A 25-year-old male presents to the emergency department with his family, who report that he has been hearing voices telling him to harm himself for the past 8 months. He also exhibits disorganized speech and believes that government agencies are constantly monitoring him. According to Schneider's first-rank symptoms of schizophrenia, which of the following is a classic example?

Explanation

Schneider's first-rank symptoms (FRS) are a set of symptoms historically considered highly indicative of schizophrenia, although their diagnostic specificity is now debated. Classic FRS include specific types of auditory hallucinations (e.g., voices arguing or discussing the patient, voices speaking the patient's thoughts aloud, or voices commenting on the patient's actions), thought withdrawal, thought insertion, thought broadcasting, and delusions of control, influence, or passivity. Auditory hallucinations of a running commentary on his actions directly fit this description. Disorganized speech and delusions of persecution are core symptoms of schizophrenia but are not specifically classified as FRS by Schneider. Social withdrawal and anhedonia are negative symptoms.