Silverstein M L, Harrow M
Am J Psychiatry. 1978 Dec;135(12):1481-6. doi: 10.1176/ajp.135.12.1481.
Schneider's diagnostic system of first-rank symptoms (FRS) is acknowledged by psychiatrists throughout the world as a decisive basis for the diagnosis of schizophrenia. Recently, the author's and others' works have challenged this view. This report examines the relationship between FRS, psychotic symptoms, prognosis, and outcome at the postacute stage. The assessment of FRS was made from an interview schedule (a modification of the Wing Present State Examination) developed for the systematic assessment of psychotic symptoms. The results question the utility of FRS as a primary diagnostic approach to schizophrenia, suggesting that Schneider's system may not be superior to other diagnostic approaches.
施奈德的一级症状(FRS)诊断系统被全世界的精神科医生公认为精神分裂症诊断的决定性依据。最近,作者及其他人的研究对这一观点提出了挑战。本报告探讨了FRS、精神病性症状、预后及急性后期结局之间的关系。FRS评估是根据一份为系统评估精神病性症状而制定的访谈提纲(对温氏现况检查的修订版)进行的。结果对FRS作为精神分裂症主要诊断方法的效用提出了质疑,表明施奈德的系统可能并不优于其他诊断方法。