Simple Schizophrenia: Symptoms, Causes And Treatment
Mental disorders are the subject of study of clinical psychology. One of the most disabling is schizophrenia, a chronic and serious disorder whose lifetime prevalence 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 the 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.
To know simple schizophrenia, first we are going to see the three most characteristic types of symptoms in schizophrenia, which are the following.
Positives
Appearance or exacerbation of some psychological function For example, hallucinations, delusions, disorganized speech, and disorganized behavior.
They are typically known as psychotic behaviors The patient may “lose contact” with reality.
Negatives
Absence or reduction of some function, for example affective flattening, decreased fluidity and thinking, apathy, abulia, reduced speech, etc. Thus, they are associated with the interruption of behavior and emotions considered normal.
It is important to make a differential diagnosis regarding depression or other mood problems.
Cognitive
Reduction or impairment of some cognitive processes such as attention, memory and executive functions (working memory, thinking speed,…).
Thus, the patient may show difficulties with attention and concentration, difficulty understanding information and making decisions, etc. Lack of awareness of the disease (anosognosia) may also appear.
What characterizes simple schizophrenia?
Simple schizophrenia is a classic category that remains only in the 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 in the section Criteria and axes proposed for subsequent studies, called 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, 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 residual type (in which there has been a psychotic episode, but at the time of diagnosis there are no symptoms). positive, but continuous manifestations in the form of negative symptoms).
The symptoms imply alterations in personal relationships, as well as a significant worsening of work or academic activity. Fleeting episodes of self-referential delirium, depressed mood and social isolation may appear associated.
It is necessary that the symptoms be present for a period of at least 1 year. His prognosis is very bad ; In fact, it is the subtype of schizophrenia with the worst prognosis, along with hebephrenic or disorganized schizophrenia.
Simple schizophrenia was proposed by Eugen Bleuler. This author proposed five clinical forms of schizophrenia Three of them coincided with Kraepelin’s subtypes: paranoid, catatonic and hebephrenic. The last one was “latent”, compensated or paucisymptomatic schizophrenia.
Bleuler introduced the term “schizophrenia” (split mind) and characterized the condition based on its most important psychopathological feature, which was the split of the ego. So, Unlike Kraepelin, he focused on nuclear psychopathology and not so much in the symptoms and evolution.
This author distinguished the essential symptoms (fundamental and common to all schizophrenic disorders) from the 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 only has negative symptoms. In simple schizophrenia, however, there have never been positive symptoms
Treatment
The treatment of simple schizophrenia consists of an interdisciplinary approach between doctors and clinical psychologists. Normally, it is based on psychotherapy and the use of psychotropic drugs as support.
