Treatment-relevant subtypes of schizophrenia

The heterogeneity of schizophrenia and the failure of classical subtypes to predict treatment response reliably have led to two contrasting assumptions. The first is that the treatment approach is essentially the same for all schizophrenics. The second is that the treatment needs of schizophrenic patients can be based only on clinical "hunches" or the biases of the therapist, because meaningful criteria for making therapeutic decisions are lacking. Both assumptions tend to discourage careful and critically reasoned treatment planning. This report argues that current knowledge permits the formulation of subtypes that can assist in the rational choice of individualized treatment approaches. It proffers a number of such subtypes and deals with their application to therapeutic decision-making at various phases of the illness.