Background: Schneider’s First Rank Symptoms (FRS) are positive symptoms that are characteristic but not pathognomonic of Schizophrenia. Most of the FRS are among the most significant diagnostic criteria for Schizophrenia in ICD-10. FRS is reported to occur in other psychiatric disorders. They are not uncommon in patients with affective disorders. Aims: This study was to evaluate the frequency of Schneider’s First Rank Symptoms and to study symptom clusters associated with FRS in patients with Bipolar Affective (Mood) Disorder and Schizophrenia and to compare the same in the two disorders. Methodology: This study was done in the department of Psychiatry, Father Muller Medical College, Mangalore from March 2016 to July 2016. All the inpatients with diagnosis of Bipolar Affective Disorder and Schizophrenia constituted the population for the study. Consecutive 80 patients admitted to the ward who satisfied the inclusion and exclusion criteria formed the sample for the study, with Bipolar Affective Disorder (n=40) and Schizophrenia (n=40). All the patients in the sample were subjected to clinical examination which included MSE and physical examination. All of them were assessed using Mellor’s Symptom Check List for First Rank Symptoms and Scale for Assessing Positive Symptoms (SAPS). The data obtained were analyzed using the student t test and chi square test. Results: First rank symptoms (FRS), were found in 88% of Schizophrenia patients and in 35% of Bipolar affective patients. Statistical analysis revealed highly significant difference in prevalence of FRS (p < 0.001). Voices arguing and voices commenting were the most common FRS ( 65%) in patients with Schizophrenia. Thought insertion, audible thoughts, made acts, thought withdrawal, thought broadcast and somatic passivity were seen in schizophrenia patients. In bipolar affective disorder patients, voices arguing (20%) and voices commenting (37.5%) were more common than thought broadcast and made act, but voices commenting and somatic passivity seen in equal frequency in both disorders. There were no cases with audible thoughts, thought withdrawal and thought insertion. The SAPS score in schizophrenia patients was high for auditory hallucinations (72.5%). Third person auditory hallucinations manifested in 67.5%, voices conversing in 47.5%, voices commenting in 52.5%%, and delusions in 67.5%. In bipolar affective disorder, auditory hallucinations were found in about 37.5%, and voices commenting in 27.5% persecutory delusions in 15% of patients but less than these in Schizophrenia cases. Conclusion: FRS is most common in Schizophrenia. FRS is common in Bipolar Affective Disorder. The difference in frequency and nature of FRS in Schizophrenia and Bipolar affective disorders are statistically significant.
