Schneiderian first-rank symptoms in schizophrenia

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.