibility). Often, even if they are in what appears to be an uncomfortable position, they might show extreme resistance to another person’s attempt in helping at re-positioning.
The patient may voluntarily resort to unusual limb movements or facial expressions or body positions. Thus the disease may be confused with tardive dyskinesia. It may also be confused with Tourette’s Syndrome as the patient may start parrot-like repeating of what is heard (echolalia) or mimicking other’s body movements.
Undifferentiated Sub-type schizophrenia
Of all the schizophrenia sub types this is the one that does not fall into the category of either and is diagnosed when a schizophrenic patient does not exhibit symptoms resembling any of the other types of schizophrenia.
In this schizophrenia type, the patient’s symptoms may fluctuate or might stay excessively stable, causing a doubt in placing it under any other sub type. The best schizophrenia type’s definition for this type of schizophrenia is ‘mixed clinical condition
Residual Sub-type schizophrenia
Here the symptoms have become less severe, and though idiosyncratic behaviors, delusions or hallucinations, maybe still present, they appear less prominent as they were in the worst days of illness.
Just like varying types of schizophrenia, the ramifications are highly varying too. Different impairments affect different people in different degrees. While some need custodial care, others may have a fairly normal career and family life. Though generally, patients do not stand at either of the two extreme points, they generally have to opt for waning and waxing treatments marked with hospitalization visits, requiring outside support too.
A better outcome is noticed when the patients, especially women, have had a higher functioning capacity before illness, or when the severest episodes were brief and were followed with the patient returning to normal. In all types of schizophrenia, it has been noticed that those with normal brain structures recover better.
On the other hand, a weaker prognosis is marked by sinister and gradual onsets, starting from adolescence or childhood. They cause abnormalities in the brain structure which can be revealed by imaging studies often causing permanent damages after severe incidents.