was to be diagnosed only when the person failed to have symptoms
of the catatonic, disorganized, or paranoid subtypes. Despite the
introduction of a subtyping hierarchy in DSM-IV with the catatonic
and disorganized subtypes at the apex of the hierarchy, these subtypes
are still very rarely diagnosed. Administrative psychiatric practice
data in the USA reveal that the catatonic subtype is applied to just
1% of all Medicaid recipients and 2% of general outpatients with a
diagnosis of schizophrenia. Similarly, the disorganized subtype is
applied to 2% of Medicaid recipients and 3% of general outpatients
with a diagnosis of schizophrenia. In a large sample of 19,000 hospitalized
psychiatric patients in China over a 10-year period with a
diagnosis of schizophrenia, the catatonic subtype was diagnosed in
0.2% of patients and the disorganized subtype was applied in 1.0% of
patients; in that sample, 91% of the schizophrenia patients received
a diagnosis of the undifferentiated subtype (Xu, 2011).