Simple schizophrenia or disorganisation syndrome? A case report and review of the literature

Susannah Whitwell trained in psychiatry at the Maudsley Hospital, London, and she is now a medical officer in psychiatry at Waitakere Hospital, Auckland, New Zealand. Jessica Bramham is a clinical psychologist with South London and Maudsley NHS Trust, London, where she has worked for 4 years in the neuropsychiatry and behavioural genetic disorders services. She is involved in researching social cognition following neurosurgery, and attention-deficit hyperactivity disorder in adults. John Moriarty is a consultant psychiatrist with South London and Maudsley NHS Trust (Department of Psychological Medicine, King’s College Hospital, London SE5 9RS, UK. E-mail: john.moriarty{at}slam.nhs.uk). He has worked in community services in central London and now provides a neuropsychiatry service. His research interests include psychiatric aspects of epilepsy and movement disorders. Mr B gave his written consent for this article to be published.

Simple schizophrenia is a sometimes controversial diagnosis. Here we review the concept with particular reference to its history in diagnostic systems. Using an illustrative real case of a 25-year-old man, we show that there is a need to retain this diagnostic category, which may fit better within proposed dimensional (psychomotor poverty, disorganisation and reality distortion) rather than categorical classifications of schizophrenia. Symptoms of the disorder may be better revealed by functional assessment than by relying on descriptive psychopathology.