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FIRST-RANK SYMPTOMS: CURRENT STATUS Presenter: Ravi Philip Rajkumar Chairperson: Dr. G. Venkatasubramanian
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INTRODUCTION ,[object Object],[object Object]
INTRODUCTION ,[object Object],[object Object]
INTRODUCTION ,[object Object],[object Object],[object Object],[object Object]
DEFINITION ,[object Object],[object Object]
In other words…. ,[object Object]
What are they? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What was their basis? ,[object Object],[object Object],[object Object]
Rise of the FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rise of the FRS ,[object Object],[object Object],[object Object]
Theories behind FRS ,[object Object],[object Object],[object Object],[object Object]
Current theories behind FRS ,[object Object],[object Object],[object Object],[object Object]
Current theories behind FRS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current theories behind FRS ,[object Object],[object Object],[object Object]
Origins of Delusion of Control Motor Instruction Comparator Or Self Monitoring System Motor Act Proprioceptive Input Reference Copy Re-afference Copy Ownership Agency
Evidence from imaging ,[object Object],[object Object]
 
In conclusion ,[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object],[object Object]
Clinical correlates of FRS ,[object Object],[object Object],[object Object]
Criticism of the FRS ,[object Object],[object Object],[object Object],[object Object]
Criticism of the FRS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Unreliability of assessment ,[object Object],[object Object],[object Object],[object Object]
Lack of diagnostic utility ,[object Object],[object Object],[object Object],[object Object]
Flaws in Schneider’s original work ,[object Object],[object Object],[object Object],[object Object]
Diverting attention from other “core” symptoms ,[object Object],[object Object]
Current status: ICD-10 ,[object Object],[object Object],[object Object],[object Object],[object Object]
APPROACH TO DIAGNOSIS OF PSYCHOSIS – ICD-10 Psychotic illness First-rank symptoms Affective symptoms Duration > 1 month Polymorphic picture ACUTE SCHIZOPHRENIA- LIKE PSYCHOSIS SCHIZOPHRENIA ACUTE POLYMORPHIC  PSYCHOSIS WITH SZ YES SCHIZOAFFECTIVE DISORDER NO YES YES NO YES To page 2
APPROACH TO DIAGNOSIS OF PSYCHOSIS – ICD-10 Psychotic illness without first-rank symptoms Affective symptoms YES MOOD DISORDER WITH PSYCHOTIC SYMPTOMS NO Other schizophrenic symptoms YES Duration > 1 month NO YES SCHIZOPHRENIA Polymorphic  picture NO YES NO ACUTE PSYCHOSIS  (OTHER) ACUTE  POLYMORPHIC  PSYCHOSIS Single persistent delusion YES Duration  > 3 months NO Other persistent  delusions ± hallucinations Lasts > 1 month NO YES NO PSYCHOSIS NOS NO YES F23.3 DELUSIONAL  DISORDER YES F22.8
Current status: DSM-IV-TR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
APPROACH TO DIAGNOSING PSYCHOSIS (DSM-IV) Psychotic illness Affective symptoms Interim periods with only psychosis? SCHIZOAFFECTIVE  DISORDER MOOD DISORDER WITH PSYCHOTIC SYMPTOMS Criterion A for schizophrenia met? Total duration > 6 months Total duration > 1 month SCHIZOPHRENIA SCHIZOPHRENIFORM DISORDER Single persistent delusion? Total duration  > 1 month Total duration  > 1 month PSYCHOSIS NOS BRIEF PSYCHOTIC DISORDER YES YES YES YES YES YES NO NO NO NO NO NO NO DEL. DISORDER YES
Current status: Implications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current status: Implications ,[object Object],[object Object],[object Object]
Current status: Implications ,[object Object],[object Object],[object Object],[object Object]
Current status: Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object]
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[object Object]

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First rank symptoms %80%a0%a0%92%b6 seminar

  • 1. FIRST-RANK SYMPTOMS: CURRENT STATUS Presenter: Ravi Philip Rajkumar Chairperson: Dr. G. Venkatasubramanian
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  • 17. Origins of Delusion of Control Motor Instruction Comparator Or Self Monitoring System Motor Act Proprioceptive Input Reference Copy Re-afference Copy Ownership Agency
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  • 36. APPROACH TO DIAGNOSIS OF PSYCHOSIS – ICD-10 Psychotic illness First-rank symptoms Affective symptoms Duration > 1 month Polymorphic picture ACUTE SCHIZOPHRENIA- LIKE PSYCHOSIS SCHIZOPHRENIA ACUTE POLYMORPHIC PSYCHOSIS WITH SZ YES SCHIZOAFFECTIVE DISORDER NO YES YES NO YES To page 2
  • 37. APPROACH TO DIAGNOSIS OF PSYCHOSIS – ICD-10 Psychotic illness without first-rank symptoms Affective symptoms YES MOOD DISORDER WITH PSYCHOTIC SYMPTOMS NO Other schizophrenic symptoms YES Duration > 1 month NO YES SCHIZOPHRENIA Polymorphic picture NO YES NO ACUTE PSYCHOSIS (OTHER) ACUTE POLYMORPHIC PSYCHOSIS Single persistent delusion YES Duration > 3 months NO Other persistent delusions ± hallucinations Lasts > 1 month NO YES NO PSYCHOSIS NOS NO YES F23.3 DELUSIONAL DISORDER YES F22.8
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  • 39. APPROACH TO DIAGNOSING PSYCHOSIS (DSM-IV) Psychotic illness Affective symptoms Interim periods with only psychosis? SCHIZOAFFECTIVE DISORDER MOOD DISORDER WITH PSYCHOTIC SYMPTOMS Criterion A for schizophrenia met? Total duration > 6 months Total duration > 1 month SCHIZOPHRENIA SCHIZOPHRENIFORM DISORDER Single persistent delusion? Total duration > 1 month Total duration > 1 month PSYCHOSIS NOS BRIEF PSYCHOTIC DISORDER YES YES YES YES YES YES NO NO NO NO NO NO NO DEL. DISORDER YES
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