Schneiderian first-rank symptoms and clinical prognostic features in schizophrenia.

Abstract

The records of 78 male patients diagnosed as schizophrenic admitted to a closed psychiatric ward were reviewed. Patient age, race, social class, response to treatment, need for somatic treatment, disposition, and final diagnosis were related to the presence or absence of schneiderian first-rank symptoms and good or poor prognostic signs. Patients exhibiting first-rank symptoms and those exhibiting poor prognostic signs were found to be suffering from the same illness. They were younger, responded less well to treatment, required further hospitalization, and more frequently received high-dose neuroleptics than the clinically heterogeneous patients exhibiting good prognostic signs and without first-rank symptoms. The use of first-rank symptoms and prognostic signs as a diagnostic checklist of schizophrenia and as predictors of response to treatment and clinical outcome is discussed.