The personalized content and subjective reality of the voices play a key role in the development of strong beliefs about the intent and power of voices, and an intense relationship may develop between the voice-hearers and their voices.Ī significant proportion of persons with schizophrenia also experience nonverbal hallucinations (music and other sounds). The voices describe what the person is feeling or thinking, and speak about his or her fears or worries. The content of voices is usually highly personalized. However, in 40% of cases, the voices are pleasant and supportive-some individuals report feelings of loss when their treatment makes the voices disappear. These negative voices cause considerable distress. In 55% of cases, the voices have negative and malicious content: they are derogatory, insulting, or commanding (to do something intolerable). 3,4 Patients with schizophrenia who have auditory hallucinations commonly hear several different voices, and these are often recognized as belonging to someone who is familiar (eg, a neighbor, family member, or TV personality) or to entities such as God, the devil, or angels. 2 In clinical settings, features such as frequency, emotional response, and functional interference are the most commonly used dimensions when evaluating response to treatment.Īuditory hallucinations occur more commonly in individuals with schizophrenia or schizophrenia spectrum disorders than in those with any other disorder: estimates range between 60% and 75%. Given the complex and multifaceted nature of hallucinations, it is helpful to segment their multiple phenomenological dimensions ( Table). The message carried by hallucinated voices often contains such personalized and emotionally charged contents that it often resonates with the idea of a “speaking character.” However, they are much more than auditory perceptions. Noise volume varies from hardly audible (eg, whispers) to very loud.Īuditory hallucinations have veridical perceptual qualities in the sense that individuals are often convinced of the objective reality of the experience. The contents vary widely and may involve language or other sounds, such as music, footsteps, telephone ringing, buzzing, scratching, whistling, bangs, animal calls, water falling, or engines. They may be experienced as coming from anywhere in external space, “in the mind,” or on the surface of the body. 1)Īuditory hallucinations refer to auditory percepts that a person experiences when awake that are not elicited by an external stimuli. (For a discussion of hallucinations in children and adolescents see the article by Jardri and colleagues. This article focuses specifically on adult populations. It is increasingly clear, however, that auditory hallucinations occur in a range of psychiatric and medical disorders as well as in individuals without mental illness.ĭespite these recent advances, there are important gaps in our understanding of hallucinations outside of psychotic disorders. Until recently, auditory hallucinations carried considerable weight in the diagnostic process as pointing to schizophrenia spectrum disorders. Throughout history, auditory hallucinations (“voices”) have been construed as evidence of communication with divine powers, although 20th century medical models have often viewed these experiences as “undesirable” and a sign of mental illness.
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