The Two Faces of First-Rank Symptoms

  title={The Two Faces of First-Rank Symptoms},
  author={Angelo Picardi},
  pages={221 - 231}
  • A. Picardi
  • Published 1 October 2019
  • Psychology
  • Psychopathology
Recently, there has been renewed interest in Schneider’s first-rank symptoms (FRS) of schizophrenia, thanks in part to a meta-analysis of their diagnostic accuracy, which deserves much credit for its methodological rigor. Conceptualising FRS as a diagnostic test whose performance can be measured in terms of sensitivity and specificity involves some issues that require reflection. First, the full adequacy of sensitivity as a measure of diagnostic accuracy for FRS might be questioned. However, it… 
Schneider's first-rank symptoms have neither diagnostic value for schizophrenia nor higher clinical validity than other delusions and hallucinations in psychotic disorders.
It is suggested that FRS do not have diagnostic value for diagnosing schizophrenia and that they do not meaningfully add to the external validity showed by other delusions and hallucinations.
A major flaw in the diagnosis of schizophrenia: what happened to the Schneider's first rank symptoms
The definition and assessment of the ‘experienced’ symptoms of schizophrenia, only directly observed and reported by the patients, represent a specific, crucial, irreplaceable domain of psychopathology, to be carefully distinguished from the domain of the "behavioral” symptoms observed by the clinician.
Schizoaffective disorder: the past and the future of hybrid construction
The article argues for the discrepancy between the artificial construction of «schizoaffective disorder» (SAD) and the principles of nosological diagnostics and joins opinion of experts who suggesting the existence of a «third psychosis» or even several discrete forms of diseases, which are still mistakenly dissolved in the dichotomous / dimensional hybrid SAD.
Thoughts About Schizophrenia 66 Years After Chlorpromazine.
  • R. Meyer
  • Psychology, Medicine
    Journal of clinical psychopharmacology
  • 2020
In addition to acute treatment and symptomatic management, efforts to diminish disability and to enhance function are part of the core of essential services for patients with Parkinson disease, stroke, and other central nervous system conditions with residual impairment.
Delusional Perception Revisited.
The clinical roots of delusional perception are explored, the psychopathological phenomenon is elucidated, and its two predominant conceptualizations are discussed, i.e., Schneider's well-known two-link model and Matussek's lesser known one-link models are discussed.
S0033291720001816jrv 1409..1417
  • 2020
Front & Back Matter


Shall we really say goodbye to first rank symptoms?
What is the future for Schneiderian first-rank symptoms, in the Diagnostic and Statistical Manual of Mental Disorders and otherwise?
Most FRS appeared especially elevated in schizophrenia and schizoaffective groups, with relatively lower prevalence in remaining groups, except for heightened thought echo in depressive psychosis.
The diagnostic status of first-rank symptoms.
Until the status of FRS is clarified in depth, it is suggested that the FRS, as these are currently defined, should be de-emphasized in the next revisions of the authors' diagnostic systems.
First-Rank Symptoms or Rank-and-File Symptoms?
  • P. Crichton
  • Psychology, Medicine
    British Journal of Psychiatry
  • 1996
Kurt Schneider's first-rank symptoms (FRS) of schizophrenia h vehad an immenseinfluence on the way schizophrenia has been diagnosed in clinical practice throughout the world, especially
Association between Clinician's Subjective Experience during Patient Evaluation and Psychiatric Diagnosis
Evidence is provided that the clinician's subjective experience may play a useful role in the diagnostic process as well as the traditional, though still relatively unexplored empirically, tenet that particular diagnostic groups elicit distinct and diagnostically useful reactions from clinicians.
Definition and description of schizophrenia in the DSM-5
DSM and the death of phenomenology in america: an example of unintended consequences.
Since the publication of DSM-III in 1980, there has been a steady decline in the teaching of careful clinical evaluation that is targeted to the individual person's problems and social context and that is enriched by a good general knowledge of psychopathology.
Rediscovering Psychopathology: The Epistemology and Phenomenology of the Psychiatric Object
It is argued that neglect of these issues is a crucial source of the stagnation of psychiatric research, and offers a critique of the contemporary “operationalist” epistemology, consistent with Jaspers’ views.
Towards an Empirically Based Validation of Intuitive Diagnostic: Rümke’s ‘Praecox Feeling’ across the Schizophrenia Spectrum: Preliminary Results
  • M. Grube
  • Psychology, Medicine
  • 2006
A high intensity of ‘praecox feeling’ strongly correlated with a hereditary predisposition to schizophrenia and can possibly help in contributing to reflection on diagnostic practices and help to make the various factors involved in establishing diagnoses apparent.
Self-Disturbance and the Bizarre: On Incomprehensibility in Schizophrenic Delusions
It is argued that Jaspers' examples of incomprehensibility can be understood as manifestations of the three complementary aspects of ipseity-disturbance: diminished self-presence, hyperreflexivity and disturbed grip/hold, and fitting the various instances of bizarreness into a comprehensive explanatory framework.