Schizophrenia is a mental disorder associated with unusual expressions or perceptions of reality. The presence of thought disorders, abnormal behavior, and antisocial make it difficult for sufferers to distinguish between fantasy and reality.
The hallmark of schizophrenia is auditory hallucinations or hearing things that are not really there. Sufferers can also experience visual hallucinations, but this feature is less common.
Previously, schizophrenia was categorized into five types
In the past, schizophrenia was divided into five types. However, in 2013, in the manual “Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V)” issued by the American Psychiatric Association (APA), the classification method was changed. From the initial five, there was only one classification, namely schizophrenia.
The changes are based on the decisions of experts from APA. They agree that the classification has limited stability, poor validity, and low reliability.
Even so, let’s get to know the types of schizophrenia that used to be a reference for experts and their differences!
1. Paranoid schizophrenia: excessive fear
According to the book “Notes on Psychiatric Medicine” written by Willy F. Maramis and Albert A. Maramis, paranoid schizophrenia is the most common type. It is more common in people over the age of 30.
Paranoid schizophrenia is characterized by the presence of delusions (false beliefs or thoughts because they are contrary to reality and are built on elements that are not based on logic) and excessive fear.
Reporting to the Psycom page, generally, patients are at least ‘occupied’ with one delusion or often experience auditory hallucinations. Patients will feel that someone is always being chased by someone and will be killed. He would also hear whispers saying that someone was going to kill him. Hallucinations of sound that can also be heard are the sound of footsteps as if someone is following or chasing them. In fact, however, there is none.
Paranoid schizophrenia will also find it difficult to trust others, so it will be difficult to socialize, it can even become antisocial or social phobia (social anxiety disorder).
However, the symptoms of this type of schizophrenia are considered ‘positive’, in the sense that they respond well to medical treatment.
2. Hebephrenic schizophrenia: disconnected thought patterns
Still based on the book “Notes on Psychiatric Medicine“, this type is characterized by very striking disturbances in thought processes. What he said was not continuous between sentences or not connected, and his thoughts were very difficult to understand.
A person is said to have hebephrenic schizophrenia (also known as disorganized schizophrenia) if he has these characteristics:
- Disorganized speech: a mixture of words and phrases spoken randomly so that it is difficult to understand, incoherent, and persistent.
- Disorganized behavior: difficult to complete tasks, difficult to act appropriately in social situations.
- Flat expression or inappropriate behavior: poor eye contact, flat facial expression.
In addition, patients also have multiple personalities. There are also symptoms of mannerism and neologism. Mannerism is a characteristic of repetitive movement, usually seen in facial expressions or gait. Meanwhile, neologism is a childish behavior.
This type of schizophrenia often occurs at the age of 15-25 years.
3. Catatonic schizophrenia: apathy or even hyperactivity
Reporting to the Southeastern Arizona Behavioral Health Services, Inc. page, catatonic schizophrenia is now considered a rare subtype because it is believed to be the result of untreated schizophrenia. The occurrence of this type is reported to be less frequent among schizophrenic patients due to advances in early intervention and treatment.
This type is characterized by a significant increase or decrease in movement, with at least two of the following symptoms:
- Infrequent movement
- Stiff posture
- Refusing to be moved
- Excessive body movements
- Echolalia (imitating other people’s speech)
- Ecofracia (imitating movements of other people)
- Odd posture
- Typical movements such as moving back and forth (rocking), waving, and biting nails
- In addition, his attitude is very apathetic toward the environment. The sufferer will remain silent when spoken to, expressionless face, will not move at all for a long time, refuses to eat, and does not even want to swallow the saliva that has been coming out of his mouth for a long time. If asked something, the sufferer will do the opposite.
Sufferers will also have difficulty sleeping and are unable to eat and drink, which eventually leads to fatigue, dehydration, and nutritional deficiencies. Catatonic schizophrenia usually first appears between the ages of 15-30 years. Usually, the cause is preceded by emotional stress.
4. Schizophrenia simplex: loss of emotion and concern
Schizophrenia simplex is characterized by a dulling of emotions. Usually, the sufferer will not care about important things to him, such as his future. In addition, the patient will also experience anhedonia, which is a decrease in interest in an activity. Patients will begin to not care about the environment and their families and will withdraw from the association. Over time, there is a decline in the quality of work or studies.
In simple schizophrenia, delusions and hallucinations are rare. His mindset is also still understandable. Usually, it appears since puberty.
5. Residual schizophrenia: the appearance is no longer maintained
Residual schizophrenia is a type that has been experienced by sufferers for a long time. Generally, sufferers look unkempt and dirty because they cannot take care of themselves. In this type, most positive symptoms (visible symptoms) decrease with severity. Positive symptoms such as hallucinations or delusions rarely occur or even stop. However, it appears negative symptoms such as psychomotor decline, dulling of feelings, passiveness and lack of initiative, including loss of passion for life.
If someone you know has schizophrenia, don’t shun it. Support her to get proper medical treatment and help her fight stigma and discrimination. That way, the recurrence can be prevented and the quality of life is maintained.