Schneider's First-rank Symptoms and the Longitudinal Evolution in Psychosis

Abstract

Schneider's first-rank symptoms have been connected to the diagnosis of Schizophrenia for decades. More recently, these types of symptoms have also been described in other types of psychosis, including affective psychosis. In general, current research focuses on the relationship between Schneider's first-rank symptoms and the subsequent clinical course, i.e. their role in the prognosis of the disorder. Objectives To determine how the presence of Schneider's first-rank symptoms in psychosis can influence the evolution of the disorder. Method We analyzed a group of subjects (N = 106) who had a first-episode psychosis between 1995-1998. This group was divided into two subgroups: one that presented Schneider's first-rank symptoms (N = 70) and another group (N = 36) without these symptoms. The groups were compared in terms of subsequent evolution. It is worth noting that this study only included subjects who were currently in active psychiatric follow-up in the outpatient service. Results There are differences between the two groups in terms of clinical parameters (age, onset, educational level, employment and family status, clinical diagnosis) and disorder progression (number of admissions), but without any statistically significant differences in the first 10 years of evolution. The existence of transparency-influence symptoms in a first-episode psychosis correlates with an increase in the number of hospital admissions after 10 years of evolution. Conclusions The transparency-influence phenomena are correlated with an increase in the number of hospital admissions across the longitudinal evolution.