Relevance of Schneider's first-rank symptoms

Abstract

Replies to the comment by F. Ortuño and R. M. Bonelli (see record 2000-00147-014) on the study by V. Peralta and M. J. Cuesta (see record 1999-10564-010), which concluded that first-rank symptoms are not useful in differentiating schizophrenia from other psychotic disorders. The authors agree that their study results, by showing that first-rank symptoms spread across the full spectrum of psychoses, do not necessarily contradict Schneider's (1925, 1987) schizophrenia concept. They agree that the division of psychotic disorders into schizophrenic and non-schizophrenic psychoses is an artificial one. They do not agree with the contention that all psychotic disorders must be diagnosed as schizophrenia. Given that first-rank symptoms are present with a similar prevalence across the full spectrum of psychotic disorders, and that first-rank symptoms are unrelated to the prognosis of schizophrenia, it seems fair to conclude that they are useless for the diagnosis of schizophrenia. In fact, the authors' data support T. J. Crow's (1995) contention that they are not disase entities but continua of variation where schizophrenia and manic-depressive illness represent the extreme forms of the psychotic continuum. (PsycINFO Database Record (c) 2016 APA, all rights reserved)