Am J Psychiatry 1978; 135:1481-1486
Copyright © 1978 by American Psychiatric Association
First-rank symptoms in the postacute schizophrenic: a follow-up study
ML Silverstein and M Harrow
Schneider's diagnostic system of first-rank symptoms (FRS) is acknowledged
by psychiatrists throughout the world as a decisive basis for the diagnosis
of schizophrenia. Recently, the author's and others' works have challenged
this view. This report examines the relationship between FRS, psychotic
symptoms, prognosis, and outcome at the postacute stage. The assessment of
FRS was made from an interview schedule (a modification of the Wing Present
State Examination) developed for the systematic assessment of psychotic
symptoms. The results question the utility of FRS as a primary diagnostic
approach to schizophrenia, suggesting that Schneider's system may not be
superior to other diagnostic approaches.
