Which of the following are NOT included in Schneider’s First Rank Symptoms of schizophrenia?& x20; - NORCET 9 Mains - 2025

NORCET 9 Mains - 2025

Mental Health Nursing

Easy

Appeared in: NORCET 9 Mains - 2025

Explanation

The question asks to identify the symptom that is NOT part of Schneider's First Rank Symptoms (SFRS) for schizophrenia.
SFRS are a specific list of symptoms considered highly characteristic of schizophrenia, focusing on specific auditory hallucinations and delusions of control.
Visual hallucinations, while they can occur in schizophrenia, are not part of this specific list and are considered second-rank symptoms.
Second-rank symptoms are less specific to schizophrenia and are also seen in other conditions like organic brain disorders or substance-induced psychosis.

Option A: Delusional perception is a classic First Rank Symptom. It involves a two-stage process where a normal perception occurs, which then triggers a sudden and intense delusional belief.
Option B: Command hallucinations are a type of auditory hallucination. While the classic SFRS list specifies voices arguing or commenting, command hallucinations are still auditory in nature and are more closely related to schizophrenia symptoms than visual hallucinations.
Option C: This is synonymous with 'command hallucination' and is an auditory hallucination. The key distinction in SFRS is the type of hallucination. Auditory hallucinations are central to SFRS, whereas visual hallucinations are not.

Visual 1: Infographic: A chart listing the 11 Schneiderian First Rank Symptoms, grouped by category (Auditory Hallucinations, Thought Disorder, Passivity Phenomena, Delusional Perception). This helps in memorizing the specific list.
Visual 2: Comparison Table: A table comparing First-Rank Symptoms (e.g., voices commenting, thought insertion) with Second-Rank Symptoms (e.g., visual hallucinations, other delusions, mood changes) to clarify the distinction.

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 First Rank Symptoms is a key clinical skill in differentiating schizophrenia from other psychotic disorders, although modern diagnostic systems (like DSM-5) use a broader set of criteria.
The presence of visual hallucinations in a patient with psychosis should prompt a nurse to consider other potential causes, such as delirium, substance withdrawal, or neurological conditions (e.g., Lewy body dementia), requiring a thorough medical workup.
What if? If a patient reported hearing their thoughts spoken aloud ('audible thoughts') and also seeing shadows in the corner of their eye, the audible thoughts would be considered a First-Rank Symptom pointing towards schizophrenia, while the visual hallucinations would be a less specific, second-rank symptom requiring further investigation for other causes.

How to Approach the Question

First, identify the keywords in the question: 'NOT included' and 'Schneider’s First Rank Symptoms'. This tells you it's a negative recall question.
Second, recall the specific list of symptoms defined by Kurt Schneider. The list is primarily composed of specific auditory hallucinations and delusions of control.
Third, evaluate each option against this recalled list.
Delusional perception is on the list. Eliminate it.
Command hallucinations/voices commanding are auditory. While not a classic category like 'voices commenting', they are still auditory. Keep them as possibilities but look for a better answer.
Visual hallucinations are sensory (like auditory) but are explicitly not on the list of First Rank Symptoms. They are considered second-rank.

Concept Tested & Keywords

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