The prevalence, diagnostic significance and demographic characteristics of Schneiderian first-rank symptoms in an epidemiological sample of first-episode psychoses.
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Authors
Ihara, Kazushige
Morgan, Craig
Fearon, Paul
Dazzan, Paola
Demjaha, Arsime
Lloyd, Tuhina
Kirkbride, James B
Hayhurst, Hazel
Murray, Robin M
Jones, Peter B
Issue Date
2009-02-19
Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, Non-U.S. Gov't
Language
en
Keywords
Alternative Title
Abstract
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.
We identified everyone aged 16-64 presenting with their first psychosis over 2 years in 3 UK centres.
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.
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.
We identified everyone aged 16-64 presenting with their first psychosis over 2 years in 3 UK centres.
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.
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.
Description
Citation
Ihara, K., Morgan, C., Fearon, P., Dazzan, P., Demjaha, A., Lloyd, T., Kirkbride, J. B., Hayhurst, H., Murray, R. M., & Jones, P. B. (2009). The prevalence, diagnostic significance and demographic characteristics of Schneiderian first-rank symptoms in an epidemiological sample of first-episode psychoses. Psychopathology, 42(2), 81–91. https://doi.org/10.1159/000203340
Publisher
License
Copyright 2009 S. Karger AG, Basel.
Journal
Psychopathology
Volume
42
Issue
2
PubMed ID
ISSN
1423-033X