title: [In defence of the diagnosis of simple schizophrenia: reflections on a case presentation].
abstract: BACKGROUND
  Since the first case descriptions of dementia praecox (Diem, 1903), the diagnosis of simple schizophrenia has continued to be controversial. The questioning of its descriptive validity and its reliability, as well as its infrequent use, has led to it being eliminated as a sub-type of schizophrenia in the DSM-III. Criteria for the diagnosis of «simple deteriorative disorder» are currently included in the DSM-IV-TR as a disorder requiring more studies for its possible inclusion.
  
  
  OBJECTIVE
  An attempt is made, using a clinical case, to perform a historical review of the concept of simple schizophrenia, and at the same what has led to the reflection on the possible reasons for the controversy, and a potential route to resolve it.
  
  
  METHODS
  Using a controversial clinical case, which meets ICD-10 clinical criteria for simple schizophrenia (and those of the DSM-IV-TR for the simple deteriorative disorder), we reflect on the symptoms and diagnostic difficulties. A literature review and update on the subjects was also performed.
  
  
  CONCLUSIONS
  Our patient highlights, by the absence in the clinical picture of the most obvious positive psychotic symptoms, the tendency by psychiatrists to identify the diagnosis of schizophrenia with the presence of the same, at least at some time during its evolution. The use of neuroimaging tests was useful to assess the level of deterioration and prognosis of the patient.
  
  
  CONCLUSIONS
  Considering simple schizophrenia in the differential diagnosis of other chronic deteriorative disorders could increase its recognition in the initial phases. The use of neuropsychological function tests, and looking for typical deteriorative patterns of the schizophrenia spectrum, could help to increase the reliability of the diagnosis.
authors.affiliation: Unidad de Corta Estancia, Hospital Psiquiátrico Román Alberca, El Palmar, Murcia, España. jose.martinez22@carm.es
authors.forename: José
authors.initials: J
authors.lastname: Martínez Serrano
authors.forename: María L
authors.initials: ML
authors.lastname: Medina Garrido
authors.forename: Rosario
authors.initials: R
authors.lastname: Consuegra Sánchez
authors.forename: Matias
authors.initials: M
authors.lastname: Del Cerro Oñate
authors.forename: José L
authors.initials: JL
authors.lastname: López-Mesa
authors.forename: Juana
authors.initials: J
authors.lastname: González Matás
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D012559:Schizophrenia / Q000175:diagnosis*