The Two Faces of First-Rank Symptoms

  title={The Two Faces of First-Rank Symptoms},
  author={Angelo Picardi},
  pages={221 - 231}
  • A. Picardi
  • Published 2019
  • Psychology, Medicine
  • 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… Expand
6 Citations
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. Expand
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. Expand
S0033291720001816jrv 1409..1417
Kurt Schneider introduced in the definition of the first-rank symptoms (FRS) the criterion that, where unequivocally present, the FRS are always psychological primaries and irreducible. ThisExpand
Thoughts About Schizophrenia 66 Years After Chlorpromazine.
  • R. Meyer
  • 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. Expand
Front & Back Matter


Shall we really say goodbye to first rank symptoms?
The importance of first rank symptoms of schizophrenia may indeed be scaled down to a degree that the occurrence of a single FRS alone should not suffice to diagnose schizophrenia, but, on the other hand, absence of FRS should be regarded as a warning sign that the diagnosis of schizophrenia or schizoaffective disorder is not warranted and requires specific care to rule out other causes. Expand
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. Expand
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. Expand
The core Gestalt of schizophrenia
  • J. Parnas
  • Computer Science, Medicine
  • World psychiatry : official journal of the World Psychiatric Association
  • 2012
The recent debate in World Psychiatry on prototypes versus operational criteria 1 invites a prototypical reassessment of the clinical-phenomenological presentation of schizophrenia, especially in theExpand
First rank symptoms of schizophrenia: their nature and origin
  • J. Cutting
  • Psychology, Medicine
  • History of psychiatry
  • 2015
It is argued that these psychopathological phenomena are indeed relatively sensitive and specific to the condition, that their nature can be formulated within a Schelerian model of what constitutes a human being, and that their origin fits anthropological and neuropsychological notions of the make-up of contemporary human beings. Expand
The Psychopathology of K. Jaspers and K. Schneider as a Fundamental Method for Psychiatry
  • G. Huber
  • Psychology, Medicine
  • The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
  • 2002
The essay shows that this psychopathology is far from over, but remains relevant for clinical and biological psychiatry and should lead now, as ever, all other special and basic sciences in psychiatry. Expand
On the Concept of Praecox Feeling
The present analysis of the original concept of Rümke's popular concept of praecox feeling suggests that a renewed research interest in the role of the clinician’s subjective experience with regard to the schizophrenic patient could be helpful. Expand
The Prehistory of Schneider's First-Rank Symptoms: Texts From 1810 to 1932.
The descriptions of these specific symptoms, with substantial continuity, over more than 2 centuries and many countries, suggest that an understanding of their etiology would teach us something foundational about the psychotic illness. Expand
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. Expand
Schneider's first rank symptoms and the tabulators.
  • J. Hoenig
  • Psychology, Medicine
  • Comprehensive psychiatry
  • 1984
The findings show wide discrepancies, and Schneider's opinion that FRSs do not occur outside schizophrenia has been challenged, and a brief presentation of Schneider's diagnostics hopes to put the diverse and contradictory findings into a contextual perspective. Expand