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Schizophrenia is a chronic mental disorder that affects an individual’s social interactions and ability to think rationally and express themselves emotionally (Lopes et al., 2021). It leads to difficulties in proper communication, social relationships, work or school, self-care, and conducting daily activities effectively. Patients may also experience hallucinations, delusions, disorganized thinking, and changes in behavior, as well as difficulties with memory, concentration, and decision-making (Orsolini, Pompili & Volpe, 2020). Despite the condition having no cure, this chronic illness is manageable through the use of the correct kind of care. However, the adverse effect of schizophrenia on health means that there is a need to understand the condition better by conducting a thorough classification and diagnosis for improved management.
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Classification of Schizophrenia
There are five distinct forms of schizophrenia. They include undifferentiated schizophrenia, residual schizophrenia, catatonic schizophrenia, and disorganized or hebephrenic schizophrenia (Crider, 2020). Paranoid schizophrenia is the most prevalent type. It is characterized by frequent visual and auditory hallucinations, fixation with one or more disorganized speeches, delusions, difficulty concentrating, and considerable behavioral impairment (Crider, 2020). This form of schizophrenia initially manifests during adolescence or early adulthood. Notably, paranoid schizophrenia is related to psychosis. On the other hand, catatonic schizophrenia is an uncommon and serious mental illness characterized by extreme changes in motor behavior, ranging from lack of voluntary movements to excessive activity and restlessness.
In some cases, the patient may remain completely still, often assuming rigid postures, exhibiting a lack of response to stimuli, weird body postures, weird movements, or inflexible limbs. Catatonic stupor is marked by abnormally low movement levels, while high movement levels characterize catatonic excitation. Other signs include mutism (inability to speak), echolalia (the imitation of words and actions), and echopraxia (the inability to move or speak) (Crider, 2020). Although catatonia can be a separate diagnosis, patients with catatonic schizophrenia frequently exhibit negative signs of the illness and are unresponsive.
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Hebephrenic schizophrenia is also known as disorganized schizophrenia since the speech and conduct of those with this condition are frequently erratic (Crider, 2020). They could also exhibit incorrect emotional behavior or show no emotion at all. Notably, young people and adolescents between the ages of 15 and 25 typically display symptoms of disorganized schizophrenia. Individuals with this form of schizophrenia usually have difficulties with attention span, motor skills, memory, and cognitive abilities. In the absence of delusions and hallucinations, disorganized schizophrenia is defined by disordered activities and absurd speech. Other symptoms include difficulties conducting routine chores, unclear thinking, expressionless faces, and improper emotional, facial, and behavioral expressions.
Residual schizophrenia refers to a condition in which an individual previously displayed positive symptoms of schizophrenia but now only displays persistent negative symptoms or no overt symptoms like delusions or hallucinations. However, they still exhibit symptoms like a pancaked impact, psychomotor challenges, and disturbed speech (Crider, 2020). Poor focus, a tangible level of mental disarray, and emotional detachment are possible persistent symptoms. A person with residual schizophrenia may be transitioning from the intensive phase of the disease to the relapsing stage or vice versa. Residual schizophrenia does not follow a predictable pattern in that symptoms might appear or disappear at any moment. On the other hand, patients that exhibit symptoms of more than one type of schizophrenia may not fall under any of the categories of schizophrenia and are, therefore, classified as having undifferentiated schizophrenia (Crider, 2020). For instance, an individual patient with cognitive difficulties and catatonic behavior (delusions and hallucinations) might be diagnosed with undifferentiated schizophrenia.
Diagnosis of Schizophrenia
Schizophrenia is typically diagnosed by a mental health professional based on a comprehensive psychiatric evaluation. The evaluation typically includes a detailed interview and assessment of symptoms, as well as a complete medical history. The mental health professional may also use psychological tests and brain imaging studies to help in making a diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) specifies that a patient’s unique symptoms and indications must be considered when making a schizophrenia diagnosis (American Psychiatric Association, 2013). According to the DSM-5, schizophrenia is diagnosed in a case where two or more symptoms these symptoms, i.e. lack of motivation, catatonic behavior, disorganized speech, hallucinations, and false beliefs, remain present for at least one month (Psychiatric Association of the United States of America, 2013). Notably, there has to be at least one of the following symptoms present: disorganized speech, illusions, or delusions. In addition, the patient’s impaired level of functioning is required by the DSM-5 in order to support a diagnosis of schizophrenia (Atkinson et al., 2014). Moreover, there must be a history of schizophrenia symptoms for at least six months, with the active-phase symptoms lasting for at least a month.
Consequently, schizophrenia is one of the most significant chronic mental ailments. It is a long-term mental health condition that impairs a person’s ability to interact socially, think logically, and express emotions. Generally, schizophrenia is divided into five categories based on the patient’s symptoms: undifferentiated, residual, catatonic, disorganized, and hebephrenic. Ultimately, a physician administers the DSM-5 criteria to evaluate whether a patient has schizophrenia.
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- Atkinson, D., Gohil, K., & Patel, K. R. (2014). Overview and available treatments for schizophrenia. P T. 39(9), 638-45.
- Crider, A. (2020). Schizophrenia: A biopsychological perspective. Routledge.
- Lopes, R. P., Barroso, B., Deusdado, L., Novo, A., Guimarães, M., Teixeira, J. P., & Leitão, P. (2021). Digital technologies for innovative mental health rehabilitation. Electronics, 10(18), 2260.
- Orsolini, L., Pompili, S., & Volpe, U. (2020). Schizophrenia: A narrative review of etiopathogenetic, diagnostic and treatment aspects. J. Clin. Med. 11, 5040. https:// doi.org/10.3390/jcm11175040