Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.
Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
Schizophr Bull. 2019 Sep 11;45(5):971-990. doi: 10.1093/schbul/sbz047.
First-rank symptoms (FRS), proposed by Kurt Schneider in 1939, subsequently became influential in schizophrenia diagnosis. We know little of their prehistory. How often were FRS described before 1939 and in which countries and time periods? Which FRS was most frequently noted?
Forty psychiatric texts from 37 authors, published 1810-1932, were identified that described FRS. In a systematic subsample, half of the textbooks examined contained such descriptions with little differences between countries or over time. Somatic passivity was most commonly noted, followed by thought insertion, thought withdrawal, and made actions. This pattern resembled that reported in recent studies of schizophrenia. A novel term-delusions of unseen agency-was seen in psychiatric texts and then found, from 1842 to 1905, in a range of official reports, and psychiatric, medical, and general audience publications. The Early Heidelberg School (Gruhle, Mayer-Gross, Beringer) first systematically described "self-disturbances" (Ichstörungen), many of which Schneider incorporated into FRS.
From the beginning of Western descriptive psychopathology in the early 19th century, symptoms have been observed later described as first-rank by Schneider. A term "delusion of unseen agency"-closely related to Schneider's first-rank concept-was popular in the second half of the 19th century and described in publications as prominent as the Encyclopedia Britannica and New England Journal of Medicine. The descriptions of these specific symptoms, with substantial continuity, over more than 2 centuries and many countries, suggest that an understanding of their etiology would teach us something foundational about the psychotic illness.
一级症状（FRS）由 Kurt Schneider 于 1939 年提出，随后对精神分裂症的诊断产生了影响。我们对其历史知之甚少。1939 年之前以及在哪些国家和时期一级症状描述的频率有多高？哪个一级症状被最频繁地记录？
从 1810 年至 1932 年，确定了 37 位作者的 40 本精神病学教科书，其中描述了一级症状。在一个系统的抽样中，检查的一半教科书都包含了这些描述，国家之间或时间上几乎没有差异。躯体被动性是最常被注意到的，其次是思维插入、思维抽离和被强加的动作。这种模式与最近对精神分裂症的研究报告相似。一个新的术语——未被感知的代理妄想——在精神病学文本中出现，然后从 1842 年到 1905 年，在一系列官方报告、精神病学、医学和一般受众出版物中都有发现。早期海德堡学派（Gruhle、Mayer-Gross、Beringer）首次系统地描述了“自我干扰”（Ichstörungen），其中许多被 Schneider 纳入一级症状。
从 19 世纪初西方描述性精神病学的开始，就已经观察到了后来被 Schneider 描述为一级症状的症状。一个术语“未被感知的代理妄想”——与 Schneider 的一级症状概念密切相关——在 19 世纪下半叶很流行，并在像《大英百科全书》和《新英格兰医学杂志》这样的知名出版物中被描述。这些特定症状的描述，具有很大的连续性，跨越了 200 多年和许多国家，这表明对其病因的理解将使我们对精神疾病有一些基础性的认识。
