FREQUENCY OF FIRST RANK SYMPTOMS IN PATIENTS OF SCHIZOPHRENIA: A HOSPITAL BASED STUDY

Background: Schizophrenia affects 1% of population worldwide. In spite of its enormous impact, issues as basic as its diagnostic criteria remain ill-defined and controversial. Schneider claimed that in absence of somatic illness, first rank symptoms are pathognomonic of schizophrenia. However this claim has been criticized and first rank symptoms are reported to be present in other psychiatric disorders as well. The aim of this study was to see the prevalence of first rank symptoms in indoor schizophrenic patients in our set up. Material & Methods: This was an observational study carried out in Psychiatry unit, Khyber Teaching Hospital Peshawar during the year 2009. One hundred patients admitted during this period who fulfilled the DSM-IV criteria for schizophrenia were included in the study. First rank symptoms were elicited by interviewing the patients based on Present State Examination (P.S.E). First rank symptoms were defined according to Mellor's criteria (1970). Results: Out of 100 patients, only 34 (34%) reported having one or more first rank symptoms, most frequent being 'voices commenting' and least reported was "thought broadcasting". Interestingly, Delusional Perception was conspicuous by its absence in all patients. Maximum number of first rank symptoms found in an individual was five. Age, and gender did not differ significantly in patients with or without first rank symptoms. However, those experiencing first rank symptoms tended to be older in age and had more occupational dysfunction. Conclusions: Sixty-six percent of patients diagnosed as schizophrenia do not report any first rank symptom, thus reducing its diagnostic value.