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Diagnostic significance of Schneider's first-rank symptoms in schizophrenia

Comparative study between schizophrenic and non-schizophrenic psychotic disorders

Published online by Cambridge University Press:  02 January 2018

Victor Peralta  and
Manuel J. Cuesta
Victor Peralta*
Affiliation:
Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain
Manuel J. Cuesta
Affiliation:
Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain
*
Victor Peralta, Psychiatric Unit, Virgen del Camino Hospital, Irunlarrea 4, E-31008 Pamplona, Spain. Tel: (48) 422488; Fax: (48) 429924. E-mail: [email protected]
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Abstract

Background

Despite the lack of consistent empirical support, modern diagnostic criteria of schizophrenia give particular emphasis to Schneider's first-rank symptoms (FRSs).

Aims

To examine the diagnostic significance of FRSs for schizophrenia by trying to overcome the limitations of previous studies.

Methods

This study examined the diagnostic accuracy of FRSs for schizophrenia in 660 in-patients with the full spectrum of functional psychotic disorders. Schizophrenia was diagnosed according to three criteria: DSM–III–R broad, DSM–III–R narrow and Feighner, the latter being considered as the gold standard because it does not give particular emphasis to FRSs.

Results

FRSs were highly prevalent in both schizophrenia and non-schizophrenic psychoses. The likelihood ratios (and 95% Cl) of one or more FRSs for Feighner, DSM–III–R narrow and DSM–III–R broad schizophrenia were 1.06 (0.94–1.20), 1.23 (1.09–1.39) and 1.73 (1.44–2.08), respectively. These data indicate that FRSs do not significantly increase the likelihood of having schizophrenia.

Conclusions

FRSs are not useful in differentiating schizophrenia from other psychotic disorders. Diagnostic systems for schizophrenia that are heavily based on these symptoms may arise from a tautological definition of the disorder.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 3 , March 1999 , pp. 243 - 248
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

None.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1984) The Scale for the Assessment of Positive Symptoms (SAPS). Iowa: University of Iowa.Google Scholar
Carpenter, W. T., Strauss, J. S. & Muleh, S. (1973) Are there pathognomonic symptoms in schizophrenia? An empirical investigation of Schneider's first-rank symptoms. Archives of General Psychiatry, 28, 847–852.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 28, 57–63.CrossRefGoogle Scholar
Geddes, J. R., Christofi, G. & Sackett, D. L. (1996) Commentaries on ‘first-rank symptoms or rank-and-file symptoms’? British Journal of Psychiatry, 169, 541–550.Google Scholar
Goldman, D., Hien, D. A., Haas, G. L., et al (1992) Bizarre delusions and DSM–III–R schizophrenia. American Journal of Psychiatry, 149, 494–499.Google Scholar
Hawk, A. B. Carpenter, W. T. & Strauss, J. S. (1975) Diagnostic criteria and five-year outcome in schizophrenia. Archives of General Psychiatry, 32, 343–347.Google Scholar
Jaeschke, R., Guyatt, G. H. & Sackett, D. L. (1994) III. Users' guide to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients. Journal of the American Medical Association, 271, 703–707.CrossRefGoogle Scholar
Jaspers, K. (1963) General Psychopathology (translated by Hoenig, J. & Hamilton, M. W.). Chicago, IL: University of Chicago.Google Scholar
Landmark, J. (1982) A manual for the assessment of schizophrenia. Acta Psychiatrica Scandinavica, 65 (suppl. 298). 1–88.Google Scholar
Mason, P., Harrison, G., Croudace, T., et al (1997) The predictive validity of a diagnosis of schizophrenia. A report from the International Study of Schizophrenia (ISoS) coordinated by the World Hearth Organization and the Department of Psychiatry, University of Nottingham. British Journal of Psychiatry, 170, 321–327.Google Scholar
McGorry, P., Singh, B. S., Connell, S., et al (1992) Diagnostic concordance in functional psychosis revisited: a study of inter-relationships between alternative concepts of psychotic disorder. Psychological Medicine, 22, 367–378.Google Scholar
Mellor, C. S. (1970) First-rank symptoms of schizophrenia. I. The frequency in schizophrenics on admission to hospital. 2. Differences between individual first-rank symptoms. British Journal of Psychiatry, 117, 15–23.Google Scholar
Peralta, V. & Cuesta, M. J. (1992) A polydiagnostic approach to self-perceived cognitive disorders in schizophrenia. Psychopathology, 25, 232–238.Google Scholar
Peralta, V., Cuesta, M. J. & Farre, C. (1997) Factor structure of symptoms in functional psychotic disorders. Biological Psychiatry, 42, 806–815.Google Scholar
Pope, H. G. & Lipinski, J. F. (1978) Diagnosis in schizophrenia and manic-depressive illness. A reassessment of the specificity of ‘schizophrenic’ symptoms in the light of current research. Archives of General Psychiatry, 35, 811–828.CrossRefGoogle ScholarPubMed
Radhakrishnan, J., Mathew, K., Richard, J., et al (1983) Schneider's first-rank symptoms. Prevalence, diagnostic use and prognostic implications. British Journal of Psychiatry, 142, 557–559.Google Scholar
Schneider, K. (1959) Clinicol Psychopathology (translated by W Hamilton, M.). New York: Grune & Stratton.Google Scholar
Wing, J. & Nixon, J. (1975) Discriminating symptoms in schizophrenia. Archives of General Psychiatry, 32, 853–859.Google Scholar
Wing, J. & Nixon, J. (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10). Geneva: WHO.Google Scholar
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