**Question:** Which one of the following is not considered as first rank symptom of schizophrenia?

A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Psychomotor retardation

**Core Concept:** In psychiatry, schizophrenia is a complex psychiatric disorder characterized by both positive and negative symptoms. First rank symptoms are considered to be the core and most distinctive symptoms of schizophrenia.

**Why the Correct Answer is Right:** D) Psychomotor retardation refers to a decrease in the rate or speed of movement and is a negative symptom in schizophrenia. It is not considered a first rank symptom because it does not represent the core, most distinctive features of the disorder. First rank symptoms are believed to be unique to schizophrenia and are essential for the diagnosis.

**Why Each Wrong Option is Incorrect:**

A) Positive symptoms: These include hallucinations (e.g., auditory or visual), delusions, disorganized speech, and disorganized behavior. Positive symptoms are considered first rank symptoms as they are considered unique to schizophrenia and essential for the diagnosis.

B) Negative symptoms: This includes a range of symptoms like flat affect, alogia (reduced speech), avolition (decreased motivation), and anhedonia (reduced ability to experience pleasure). Negative symptoms are considered first rank symptoms as they are also unique to schizophrenia and essential for the diagnosis.

C) Cognitive symptoms: This category includes deficits in attention, memory, and thinking processes. While cognitive symptoms are important in schizophrenia, they are not considered first rank symptoms because they are also seen in other psychiatric disorders.

**Core Concept Explanation:** In schizophrenia, first rank symptoms are essential for the diagnosis and differentiate it from other psychiatric disorders. These symptoms are unique to schizophrenia, representing core features of the disease. Negative symptoms and positive symptoms are considered first rank symptoms, while cognitive symptoms are not.

**Clinical Pearl:** First rank symptoms represent the core features of schizophrenia and are essential for the diagnosis. Negative symptoms and positive symptoms are unique to schizophrenia, while cognitive symptoms are seen in other psychiatric disorders as well. Understanding these core features is crucial for proper diagnosis and treatment planning in schizophrenia.