Cognitive symptoms refer to the difficulties with concentration and memory. These can include:
1. Disorganized thinking
2. Slow thinking
3. Difficulty understanding
4. Poor concentration
5. Poor memory
6. Difficulty expressing thoughts
7. Difficulty integrating thoughts, feelings and behavior.
Each schizophrenic falls under a subtype of schizophrenia defined by a unique indicator. This indicator may be one dominant symptom only or a combination of positive and negative symptoms. People with schizophrenia are classified into 5 sub-types, namely “Paranoid Type”, “Disorganized Type”, “Catatonic Type”, “Undifferentiated Type” and “Residual Type”.
For example, schizoaffective disorder exhibits schizophrenia alongside another mental disorder. Undifferentiated schizophrenia can be thought of as “general” schizophrenia, as it doesn’t display any one dominant symptom. Below are the different types of schizophrenia and their characteristics.
There are different kinds of schizophrenia. The International Classification of
Diseases (ICD-10) manual describes them as below:
1.Paranoid schizophrenia: These persons are very suspicious of others and often have grand schemes of persecution at the root of their behavior. Halluciations, and more frequently delusions, are a prominent and common part of the illness.
-Common form of schizophrenia.
-Prominent hallucinations and/or delusions.
-May develop at a later age than other types of schizophrenia.
-Speech and emotions may be unaffected.
2. Hebephrenic schizophrenia (Disorganized schizophrenia): In this case the person is verbally incoherent and may have moods and emotions that are not appropriate to the situation. Hallucinations are not usually present.
– Disorganized behavior (e.g., difficulty starting or finishing a task, difficulty acting appropriately in social situations)
-Disorganised thoughts: other people may find it difficult to understand others.
-Pranks, giggling, health complaints and grimacing.
-Short-lasting delusions and hallucinations.
-Usually develops between 15 and 25 years old.
-Disorganized speech (e.g., word salad, incoherence, perseverance)
-Flat or inappropriate affect (e.g., poor eye contact, lack of facial expressions)
3. Catatonic schizophrenia: In this case, the person is extremely withdrawn, negative and isolated, and has marked psychomotor disturbances.
-Rarer than other types.
-Unusual movements, often switching between being very active and very still.
-You may not talk at all.
.Undifferentiated schizophrenia: Conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the above subtypes, or exhibiting the features of more than one of them without a clear predominance of a particular set of diagnostic characteristics.
One’s diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesn’t obviously fit into one of these types alone.
5. Residual schizophrenia: In this case the person is not currently suffering from delusions, hallucinations, or disorganized speech and behavior, but lacks motivation and interest in day-to-day living. One may be diagnosed with this if he/she has a history of psychosis but only have negative symptoms.
6. Simple schizophrenia:
-Rarely diagnosed in the UK.
-Negative symptoms are prominent early and get worse quickly.
-Positive symptoms are rare.
7. Cenesthopathic schizophrenia:
People with cenesthopathic schizophrenia experience unusual bodily sensations.
8. Unspecified schizophrenia:
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
9. Schizoaffective Disorder: These people have symptoms of schizophrenia as well as mood disorder such as major depression, bipolar mania, or mixed mania.
Schizoaffective disorder is a mixture of schizophrenia and either depression or bipolar disorder. This type of schizophrenia is typically hard to diagnose because of the myriad of symptoms that depression or bipolar disorder may bring.
Depression is marked by prolonged feelings of sadness and worthlessness, as well as cognitive problems like problems with concentrating and remembering details. On the other hand, bipolar disorder causes shifts in mood — one moment you may feel elated, and then you suddenly feel low, often to the point of sadness.
The cycle between high and low emotions may become so intense and frequent that they begin to interfere with your daily life and affect your relationships and work or academic performance. The two tables below indicate the symptoms for the mental disorders that may coexist with schizophrenia.
-Weight gain or loss
-Changes in sleeping patterns
-Lack of energy
-Loss of interest in hobbies or favorite activities
-Feelings of worthlessness or hopelessness
-Guilt or self-blame
-Troubles with thinking or concentration
-Thoughts of death or suicide
Bipolar Disorder Symptoms:
Bipolar Mania (High):
• Euphoria or irritability
• Increased energy and activity
• Excessive talk or racing thoughts
• Inflated self-esteem
• Unusual energy, plus a lowered need for sleep
• Reckless pursuit of gratification
Bipolar Depression (Low):
• Depressed mood and low-self esteem
• Low energy levels and apathy
• Sadness, loneliness, helplessness, guilt
• Slow speech, fatigue and poor coordination
• Insomnia or oversleeping
• Suicidal thoughts and feelings
• Poor concentration
10. Disorders Related to (or sometimes with similar symptoms to) Schizophrenia/ Schizophrenia Spectrum Disorders:
Knowing the symptoms of these disorders, and how they can be similar and different from schizophrenia, can help prevent a possible misdiagnosis. The concentration on predominant symptoms at presentation has helped mental health professionals distinguish and better treat other mental disorders that resemble schizophrenia, creating the schizophrenia spectrum of disorders.
-Schizoid Personality: Schizoid personality disorder (SPD) is a chronic and pervasive condition characterized by social isolation and feelings of indifference toward other people. Those who suffer from this disorder are often described as distant or withdrawn.
-Schizophreniform Disorder: Schizophreniform disorder has identical features to schizophrenia but the duration of symptoms is less. The patient has experienced symptoms for longer than one week but less than six months. This diagnosis is often considered the first step towards an eventual schizophrenia diagnosis, which requires continuous signs of disturbance for at least six months.
-Schizotypal Personality: develops by early adulthood and is characterized by pervasive deficits in social and interpersonal skills, eccentric behavior, discomfort forming close personal relationships, as well as cognitive and perceptual distortions. Someone with schizotypal personality disorder may have ideas of reference. These are unlike delusions of reference, in which a person’s behavior is altered by their belief that something is referential to them personally.
-Bipolar Disorder (Manic Depression) – frequently misdiagnosed as schizophrenia (and vice versa).
-Asperger’s Syndrome – a type of Autism that may be misdiagnosed
as schizophrenia in children