Types of Schizophrenia: Classical Subtypes vs. the Modern Approach

You might have seen dramatic portrayals of schizophrenia in movies—featuring violent behaviour, delusional thinking, or unpredictable behaviour—but schizophrenia is far more than those stereotypes. It is one of the most complex and often misunderstood mental health conditions.

For decades, doctors attempted to organise this complex mental health disorder into “types”: paranoid, disorganised, catatonic, residual, and undifferentiated. These classical sub-types of schizophrenia helped label symptoms but didn’t always help people heal.
So, how did we get from rigid subtypes to a more dynamic, human-centred understanding of schizophrenia? Let’s break it down.

What Is Schizophrenia?

Schizophrenia is a chronic mental health disorder that affects how a person thinks, feels, and behaves. It typically develops during late adolescence or early adulthood and often persists for a lifetime, although symptoms can fluctuate in intensity.

The condition typically exhibits a combination of:

• Positive Symptoms – things that are added to a person’s experience, such as hallucinations (hearing voices), delusions (false beliefs), and disorganised thinking.
• Negative Symptoms – aspects that are lost, including emotional flatness, lack of motivation, and social withdrawal.
• Cognitive Symptoms – difficulties with memory, focus, or decision-making.

It’s important to note that schizophrenia can look very different from one person to the next. Which is exactly why the old sub-types of schizophrenia were created in the first place.

The 5 Types of Schizophrenia

The 5 types of schizophrenia were officially removed from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in 2013. However, they’re still widely used online and unofficially in clinical settings because they help categorise certain sets of symptoms into a group.

Here’s a quick summary of different types of schizophrenia:

1. Paranoid Schizophrenia
   People with this type of schizophrenia often experience hallucinations and delusions with themes of persecution (the belief that others conspire against them) or grandeur (the belief that they’re someone important, like an actor or a famous personality).
2. Disorganised Schizophrenia
   People with this type of schizophrenia experience disorganised speech, behaviour, and inappropriate or flat emotional responses. They also show severe impairment in their day-to-day functioning.
3. Catatonic Schizophrenia
   People with this type of schizophrenia often experience motor symptoms such as rigidity in the body, repetitive movements, and complete immobility.
4. Undifferentiated Schizophrenia
   Clinicians used this diagnosis when someone displayed symptoms from multiple different types of schizophrenia without fitting one specific category clearly.
5. Residual Schizophrenia
   This type of schizophrenia featured minimal positive symptoms, such as resolved hallucinations and delusions, but with ongoing negative symptoms like low motivation or reduced emotional capacity.

These different types of schizophrenia were useful in the past to describe symptom clusters, but they had major limitations, too.

Why These Types Were Retired — and Why They Still Matter

Over time, research showed these subtypes lacked reliability. Many people didn’t fit neatly into one type, or they shifted between types over time. Furthermore, the categories didn’t help clinicians decide on the best treatment for their patients.

So, in 2013, the American Psychiatric Association updated the DSM-5, officially removing the classical schizophrenia types. The modern approach treats schizophrenia as a spectrum and requires clinicians to assess the symptoms and severity the person currently experiences, focusing on:

• Main negative symptoms
• Prominent hallucinations or delusions
• Disorganised speech or behaviour
• Catatonic features
• Mood-related symptoms

That said, the 5 types of schizophrenia remain useful in clinical conversations. They help professionals quickly describe a patient’s presentation and are helpful for educating families. For example, a doctor might say someone is “presenting with catatonic features,” even though that’s no longer an official subtype.

So while they’re no longer used diagnostically, these labels still offer meaningful insights into what someone is going through.

Conclusion

The traditional 5 types of schizophrenia—paranoid, disorganised, catatonic, undifferentiated, and residual—may no longer appear in modern diagnostic manuals, but they still offer valuable context for understanding this deeply complex condition.

Today, clinicians understand schizophrenia by focusing on the person’s unique symptoms, not by forcing them into strict categories. By exploring both the old and new ways of looking at schizophrenia, we gain a richer, more compassionate understanding of how it affects people’s lives, and how best to support them.