Video Transcription

“Hi Everyone. Welcome to another psychstudent video. Today we focus on first rank symptoms of schizophrenia. These were originally described by Schneider in 1959! There are many diagnoses with psychosis as a feature. One of which is schizophrenia. Whilst it is rarely possible to diagnose schizophrenia at a single meeting these symptoms make the presence of this diagnosis more likely”.

Mind Map Diagram:

“ Symptoms can be broken down into four categories to try to remember them more easily. Auditory, made, thoughts and other. There are roughly three symptoms to note within each category except other where there are 2”.

Auditory 3 Page:

“ We will start first with the 3 auditory symptoms. The first one that I am drawing out for you now looks at when the person feels that there is the perception that voices are speaking their own thoughts out loud. The next one that we think about is the more classically considered. This is when there are 3rd person voices which feels as if the voices are discussing the person. They might be talking to each other, they might be talking to the person, but it feels as if they are talking about them. The last one that we tend to think about within this category is something called running commentary. So this is a voice that states out loud everything that the person is actually doing. So, for example, “He went outside”, “He brushed his teeth”, “He is putting his shoes on”. As I am sure you can imagine these can be very distressing phenomena and very distracting for the person. Particularly if voices are very negative or are telling the person to do things that they don’t want to do”.

Thoughts 3 Page:

“Next we consider thoughts. This describes interference in the persons thinking process. In some cases people may feel as if their thoughts can be heard by others, this is termed thought broadcasting. And it feels like everyone around them knows what they’re thinking which can be really difficult. So in this case I have put some thoughts that maybe they might be having so: “I want to go for coffee”, “Can they hear what I’m thinking”, “Why are they doing that”, any thought that they might be having. And it would feel as if everyone around them could hear that and it feels a lot like a really big invasion of privacy to the people experiencing these phenomena.

In other cases they may feel as if their thoughts are being added in. In these cases it feels as if the thoughts are not really their own and the thoughts inserted can be any kind of thoughts. So in this case I have put the person might be thinking “I might stop for coffee” but actually there is another thought that’s coming, and it feels like an external thought that maybe they should go home. As I say this is called thought insertion.

The opposite can also occur when the person feels their own thoughts are being removed in some way. This can be really hard for them to describe and might clinically present as a kind of paucity of speech. This links in really with our kind of previous video about thought disorders that you might see and how it might present to you symptomatically. But this really is the sensation of a thought being removed that was there but now is just no longer there at all”.

Made 3 Page:

“Next we consider made phenomena. This is most easily understood as the sensation that an external force is changing how we actually feel. In an emotional context this can present as made feelings, but it could also present as made acts or made impulses. In each case the person reports the feeling, movement or impulse as coming from externally so, not their own kind of plans really. Explanations for who they feel is responsible for these external phenomena can be really variable so they might feel really unsure about who is causing these things to happen and where they are coming from or they might give you a really bizarre explanation for who is causing these things. Maybe it’s the government, maybe it’s aliens. So its really hard to know, it can be really really variable depending on that persons illness itself”.

Other 2 Page:

“ The final 2 symptoms don’t fit so easily into those other categories and these are somatic hallucinations and delusional percept. Somatic hallucinations differ from made feelings which are more emotion focused and made acts which are more movement focused because these are more thought of as altered bodily sensations. So touch, temperature, in some cases people may feel light electric shock-like sensations for example. Delusional perception on the other hand is a highly interesting experience in which a normal stimulus for example, seeing a chair that happens to be red in colour is interpreted in a delusional way. So the person may feel that the red chair means that someone that they know might die for example. There is no plausible link between those two ideas and it can really be anything”.


“That ends this quick overview of first rank symptoms. If you found this really helpful please like subscribe and share with you colleagues and friends. Thank you!”.