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Schneider's first-rank symptoms of schizophrenia, 11 symptoms that have been thought to be indicative of the illness as long as there are no organic brain diseases present, have been generally regarded as useful to the study and diagnosis of schizophrenia. But their validity has, at times, been questioned, and whether or not they can be used for prognostic purposes remains unclear. There are also cultural variations among symptoms, necessitating the standardization of the first-rank symptoms for each culture being studied and making cross-cultural comparisons difficult. To achieve this standardization among Pakistani schizophrenics, 75 patients in Pakistan diagnosed as schizophrenic using the Research Diagnostic Criteria were assessed by a psychiatrist upon admission to a hospital, before treatment had been administered. First-rank symptoms were elicited. There were 43 males in the study and 32 females; the average age was 29.8 years. Twenty-five patients showed no first-rank symptoms, while first-rank symptoms were present in 26/43 males and 24/32 females. Most common were somatic passivity, which was exhibited by 66 percent of the patients who had at least one first-rank symptom, thought broadcast (46 percent), and thought insertion (42 percent). Comparison to other cultures is made and it is concluded that despite cross-cultural differences, first-rank symptoms have high inter-rater reliability and are simple to use in everyday assessment. However, they may be more useful within cultures than across cultures for making comparisons. (Consumer Summary produced by Reliance Medical Information, Inc.)

Voices of Reason, Voices of Insanity: Studies of Verbal Hallucinations Ivan Leudar, Philip Thomas Brunner-Routledge, 15.99 £, pp 240 ISBN 0 41514787 5 Rating: *** When I began training in [...]