In 1950, Kurt Schneider proposed that a considerable number of schizophrenic patients develop first-rank symptoms (FRS). In such cases, patients experience third-person auditory verbal hallucinations, audible thoughts, made experiences, replaced control of will, thought insertion, broadcast and withdrawal. This group of symptoms might therefore be seen as pathognomonic of schizophrenic psychopathology. Although a number of studies tend to explain these symptoms in terms of neurobiological and neuropsychological processes, the cause and development of FRS still remains unknown.

The method applied for the development of an explanatory model of FRS consists first in the overview of psychiatric and philosophical literature and secondly in the further development of the concept of disturbed intentionality and its implication to the FRS in schizophrenia. Intentionality is understood as a basic characteristic of conscious experience as being directed towards its object and, at the same time, implying a sense of mineness. This report also reviews and discusses some generally accepted views of FRS.

Current psychiatric research shows a significant increase of interest phenomenological explanations of FRS. In this contribution we introduce a phenomenological model of FRS based on the concept of intentionality. We also show that this concept offers an insight into the interrelatedness between particular FRS.

We propose that the experience of FRS in patients with schizophrenia is rooted in the disturbed and inverted intentionality of their mental and bodily actions. This theoretical model of FRS will open up new directions in psychiatric research.