Simple schizophrenia (SS) is an uncommon disorder that may go unrecognized. SS occupies an ambiguous position in the current international classification systems, due to its theoretical poor reliability and doubtful validity. Only International Classification of Diseases recognizes SS as a distinct subtype of schizophrenia.

The authors aim to illustrate the practical relevance of this diagnosis, through the presentation of two clinical pictures consistent with SS.

Case 1: 21-year-old woman, attending our outpatient unit since 2007 because of behavioral changes: she used to interact with three stuffed dolls for hours, considering them as the members of a famous rock band. Gradually, these symptoms lost preponderance and became evident a marked decline in her academic functioning, social withdrawal with difficulty in interpersonal contact, affective flattening and significant lack of concern for about her previous interests.

Case 2: 21 year-old man, attending irregularly our outpatient unit since 2006 due to behavioral changes. The patient has showed a progressive clinical picture consisting of puerility, evasive, poor, and sometimes disorganized speech, abulia, apathy, and social withdrawal. Nowadays he has no social relationships and no productive tasks. Despite some ideas of reference, he never presented overt psychotic or affective symptoms.

SS may be a laboring diagnosis due to its insidious nature and preponderance of vague, negative symptoms. These cases illustrate that SS is a suitable diagnosis for some clinical presentations, and the need of improved recognition of this entity. Recent studies suggest SS reintroduction as a valid and reliable subtype of schizophrenia.