Schizophrenia is perhaps the most complicated of the mental illnesses, and it impacts how an individual thinks, feels, and behaves on a day-to-day basis. It is a member of a class of illnesses referred to as schizophrenia spectrum disorders, which are marked by psychosis—a disconnection from reality in which one may experience delusions, hallucinations, or a disorganized thought process.1 Schizophrenia is not as common as some psychiatric illnesses but is nonetheless one of the most disabling, affecting significantly quality of life, job performance, interpersonal relationships, and self-care.
At A Mission for Michael (AMFM), we walk with people through schizophrenia by offering intensive treatment for schizophrenia near you, like therapy, medication management, and psychosocial services. And, yes, we understand how confused you can become when you hear terms like paranoid schizophrenia, catatonic schizophrenia, or schizoaffective disorder. Whereas these phrases used to define subtypes of schizophrenia, the current DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) no longer uses them as official terms.2 Instead, schizophrenia is now defined as a spectrum, with dissimilar schizophrenia symptoms that differ for everyone.
However, these older names are useful in symptom presentation understanding. This page will take you through the different types of schizophrenia written about in the past, how they were presented, and what implications that has for treatment today.
Psychiatrists have classified patients in the past by subtypes like paranoid schizophrenia, disorganized schizophrenia, and catatonic schizophrenia. These were valid identified subtypes in the DSM-IV. But the American Psychiatric Association removed them from the DSM-5 because they were not reliable for long-term schizophrenia diagnosis and did not add to treatment planning.2
Instead, schizophrenia is now characterized by clusters of positive symptoms (e.g., hallucinations or delusions), negative symptoms (e.g., social withdrawal or loss of motivation), and cognitive dysfunction (e.g., trouble with memory or planning).3 This change is a more flexible way of thinking about the schizophrenia spectrum. While the DSM-5 abolished the formal categories, clinicians find it convenient to continue labeling symptom patterns, especially when dealing with patients and families.
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
The most common subtype of earlier classification systems was paranoid schizophrenia. It is marked by severe positive symptoms, especially delusions and auditory hallucinations (e.g., hearing voices).4
Daily life becomes difficult as trust is broken, and family members may find it hard to comfort the person. Interestingly, most people with this presentation do not have severe negative symptoms, in that they may still maintain heightened emotional expression and social functioning compared to other subtypes.
Disorganized schizophrenia (also known as hebephrenic schizophrenia) is typified by disorganized speech, disorganized behavior, and flat or inappropriate affect.5
This presentation begins earlier in life and is most commonly linked with worse long-term prognosis because of the preponderance of negative symptoms of schizophrenia like lack of motivation and social withdrawal.
Catatonic schizophrenia is rare but dramatic. The defining characteristic is catatonia, which means that people freeze in unusual postures, stay still for hours at a time, or mirror the word (echolalia) or action (echopraxia) of the other person.6
Symptoms may include:
Since catatonia also happens in mood disorders and autism, it is now no longer a separate schizophrenia subtype under the DSM-5 but rather as a specifier. However, it illustrates how diverse psychotic symptoms can be.
Defect state schizophrenia was a “catch-all” category for those with clear-cut symptoms of schizophrenia but who did not fit into paranoid, disorganized, or catatonic types very well.⁷ For example, a person may show delusions and social withdrawal but not enough of any single cluster of symptoms to place them in one of the traditional categories. This is why the DSM-5 moved toward a spectrum model—because real-world cases are mixed.
Residual schizophrenia used to account for circumstances in which a person no longer had active delusions or hallucinations but still had residual negative symptoms. These were:
This remains true for describing an individual in partial remission of schizophrenia—that is, the most severe psychotic symptoms have reduced but recovery is ongoing.
The schizophrenia spectrum includes a number of connected disorders with overlapping symptoms:
Same diagnostic features as schizophrenia but for less than six months.
A sudden, transient psychotic attack most often triggered by stress or trauma.
Predominantly featuring chronic delusions but without the full range of schizophrenia features.
Identifying these differences allows mental health workers to create appropriate treatment plans.
Schizophrenia and schizophrenia’s range of disorders are difficult to diagnose. Our physicians use DSM-5 diagnostic criteria, interviews, and observation of everyday life. Tests can include ruling out other mental illness, drug or alcohol abuse, or medical illness.10
Long-term treatment is common and consists of a blend of antipsychotic medications, psychotherapy, and supportive care.
Medications of the first generation reduce positive symptoms but may cause side effects associated with movement, like tremors or rigidity. Second-generation drugs (e.g., risperidone, olanzapine, clozapine, or quetiapine) are the first-line treatment but may lead to weight gain, increased cholesterol, or hypertension.11
Cognitive-behavioral therapy (CBT) helps one challenge distorted thinking and improve coping. Family therapy and psychoeducation improve communication and reduce relapse.
On very rare occasions, electroconvulsive therapy (ECT) may be provided for severe catatonia or treatment-resistant patients.
Our medical staff focus on personalized treatment—building a treatment plan that includes medication, therapy, skills training, and family support.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Schizophrenia support is a phone call away – call 866-478-4383 to learn about our current treatment options.
See our residences in Southern California’s Orange County & San Diego County.
Take a look at our homes on the east side of the Metro area in Washington County.
View our facilities in Fairfax County, VA within the DC metro area.
Those with schizophrenia have a high risk of suicide, especially in the early years after an episode of psychosis. If you or your loved one is in crisis, the 988 Suicide & Crisis Lifeline offers 24/7 access to qualified counselors who provide confidential support and connect callers with local resources.
Untreated, schizophrenia can result in prolonged interference with schooling, employment, and daily life. With prompt mental health care, especially after the first episode, people do better. Medication combined with therapy reduces relapse and improves recovery.
When you call out at AMFM, we encourage anyone who notices red flags—hallucinations, paranoia, rapid social withdrawal—to seek help.
If you or a loved one may be experiencing schizophrenia or related disorders, don’t wait. Call AMFM today at (844) 722-6361 for a free, confidential assessment. Our team will listen, explain treatment options, and help guide you to care. Hope and healing are possible.
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National Alliance on Mental Illness (NAMI). Schizophrenia. Accessed September 3, 2025. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing, 2013.
American Psychiatric Association. What Is Schizophrenia? Accessed September 3, 2025. https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia.
Tandon, Rajiv, et al. “Definition and Description of Schizophrenia in the DSM-5.” Schizophrenia Research 150, no. 1 (2013): 3–10. https://doi.org/10.1016/j.schres.2013.05.028.
Peralta, Victor, and Manuel J. Cuesta. “Negative Symptoms in Schizophrenia: A Confirmatory Factor Analysis of Competing Models.” American Journal of Psychiatry 158, no. 3 (2001): 406–412. https://pubmed.ncbi.nlm.nih.gov/7573583/.
Fink, Max, and Michael Alan Taylor. Catatonia: A Clinician’s Guide to Diagnosis and Treatment. Cambridge: Cambridge University Press, 2003.
National Institute of Mental Health (NIMH). Schizophrenia. Accessed September 3, 2025. https://www.nimh.nih.gov/health/topics/schizophrenia.
Andreasen, Nancy C., et al. “Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus.” American Journal of Psychiatry 162, no. 3 (2005): 441–449. https://doi.org/10.1176/appi.ajp.162.3.441.
Malhi, Gin S., et al. “Schizoaffective Disorder: Diagnostic Issues and Future Recommendations.” Bipolar Disorders 15, no. 7 (2013): 732–748. https://doi.org/10.1111/bdi.12095.
Carpenter, William T., and Rajiv Tandon. “Diagnosis and Classification of Schizophrenia.” Psychiatric Clinics of North America 36, no. 1 (2005): 1–18. https://psycnet.apa.org/record/2005-09723-001.
Leucht, Stefan, et al. “Second-Generation vs First-Generation Antipsychotic Drugs for Schizophrenia: A Meta-analysis.” The Lancet 373, no. 9657 (2009): 31–41. https://doi.org/10.1016/S0140-6736(08)61764-X.
At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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