All of the following first rank symptoms of schizophrenia, except?

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

Command hallucinations, which are auditory hallucinations that order a person to perform an action, are not included in Kurt Schneider's list of first-rank symptoms (FRS).
While command hallucinations are a severe and clinically important symptom in psychosis, they are not considered a specific FRS.
The FRS concerning auditory hallucinations are specific: hearing one's thoughts aloud (thought echo), voices arguing or discussing the person, and voices providing a running commentary on the person's actions.

Option B: Thought broadcasting is a classic first-rank symptom of schizophrenia.
Option C: Delusional perception is a classic first-rank symptom of schizophrenia.
Option D: Thought withdrawal is a classic first-rank symptom of schizophrenia.

Visual 1: Chart: A chart listing and defining all of Schneider's First-Rank Symptoms, categorized by type (Auditory Hallucinations, Thought Disorders, Passivity Experiences, Delusional Perception). This helps in memorizing the specific symptoms.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Schneider's First-Rank Symptoms of Schizophrenia as background academic context rather than a clinical decision trigger.
Recognizing FRS is crucial for nurses in mental health settings as it can help in the early identification and assessment of potential schizophrenia, guiding appropriate referral and management.
While the DSM-5 no longer requires FRS for a schizophrenia diagnosis, their presence strongly suggests the disorder and can indicate a higher severity of psychosis.
A nurse's priority when encountering a patient with command hallucinations is to assess for safety, determining the nature of the commands and whether they involve harm to self or others, and implementing immediate safety protocols.

How to Approach the Question

First, identify the negative framing of the question by spotting the word 'except'. This means you are looking for the option that does not fit with the others.
The core concept is 'first-rank symptoms of schizophrenia'. Recall or look up the specific list of symptoms defined by Kurt Schneider.
Systematically evaluate each option against the list of FRS.
Option A, 'Command hallucination', is a type of auditory hallucination, but is it the specific type listed as an FRS? Check the list.
Options B, C, and D ('Thought broadcasting', 'Delusional perception', 'Thought Withdrawal') are all explicitly listed as FRS.
Since the question asks for the exception, the option not on the list of FRS is the correct answer.

Concept Tested & Keywords

QhQJ6I2JpbDc8sPYHNpS4f

Practise the full NORCET 3 - 2022 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.