Schneiderian first-rank symptoms in schizophrenia
M. L. Silverstein and M. Harrow
Schneider's first-rank symptoms (FRS) are recognized by many psychiatrists
worldwide as definitive criteria for establishing the diagnosis of
schizophrenia. The relationships between FRS and major aspects of
psychopathology were examined. Clinical course and outcome, indices of
current functioning and symptom severity, premorbid adjustment, and
prognostic indicators were assessed. Major comparisons were made between
schizophrenics with FRS at follow-up and schizophrenics with psychotic
symptoms exclusive of FRS. Positive findings in select areas of outcome
functioning argue for the utility of FRS. However, several findings
indicated that FRS were not more effective than non-Schneiderian psychotic
symptoms in delineating central characteristics of the schizophrenic
syndrome; they may identify a subgroup of schizophrenics with a more
chronic course, but they do not appear to have the unique importance or
diagnostic specificity that has been accorded them.
