Prevalence, factorial structure, and clinical correlates of first rank symptoms in urban, African-American patients with first-episode nonaffective psychosis

Rationale: Given the dearth of research on the prevalence and clinical correlates of first rank symptoms in first-episode psychosis samples, this study focused on a relatively homogenous sample of hospitalized, first-episode, urban, African-American patients. Objective: To determine frequencies of eleven first rank symptoms based on previously published definitions, to conduct correlations and an exploratory factor analysis to reveal any potential latent structure of the eleven symptoms, and to assess associations between first rank symptoms and several select clinical variables. Methods: The sample included seventy-three African-American patients hospitalized for a first episode of nonaffective psychosis. A structured inventory was used to rate the presence of first rank symptoms. Additionally, positive, negative, and general psychopathology symptoms were assessed; duration of the prodrome and duration of untreated psychosis were estimated; and depression, insight, and social functioning were rated. Results: First rank symptoms were relatively common in this sample - 56.2% experienced at least one first rank symptom. Two latent factors were suggested by the factor analysis: one related to Schneiderian hallucinatory experiences and passivity phenomena, and another comprised of the three items on thought control (thought broadcasting, thought withdrawal, and thought insertion). The presence of hallucinatory/ passivity first rank symptoms was associated with less impairment in insight, the latter being measured both by patient self-report and researcher ratings. Conclusions: In light of these findings from an urban, African-American sample of first-episode patients, additional research on first rank symptoms, especially in terms of factorial structure and clinical correlates, is warranted.

Duke Scholars

Author Lauren Franz Psychiatry, Child & Family Mental Health & Community Psychia ...