What is residual schizophrenia? 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However, healthcare professionals no longer use these subtypes in diagnosis. The DSM-5 includes several other changes in the diagnostic criteria for schizophrenia. Healthcare professionals use the DSM-5, which the American Psychiatric Association publishes, to help them diagnose people with certain mental health conditions. Unlike the DSM-4, the DSM-5 does not list the subtypes of schizophrenia. Due to this, residual schizophrenia is no longer a valid diagnosis. This article discusses how the changes in the DSM-5 affect the diagnosis and treatment of schizophrenia. What is schizophrenia Share on Pinterestselimaksan/Getty ImagesSchizophrenia is a long-term mental health condition that can cause hallucinations, delusions, and altered or disorganized thinking, among other symptoms. It may disrupt a person’s thinking, emotions, and relationships. The symptoms can present at any time, but on average, they begin in late adolescence and early adulthood. Learn more Read the articles below to find out more about schizophrenia. Understanding the symptoms of schizophreniaWhat are the different types of schizophrenia?What is catatonic schizophrenia? What has changed in the DSM-5 When experts updated the DSM-4 to create the DSM-5, they made several changes to the classification of schizophrenia. Firstly, they renamed schizophrenia “schizophrenia spectrum disorder.” Healthcare professionals see this as a more accurate term, as schizophrenia is a variable and complex condition. The symptoms of schizophrenia can vary significantly among individuals. According to the DSM-5, a person must experience certain symptoms to receive a diagnosis of schizophrenia spectrum disorder. These are:delusionshallucinationsdisorganized speechdisorganized or catatonic behaviornegative symptoms, such as not showing feelings or having a complete lack of motivation A person must experience at least two of these symptoms frequently over 1 month to receive a diagnosis, and one of these symptoms must be delusions, hallucinations, or disorganized speech. In the older DSM-4, a person could receive a diagnosis if they had one symptom and experienced one of the following: bizarre delusionsauditory hallucinations of a running commentarytwo or more voices talking with each other However, this additional method of diagnosis is not present in the more recent DSM-5. Subtypes of schizophrenia These subtypes featured in the DSM-4, allowing doctors to diagnose people with different forms of schizophrenia. The DSM-5 does not include these subtypes, so healthcare professionals no longer use them to classify schizophrenia. Residual type The DSM-4 advises a diagnosis of residual schizophrenia when a person has had at least one schizophrenic episode but is no longer experiencing positive symptoms. Positive symptoms are symptoms that cause a change in thoughts and behavior, such as:delusionshallucinationsdisorganized speech or behavior A person with residual schizophrenia will still have negative symptoms. These are symptoms that cause people to withdraw and feel emotionless or flat. They include:flat affect, or not showing emotionalogia, or restricted quantity of speechavolition, or a total lack of motivation Catatonic type In the DSM-4, the criteria for a catatonic schizophrenia diagnosis state that a person must be experiencing at least two of these symptoms:lack of movement, being near-unconscious, or holding a rigid postureexcessive motor activity that seems to have no purposerefusal to speak or follow instructionsplacing themselves in inappropriate positions, repeatedly doing purposeless movements, or making exaggerated movements or grimacesrepeating what other people say or mimicking their movements Disorganized type The DSM-4 lists disorganized schizophrenia as a subtype that involves all of the following symptoms:disorganized speechdisorganized behaviorexpressing no emotions or inappropriate ones Paranoid type According to the DSM-4, a person likely has paranoid schizophrenia if they exhibit one or more delusions or auditory hallucinations that happen regularly. However, the person must have no experience of disorganized speech or behavior, catatonic behavior, or inappropriate or lack of emotions. Undifferentiated type In the DSM-4, a person who has undifferentiated schizophrenia meets the criteria for having schizophrenia, but their symptoms do not fit into any of the other subtypes. Why does the DSM no longer list subtypes The DSM-5 saw the removal of the different schizophrenia subtypes. There were several reasons for their removal, including:they did not allow for the variable nature of schizophreniahealthcare professionals only used some of the subtypes clinicallythere were no significant differences in brain function between subtypesthe subtypes did not predict the course of the conditionsome people did not fit into a subtype based on their symptomsscientific reports were no longer using them DSM-4 vs DSM-5 Experts also made several changes to the diagnostic criteria for schizophrenia when they updated the DSM-4 to create the DSM-5. This table shows the major changes in more detail:DSM-4DSM-5Disorder schizophrenia and other psychotic disordersschizophrenia spectrum and other psychotic disordersSymptomstwo or more of the following symptoms, if they are present for longer than a month:• disorganized speech• hallucinations• delusions• catatonic or disorganized behaviorstayed the same, although a person’s symptoms must include delusions, hallucinations, or disorganized speechnegative symptoms, such as flat affect, alogia, or avolitionchanged slightly to say “restricted emotional expression or avolition”only one symptom required for diagnosis if the person also has bizarre delusions or hallucinations that involve a running commentary on the person’s actions or involve two or more voices conversing togetherremovedDurationsigns continue for at least 6 monthssamenow includes a symptom severity scale from 0–4, with the rating based on the number and severity of symptoms in the past 7 days0 means no symptoms, and 4 means severe symptomsSubtypes• residual• catatonic• paranoid• disorganized• undifferentiatedremoved How have these changes affected the diagnosis and treatment of schizophrenia Research from 2014 found that more than 99.5% of people whom healthcare professionals diagnosed with schizophrenia using earlier versions of the DSM still met the criteria for it using the DSM-5. The authors state that the removal of the subtypes was justified, as they did not help predict a person’s response to treatment. They also note that the addition of a symptom severity scale may help healthcare professionals choose the best course of treatment for an individual. Summary Residual schizophrenia is a subtype of schizophrenia. However, according to the DSM-5, it is no longer a valid diagnosis. Experts made changes to the criteria for a schizophrenia diagnosis to help healthcare professionals make more accurate diagnoses. These changes have not affected the number of people who receive a diagnosis of schizophrenia. Additionally, these changes may lead to improvements in the treatment of schizophrenia symptoms. Last medically reviewed on June 29, 2022Mental HealthSchizophreniaMedical Devices / Diagnostics 4 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health. (2016).https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t22/Mattila, T., et al. (2014). Impact of DSM-5 changes on the diagnosis and acute treatment of schizophrenia.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393695/Residual schizophrenia. (n.d.).https://dictionary.apa.org/residual-schizophreniaSchizophrenia. (n.d.).https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/SchizophreniaFEEDBACK:Medically reviewed by Nicole Washington, DO, MPH — By Anna Smith on June 29, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is childhood schizophrenia?Medically reviewed by Timothy J. Legg, PhD, PsyD Schizophrenia usually starts in adulthood, but it can sometimes affect children. Find out how to recognize it and the treatments available.READ MOREBipolar and schizophrenia symptomsMedically reviewed by Timothy J. Legg, PhD, PsyD Bipolar disorder and schizophrenia have some similarities, but there are key differences. 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