According to ICD-10, schizophrenia has clearly established diagnostic criteria, including Schneider's first-order symptoms (Ertsranksymptome nach Schneider), such as thought insertion (Gedankeneingebung), thought withdrawal (Gedankenentzug), thought broadcasting (Gedankenausbreitung), audible thoughts (Gedankenhoren/Gedankenlautwerden), acoustic-verbal hallucinations (dialogische Stimmen, komentierende Stimmen), delusional perception (Wahnwahrnehmung) or delusions of control (Willensbeeinflussung, leibliche Beeinflussungserlebnise). Is not any delusion or modality of hallucinations important to you for the diagnosis of schizophrenia, ie the positive psychotic symptom itself in the context of the course of the disease and in the context of other symptoms? It is not so much an academic question as a question of everyday clinical practice, or the diagnostic decision-making of an ordinary psychiatrist.
"Is not any delusion or modality of hallucinations important to you for the diagnosis of schizophrenia"
I have reviewed the literature on musical hallucinations and conclude that ear disorder or disease, specifically a hyperactive state of the inner ear, is a necessary trigger. This applies equally to those with psychosis, deafness or no neurological or psychiatric disorder at all. There is no case in the literature of someone with MHs and a possible causal neurological lesion but with proven normal peripheral ear function..
Dear Michal Patarák,
There is not any single symptom in mental disorder that it is pathognomonic of a disorder. As Emil Kraepelin wisely demonstrated the diagnosis in psychiatry should be confirmed by long term follow-up. The long term follow-up is the gold standard confirmation for our diagnosis. Some other psychotic patients may have Schneider's first-order symptoms, as in dementia, organic psychosis and bipolar psychotic episode. In Psychiatry the diagnosis should never be done in a transversal - one exam - way, it should be careful done in long-term follow-up. I do suggest everyone to read the texts of Emil Kraepelin.
Best regardes,
Antonio
"The reliability of using first-rank symptoms for the diagnosis of schizophrenia has since been questioned,[1] although the terms might still be used descriptively by mental health professionals who do not use them as diagnostic aids.
Individuals with dissociative identity disorder may experience first-rank symptoms more commonly than even patients with schizophrenia[2] though patients with DID lack the negative symptoms of schizophrenia and normally do not mistake hallucinations for reality.[3] Differentiating between dissociative identity disorder and psychotic disorders is not done by listing first-rank symptoms as these conditions have a considerable overlap yet a different overall clinical picture and treatment approach.[4]"
https://en.wikipedia.org/wiki/Kurt_Schneider
FYI:
Empirical studies have showed that first-rank symptoms are more common in severely traumatized and dissociative patients than in patients with schizophrenia.
Ref:
Ross, C. A., Miller, S. D., Reagor, P., Bjornson, L., Fraser, G. A., & Anderson, G. (1990). Schneiderian symptoms in multiple personality disorder and schizophrenia. Comprehensive Psychiatry, 31(2), 111-118.
Laddis, A., & Dell, P. F. (2012). Dissociation and psychosis in dissociative identity disorder and schizophrenia. Journal of Trauma & Dissociation, 13(4), 397-413.
- Badges
- Science topic
- Similar topics
- Methodology
- Research Methodology
- Research Papers