Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations but relatively normal intellectual functioning and expression of affect. The delusions can often be about being persecuted unfairly or being some other person who is famous. People with paranoid-type schizophrenia can exhibit
suspiciousness/distrust, anger, aloofness, anxiety, and argumentativeness.
Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what they are saying or doing. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
Catatonic-type schizophrenia is characterized by disturbances of movement. People with catatonic-type schizophrenia may keep themselves completely immobile or move all over the place. They may not say anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is putting these people at high risk because it impairs their ability to take care of themselves.
Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types but not enough of any one of them to define it as another particular type of schizophrenia.
Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
When to Seek Medical Care for Schizophrenia
If someone who has been diagnosed with schizophrenia has any behavior change that might indicate treatment is not working, it is best to call the doctor. If the family, friends, or guardians of a person with schizophrenia believe symptoms are
worsening, a doctor should be called as well. Do not overlook the possibility of another medical problem
being present in addition to the schizophrenia.
On a general level, anyone with an acute change in mental status (a noticeable change in
mood or behavior), whether diagnosed with schizophrenia or not, should be taken to a hospital or a physician for evaluation. The
mood or behavior change may indicate a readily treatable medical illness that, if not treated early, can cause permanent physical damage.
Someone with schizophrenia should be taken to the hospital if medical illness is suspected. People with schizophrenia may or may not be able to communicate their symptoms in the same way as someone who does not have schizophrenia. This situation requires a doctor for diagnosis and treatment. Moreover, medical illness can aggravate schizophrenia.
Take your loved one with schizophrenia immediately to the hospital and/or call "911" if he or she is in danger of self-harm or harming others. People with schizophrenia are much more likely than the general population to commit suicide.
A quick way to assess whether someone is suicidal or homicidal is to ask the questions: "Do you want to hurt or kill yourself?" "Do you want to hurt or kill anyone
else?" "Are you hearing any voices?" and "What are the voices telling you?" People will
usually tell you what is on their mind and should be taken seriously when they verbalize these thoughts.
Many families fear abusing the emergency medical system when these and similar issues arise. However, if you have any doubts, go to the emergency department. Don't worry about whether the visit should be made. If, afterward, the health concern is found not to be an emergency problem, then everyone is relieved. Likewise, if a medical emergency is found, you have made the right decision. The medical professionals can reassure you that you made the right decision in the face of unknown medical questions about someone else's health.
Reviewed by Melissa Conrad Stöppler, MD on 6/13/2012