The diagnosis of schizophrenia remains idiosyncratic, dependent on the discipline, training, experience, theoretical belief, type of practice, and other biases of individual clinicians. The desire to provide objective bases for diagnosis for schizophrenia has led to the development of several systems based on clearly defined sets of clinical criteria.
Recently, the diagnostic efforts of Schneider have received increasing attention. He simply identified the most common signs and symptoms in the schizophrenics and referred to them as symptoms of the first rank.
Despite his claim that first rank symptoms are pathognomonic for schizophrenia and predict outcome, his first rank symptoms have not been proven by empirical research to be unequivocal valid diagnostic criteria and predictors.
The purpose of this study was to evaluate the diagnostic value of the Schneider´s first rank symptoms and its correlation with the clinical course in schizophrenia. The subjects were 231 schizophrenics who had been admitted to Young-In Mental Hospital from June 1, 1983 to August 31, 1984.
The results were as follows;
1. Variables of sex, age, marital status, religion and education had not correlated with first rank symptoms.
2. Length of illness in patients with first rank symptoms was longer than them without first rank symptoms.
3. The frequency of first rank symptoms was 82.3%, which considered to have significant diagnostic value for schizophrenia.
More admitted or chronic patients had higher frequency of first rank symptoms than acute or less admitted patients.
4. Voices arguing and voices commenting had the most high frequency among the first yank symptoms.
5. Readmitted patients had more first rank symptoms such as thought broadcasting, voices arguing, voices commenting, thought insertion, somatic passivity and delusional perception, compared with the first admission.
6. There was no significant intercorrelation among the first rank symptoms.
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