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Original Paper

The Prevalence, Diagnostic Significance and Demographic Characteristics of Schneiderian First-Rank Symptoms in an Epidemiological Sample of First-Episode Psychoses

Ihara K.a · Morgan C.b · Fearon P.b · Dazzan P.b · Demjaha A.b · Lloyd T.c · Kirkbride J.B.d · Hayhurst H.d · Murray R.M.b · Jones P.B.d

Author affiliations

aDepartment of Social Medicine, Toho University School of Medicine, Tokyo, Japan; bNIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Trust and Division of Psychological Medicine, Institute of Psychiatry, King’s College, London, cDivision of Psychiatry, University of Nottingham, Nottingham, and dDepartment of Psychiatry, University of Cambridge, Cambridge, UK

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Psychopathology 2009;42:81–91

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 20, 2007
Accepted: January 15, 2008
Published online: February 19, 2009
Issue release date: March 2009

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

Abstract

Background: The diagnostic significance of first-rank symptoms (FRSs) remains uncertain. Ethnic differences in FRSs may account for high rates of schizophrenia in minority groups. This study aims to examine the prevalence of FRSs in an epidemiological sample of first-episode psychoses stratified by relevant demographic variables. Sampling and Method: We identified everyone aged 16–64 presenting with their first psychosis over 2 years in 3 UK centres. Results: A total of 426 subjects had consensus diagnoses of DSM-IV and ICD-10 psychotic conditions. Thirty-eight percent (95% CI = 33–42) reported FRSs; more frequent in those classified as having schizophrenia (DSM-IV: 55%, 95% CI = 47–63; ICD-10: 51%, 95% CI = 44–58) than those with affective psychoses (DSM-IV: 31%, 95% CI = 22–39; ICD-10: 29%, 95% CI = 21–38). FRSs in schizophrenia were more common in white British subjects, while in affective psychoses, they were more frequent in the black group. The sensitivities, specificities and positive predictive values for schizophrenia of FRSs were 55, 69 and 72% according to DSM-IV and 51, 71, 74% according to ICD-10, respectively. The sensitivities were higher in white British than in the black group. Conclusions: FRSs were common but unhelpful for differentiating schizophrenia from other psychoses as they occurred frequently in both diagnoses. Phenomenological differences did not explain the higher incidence of schizophrenia in black ethnic minority groups.

© 2009 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 20, 2007
Accepted: January 15, 2008
Published online: February 19, 2009
Issue release date: March 2009

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP


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