Forms of Schizophrenia
With the predominant symptoms at the core, schizophrenia has been categorized into five subtypes: paranoid, disorganized (hebephrenic), catatonic, undifferentiated, and residual. The first is the paranoid type. Its essential feature is the presence of prominent delusions or auditory hallucinations. Delusions are typically persecutory or grandiose, and hallucinations may also revolve around similar themes. Associated features include anxiety, anger, aloofness and argumentativeness. The person can benefit from treatment and lead an independent life.
The disorganized type is the most severe. It is characterized by silly speech and misplaced laughter, distuption in the ability to perform daily activities, and oddities of behaviour, such as grimacing and other strange mannerisms. The illness has a continuous course without significant letups.
Catatonic illness is marked by waxy flexibility, extreme negativism, rigid or bizarre posturing, parrot-like apparently senseless repetition of a word or phrase just spoken by another person and repetitive imitation of another person’s movements (echopraxia). People with this illness are faced with the risk of becoming malnourished and they may inflict injury on themselves.
The undifferentiated illness features delusions, hallucinations, incoherent speech, disorganized behaviour, or negative symptoms of muted emotion, absence of logic and lack of will to work.
The residual type is characterized by eccentric behaviour, odd beliefs, and mildly disorganized speech. Delusions and hallucinations do not occur or, if present, are mild.
This classification helps in decision-making at the time of treatment and prognosis, but it is not a rigid one. If there is major change in the clinical picture, which happens frequently, the subtype also changes.
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