Undifferentiated schizophrenia is characterized by general symptoms of schizophrenia that do not fit a specific classification or diagnosis of another subtype. People may exhibit the traditional “positive” and “negative” symptoms, but they may fluctuate over a period of time. This type of schizophrenia can be particularly challenging to diagnose with confidence because someone needs to have other possible brain diseases ruled out as well as other diagnoses such as major depression with psychotic features.
A psychiatrist will typically review a patient’s set of symptoms, evaluate them, and first diagnose schizophrenia. Once it has been established that the individual fits the general diagnostic criteria for schizophrenia, then they will usually evaluate the patient further to determine the subtype. If no specific subtype can be determined because the symptoms are randomized and fit multiple subtype categories, “undifferentiated” schizophrenia may be the diagnosis.
Undifferentiated Schizophrenia Symptoms
In the case of undifferentiated schizophrenia, there are no exact symptoms that can be listed. People that fit this type of schizophrenia tend to meet general symptoms for “schizophrenia” but not any for another subtype. For example, the person may clearly exhibit schizophrenic symptoms, but not any to be classified as having the catatonic, disorganized, or paranoid subtypes. The symptoms experienced with this particular diagnosis do not fit a specific mold – they can vary depending on the individual.
One person may be more prone to delusions and another may experience more disorganization – it totally depends on the individual. Symptoms may also fluctuate with undifferentiated schizophrenia – making it difficult to specify a diagnosis. In other words, the “undifferentiated” title is used also to describe schizophrenia with interchanging symptoms.
- Delusions: The individual may believe things that have no basis in reality. They may think that others are trying poison their food. They may think that they have supernatural powers such as the ability to talk to God or fly; these are called “delusions of grandeur.”
- Disorganization: In some cases, the person may exhibit extremely disorganized behavior, speech, and thinking. They may be unable to formulate sentences that make any sort of sense. They may also change topics from sentence to sentence. People may engage in purposeless behavior and may become hyperactive in a non-constructive, random manner.
- Hallucinations: Individuals may hear voices or see things that aren’t based in reality. It is most common to hear voices that are mean to the person or that say hurtful things. The hallucinations can involve other senses as well such as tactile hallucinations (e.g. thinking that they are being touched when no one is around).
- Flat affect: The person may have blunted emotional responses and facial expressions. They may be incapable of emotional expression and thus may appear “flat.” The individual may speak in a monotone when negative symptoms are prevalent.
- Low energy: As a result of the negative symptoms, the person may experience bouts of significantly low energy. The energy levels may be so low that they may not be able to get out of bed in the morning.
- Paranoia: In some cases, people become paranoid in which they feel as though someone is out to get them. This is a state of intense anxiety and fear, which if left untreated, can lead to hallucinations and delusions.
- Poor insight: The patient does not know that they have schizophrenia – even though they have all of the symptoms of psychosis. In some cases the person may be so unaware that anything is wrong, that they end up resisting treatment. Many people end up in denial when diagnosed with the illness because they do not think anything is wrong.
- Psychomotor slowing: The person may experience psychomotor slowing as a result of the negative symptoms. This means that they may lack energy, motivation, and emotion. They may lay in bed or sit in a single position for hours at a time.
- Social withdrawal: Many people experience social withdrawal as the symptoms become more severe. People may have a mistrust for others and become very introverted and introspective. The symptoms tend to drive people away from social activities and they become isolated from society.
Note: People with undifferentiated schizophrenia may have difficulties with all types of symptoms including: positive, negative, and cognitive. Severity of the illness is usually linked to age of onset. If you experience schizophrenia at an early age, the prognosis tends to be poorer.
Undifferentiated Schizophrenia Causes
Scientists still do not know what causes schizophrenia. Many hypothesize that it is the result of biopsychosocial factors. Most people will tell you that schizophrenia is caused by genetic and environmental triggers. Some think that traumatic experiences in early years, exposures to toxins, and brain development abnormalities can contribute to the mental illness. In the cases of undifferentiated schizophrenia, there could be a variety of dysfunction within the brain.
For example, in a person with the undifferentiated subtype that experiences many positive symptoms, it is thought that there may be overactive dopamine receptors. In the case of more negative symptoms, it is thought that problems with brain circuitry and abnormally low arousal can contribute to symptoms. Others believe that glutamate plays a key role in all types of schizophrenia. As you will read, there are a variety of theories, but no conclusive evidence regarding causes.
Undifferentiated Schizophrenia Treatment
Treatment for the undifferentiated subtype totally depends on the symptoms that are experienced. Typically antipsychotics are utilized in all types of schizophrenia. However, other augmentation strategies may prove useful if the patient is not responding well to antipsychotic medications.
- Antipsychotics: Initially an individual will be treated with an atypical antipsychotic. The “atypical” class tends to carry fewer side effects than the older “typical” antipsychotics. However, if a patient isn’t having good results with various atypical medications, a psychiatrist may prescribe a medication from the typical class.
- Electroconvulsive therapy (ECT): If the patient with undifferentiated schizophrenia does not find relief from traditional treatment options (e.g. medication), electroconvulsive therapy may be pursued. This involves administering a series of controlled electrical shocks to the brain to induce a seizure. It is thought that this may help by temporarily adjusting electrical, brainwave, and neurotransmitter activity in the brain.
- Natural treatments: There are various natural remedies for schizophrenia that may help reduce symptoms. Many natural options come with minimal side effects and have been proven to help when used as an augmentation to antipsychotics. Natural options typically consist of antioxidants and amino acids.
- Psychotherapy: It may be of great benefit to the individual with schizophrenia to schedule regular appointments with a licensed psychotherapist. The psychotherapist can help teach them how to cope with symptoms, set goals, and help them learn how to become more productive with their condition.
- Vocational skills training: This is training that helps the person with undifferentiated schizophrenia learn various skills that will ultimately help them get a job. Some people may already have basic skills to function in society, but for individuals that need some additional assistance, vocational skills training may prove beneficial.