First-rank symptoms in the postacute schizophrenic: a follow-up study

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.