Simple schizophrenia: symptoms, causes and treatment

Mental disorders are the object of study in clinical psychology. One of the most disabling is schizophrenia, a chronic and serious disorder whose prevalence throughout life is between 0.7 and 1.5%.

Within this concept, various subtypes have been proposed. In this article we will talk about one of them, simple schizophrenia. This diagnosis has caused some controversy regarding whether to include it as an independent diagnosis in the different reference mental health manuals (DSM, ICD, ...)

Currently, it only exists as a diagnostic category in ICD-10, as we will see later. This controversy has arisen as a result of the questioning of the descriptive validity and reliability of the concept, in addition to its infrequent use.

• Related article: "What is psychosis? Causes, symptoms and treatment"

Symptoms of schizophrenia

To know the simple schizophrenia before we are going to see the three most characteristic types of symptoms in schizophrenia, which are the following.

Positive

Appearance or exacerbation of some psychological function

. For example, hallucinations, delusions, disorganized language, and disorganized behavior.

They are typically known as psychotic behaviors. The patient may "lose touch" with reality.

Negative

Absence or reduction of some function, for example affective flattening, decreased fluency and thinking, apathy, abulia, reduced speech, etc. Thus, they are associated with the disruption of behavior and emotions considered normal.

It is important to make a differential diagnosis for depression or other mood problems.

Cognitive

Reduction or impairment of some cognitive processes such as attention, memory and executive functions (working memory, speed of thought, ...).

Thus, the patient may show attention and concentration difficulties, difficulty understanding information and making decisions, etc. Lack of awareness of the disease (anosognosia) may also appear.

• You may be interested: "The 11 executive functions of the human brain"

What characterizes simple schizophrenia?

Simple schizophrenia is a classic category that remains only in ICD-10 (WHO International Classification of Diseases). The ICD-6 included it for the first time in 1948, as well as the DSM-I in 1952.

The DSM-III eliminated this subtype, and the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) includes it within the section Criteria and proposed axes for subsequent studies. with the name of simple deteriorating disorder, considering it a disorder that requires more studies for its possible inclusion. In the DSM-5, however, it does not appear.

Its characteristics consist of an insidious and progressive onset of extravagant behavior, from a decline in general performance and an inability to meet social demands. There is no evidence, at any time, of the presence of hallucinations or delusions.

That is, the symptoms are only negative, without a psychotic episode appearing at any time, which is the element that would make the difference with the type residual (in which there has been a psychotic episode, but at the time of diagnosis there are no positive symptoms, but continuous manifestations in the form of symptoms negative).

The symptoms involve alterations in personal relationships, as well as a significant worsening of work or academic activity. Fleeting episodes of self-referential delusions, depressive mood and social isolation may appear associated.

Symptoms need to be present for a period of at least 1 year. Your prognosis is very bad; in fact, it is the subtype of schizophrenia with the worst prognosis, along with hebephrenic or disorganized schizophrenia.

Origin of the term: Eugen Bleuler

Simple schizophrenia was raised by Eugen Bleuler. This author raised five clinical forms of schizophrenia. Three of them coincided with the Kraepelin subtypes: paranoid, catatonic, and hebephrenic. The last one was a “latent”, compensated or paucisymptomatic schizophrenia.

Bleuler introduced the term "schizophrenia" (split mind) and characterized the picture based on its most important psychopathological feature, which was the splitting of the self. A) Yes, Unlike Kraepelin, he focused on nuclear psychopathology, and not so much in the symptoms and evolution.

This author distinguished essential symptoms (fundamental and common to all schizophrenic disorders) from accessory symptoms (more striking but less important).

Differential diagnosis with residual schizophrenia

The differential diagnosis will be made with other subtypes of schizophrenia, as well as with other affective disorders, personality disorders, organic mental disorders, etc. However, we are going to focus on residual schizophrenia, since it can make us doubt the diagnosis, due to its similarity.

As we have seen previously, residual schizophrenia is characterized by negative symptoms and attenuated positive symptoms. Significant positive symptoms may have appeared in the past, but at the time of examination the patient has only negative symptoms. In simple schizophrenia, on the other hand, there have never been positive symptoms.

Treatment

The treatment of simple schizophrenia consists of an interdisciplinary approach between physicians and clinical psychologists. Normally, it is based on psychotherapy and the use of psychotropic drugs as support.

• To see the intervention in these cases in more detail, access this article: What is schizophrenia? Symptoms and Treatments"

Bibliographic references:

• Jiménez, M., Ramos, F., Sanchís, M. Schizophrenias: Clinical aspects. In Belloch, A., Sandín, B., Ramos, F. (1996). Psychopathology Manual. McGraw-Hill, Madrid.
• Novella, E. and Huertas, R. (2010). The Kraepelin-Bleuler-Schneider Syndrome and Modern Consciousness: an approach to the history of schizophrenia. Clinic and Health, 21 (3), 205-219.
• National Institute of Mental Health (2015). Schizophrenia.