Prevalence of First Rank Symptoms in Mania

Abstract

Background: First rank symptoms (FRSs) are seen frequently in mania. There has been a scarcity of data published in consideration with the Indian population on the prevalence of FRS in mania. Aim: The aim of this study is to explore the pattern of occurrence of FRS and assess association between the presence of FRS and severity of mania. Subjects and Methods: A cross-sectional study was conducted in the psychiatry department of tertiary care institution of North India. Fifty patients selected by convenient sampling, diagnosed with mania as per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) classification. Informed consent taken, semi-structured per forma used, present state examination-9 Hindi version used for FRS, Young Mania Rating Scale (YMRS) to assess severity of mania. Descriptive statistics were used. The Chi-square test was used for the comparison between the groups. Mann–Whitney U-test was used for the comparison between individual FRS and YMRS score. Results: Mean age FRS + was 35.32 years (±13.85), 71% were males; majority belonged to urban locality, married, residing in nuclear family, educated up to matriculation, and unemployed. There was no significant association of these variables with FRS. The Presence of ≥1 FRS was 62%; voices commenting on one's action (83.9%), voices arguing (77.4%), thought broadcast (38.7%), delusional perception (23.8%), thought withdrawal and thought echo (both 12.9%), made volitional acts, somatic passivity, and thought insertion (in 3.2% each). None had the presence of made feelings and made impulse/drives. Mean YMRS was 40.16 ± 7.91. No statistical significance found between FRS and YMRS scoring, except for thought withdrawal. Conclusions: The present study confirms FRS in substantial cases of mania. FRS in mania can lead to misdiagnosis of schizophrenia, leading to inadequate management, delayed appropriate treatment, and poor prognosis.