Simple schizophrenia: what is it?

Simple schizophrenia is a subtype of schizophrenia introduced by Swiss psychiatrist Eugen Bleuler. It is a diagnosis not without controversy; The debate remains open as to whether or not to include it as such in the different reference manuals (DSM, CIE…). Currently, simple schizophrenia only exists as a diagnostic category in the ICD-10 (International Classification of Diseases), but not in the DSM-5 (Diagnostic Manual of Mental Disorders).

Schizophrenia as such, according to the DSM-5, has a lifetime prevalence of between 0.7 and 1.5%. In the previous edition (DSM-IV-TR), its prevalence was 1%. However, it should be noted that simple schizophrenia presents very particular characteristics that distance it from “classic” schizophrenia; Basically, it is a schizophrenia where there are only negative symptoms (there has never been a psychotic episode).

It must last at least 1 year to be diagnosed and its prognosis is poor.. But what else do we know about this subtype of schizophrenia? How is it different from other subtypes of schizophrenia? We will see it throughout the article.

Schizophrenia and simple schizophrenia: symptoms

Before delving into the symptoms of these disorders, some background information: the Simple schizophrenia was included for the first time in the sixth edition of the ICD (ICD-6), in 1948.; In the case of the DSM, and This diagnostic category was included in its first edition (DSM-1), in 1952, but was eliminated in the DSM-III, and it no longer appears in the DSM-5.

But what are the symptoms of simple schizophrenia? Before seeing them, Let’s look at the symptoms of “classic” schizophrenia. These can be divided into three large groups:

Positive symptoms

They are characterized by the appearance or exacerbation of some psychological function. For example: hallucinations, disorganized speech and behavior, and delusional ideas.

Negative symptoms

Characterized by the absence or reduction of some psychological function. For example: apathy, decreased fluency and thinking, apathy, decreased speech, etc.

Cognitive symptoms

The cognitive symptoms of schizophrenia are characterized by the impairment of the person’s cognitive processes. For example, attention or memory.

Symptoms in simple schizophrenia

In the case of simple schizophrenia, it differs from “classic” schizophrenia in that it only presents negative symptoms, but not cognitive or positive ones. Specifically, What symptoms characterize simple schizophrenia?

The first symptom is extravagant behavior, which appears progressively and insidiously. Another symptom is a decrease in the subject’s general performance in daily life, as well as an inability to meet social demands.

As a defining feature of simple schizophrenia, it should be noted that There is no evidence, at any time, of the presence of hallucinations or delusions (symptoms that would be present in “classic” schizophrenia, as part of the positive symptoms already mentioned). That is, the symptoms of simple schizophrenia are only negative symptoms.

In this sense, there has never been a psychotic episode (this is the difference with another subtype of schizophrenia, residual schizophrenia, which is characterized because the subject has presented a psychotic episode in the past, although currently only presents negative symptoms).

Alterations in daily life

As in any other mental disorder, the symptoms of simple schizophrenia lead to alterations in the person’s daily life, which are interrupted. Thus, on the one hand, social relationships are strongly affected, in addition to academic and/or work performance.

Other symptoms

Other symptoms that may appear in simple schizophrenia are: fleeting episodes of self-referential delirium, depressed mood, and social isolation.

Simple schizophrenia: the worst diagnosis

Among the different subtypes of schizophrenia existing in the DSM-IV-TR (in the DSM-5 the subtypes are eliminated), we find: paranoid schizophrenia, hebephrenic or disorganized, catatonic, undifferentiated and residual. Well then, simple schizophrenia has the worst prognosis of all schizophrenia subtypesalong with Hebrew or disorganized schizophrenia, which also has a poor prognosis.

This poor prognosis is especially related to the predominant negative symptoms in simple schizophrenia. These, generally, in psychotic disorders, are the ones that especially interfere with the person’s life. However, like any mental disorder, it can also be treated from psychology and psychiatry (and even from other disciplines). What does your treatment consist of?

Treatment

The ideal treatment in cases of simple schizophrenia will be one that involves a multidisciplinary approach., where psychiatrists, clinical psychologists and other professionals can make their contributions. The underlying symptoms that interfere with the patient’s life must be treated through psychotherapy and the use of drugs if required (anxiolytics, antidepressants, etc.).

On the other hand, it will be important to work with the patient on their level of insight and his awareness of the disease. In addition, efforts will be made to enhance their resources and coping strategies to deal with their difficulties.

Finally, The therapeutic alliance will also be an essential element to work on. with the patient so that he or she adheres to the treatment appropriately (both psychological and pharmacological treatment).

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