Diagnostic Significance of Schneiderian First Rank Symptoms

Schizophrenia is considered to be the heartland of psychiatry and core of its clinical practice. There have been disagreements regarding its diagnostic criteria. Schneiderian first rank symptoms have been given much importance ill international classification systems. Prevalence of first rank symptoms has been reported to be from 28% to 73%. This study was done to estimate the prevalence of first rank symptoms in schizophrenia in patients presenting in outpatients departments of Mayo hospital Lahore and Institute of mental health Lahore. 168 patients were studied. Fifty patients were suffering from schizophrenia. Twenty-live patients each were suffering from mania and psychotic depression. Fifty patients had neurotic (disorders and 18 patients were suffering from drug-induced psychosis. ICD-10 was used as diagnostic criteria and Mellor’s definitions of first rank symptoms were used. Prevalence of first rank symptoms in schizophrenia was found to be 56%. Very few patients from other diagnostic categories had first rank symptoms. Prevalence of first rank symptoms in schizophrenia is lower than reported from studies done in the West. Local criteria and instruments should be developed for use in our own population.