Do we need more schizophrenia subtypes?

It seems to me like schizophrenia is a widely varied disorder. Some people have hallucinations, some do not. Some people respond to meds, some do not. Some people have severe negatives, some do not. And on and on the differences go.

It makes me wonder a bit if we all have the same disorder. Does the research into schizophrenia really apply broadly across the entire spectrum? For instance, are we all destined for the supposed age/sz related cognitive decline that many articles claim? I’m not seeing it. I don’t see it in myself and I don’t see it in many of our sharp, witty members. Do we all struggle with severe motivational problems is another example? Some of our members seem highly motivated. I sometimes wonder if sz is too big of a tent.

It seems that we are headed more in the direction of the big tent approach. They eliminated many sub categories already ( paranoid, disorganized, catatonic, undifferentiated, and residual). I’m not sure that lumping us all in one group is a wise idea myself. I’m not saying these categories were ideal, just that I don’t believe we are all the same and its possible it’s not even the exact same disorder, with the same prognosis.

I recognize the want to not muddy the waters with dozens of classifications, but if we are different, don’t we deserve recognition as such?

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The problem is if they introduced levels like with ASD, then people will dx you as you present, even if you have worse days than others

I think if they layered their approach to dx’s it would just be used as a tool to further narrow the treatments people can have access to

Maybe I am being cynical, but that’s just what I think they’d do with something like this

A question would be on a scale, how much do your good and bad days vary

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I think the current thing is it’s spectrum and all different so treatment is the key over labels.

It’s handy to have labels sometimes. I moved overseas. It gave a good grounding for new psydoc but they soon parcel you anyways. So. I think the modern approach isn’t too bad. Yeah it’s a lot of difference but it’s all about the treatment with meds anyways because that is all we really have technology wise at the moment.

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Yeah, that would be a big problem. It’s an issue of accuracy. We don’t have the necessary tools to diagnose you as you are, just as how you appear to be. It’s unfortunate that its not a more scientific process, something that could be measured physiologically. Measuring based on observation is not very accurate. Perhaps a pipe dream of mine, that would require more accuracy than is truly possible at the current time.

Every case is unique.
Then we should have millions of subtypes


My old pdoc said to me that personalised medicine should arrive soon, where they can test your body to see what meds would be best for your metabolism etc

Still waiting on that innovation!



Another thing is the change of diagnoses during a patient’s life.
I had different symptoms 5 years ago,
and different now.

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How many of these do you experience?

  • Delusions
  • hallucinations
  • lack of motivation
  • not talking much
  • depression
  • word salad
  • inability to feel or express pleasure
  • cognitive difficulties
  • social withdrawal
  • anxiety
  • social anxiety
  • Mania
  • paranoia

0 voters

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@firemonkey, I collected so many! Just a few more and I have them all. :slight_smile:

I think we should burn the DSM, fire all psychiatrists, close down the pharmaceutical companies, and try again in a better way. With pharmaceutical and medical stuff being more in the hands of government rather than profit-aimed-companies (I’m not a communist, but in this respect I am :)).

Concerning the diagnostics. I have had so many varying diagnoses in all parts of the DSM, with one doctor saying “oh you surely are autistic and if you don’t believe me you are crazy” and the next doctor saying “oh you are surely NOT autistic and if you don’t believe me you are crazy”… that I think they should stick their diagnostic system in their ass by now.

I didn’t think it over well…but I think I am a fan of a very simple diagnostic *labeling *system, not pretending to know more than they do. With a very limited set of diagnoses.

So for example in my case a simple label “psychosis” (not sz or bipolar or psychosis NOS or sza or whatever) and “trauma”.

And then a short story description added of how this developped in me (say, history of sexual and emotional abuse and bad medication responses and hormonal issues bladiebla) and how it shows in me (delusions, catatonia, mood problems).

And then in treatment making an indivdually fitting response… with a much more varied approach depending on the story description. Not only meds, but also practical help and therapy and systems approach and all that.

I think they should include violent tendencies and agitation/irritability to sz symptoms. Maybe in positive symptoms? There is hypersexuality and hyposexuality too.


Maybe an anosognosia category too.

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All but depression. My depression is situational, once I’m out of it, I won’t be depressed. Just like I wasn’t depressed before this situation I’m in. And even now it comes and goes, it’s not constant. It was kind of daunting to click all but one.


I think if we had more solid science on the different subtypes, the subtypes would be more meaningful. If the treatment, and science, and lack thereof, for all is the same, it doesn’t matter.

Until it’s an exact science, and it isn’t, it’s all hogwash, no matter how many of them exist. Adding more would be like adding more signs to the zodiac.


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I don’t really experience any of those anymore, maybe a little anxiety on occasion.

But I voted based on how I was before meds.

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Interesting. Diagnoses are relevant for treatment purposes. The typical treatment is APs, therefore, we are clustered together.

When there will be medications for negative symptoms and cognitive decline,. then the treatment may vary and so the diagnosis would become more relevant.

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I haven’t read the entire thread. But I think there are already enough diagnosable illnesses in DSM.

Moreover, the previous subtypes of sz proved to be invalid. I think it would be hard to come to reliable subtypes with diagnosable consistency.

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what about a positives section? idk :slight_smile:

I really wish we could make a newsletter here like we do at my clubhouse :slight_smile: it could feature positive stories from members, all you need is a free account on canva and then members could collaborate and chip in :slight_smile: could be a lot of fun.

Honestly you can’t have sz categories as lots of ppl including myself have several symptoms of different sz types like catatonia, disorganized thoughts, paranoia, etc


No, I prefer a broader diagnosis. Every person with the illness will fall into the umbrella of symptoms, but not everyone will experience the same or all of the symptoms. But they still have the same disorder.

I also have fibromyalgia. There is a very wide net of symptoms. I may have the same disorder as another person, but we may present a bit differently and maybe at different severities. But I don’t mind that. We still have the same disorder.


I have had all of them to some degree

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