Auditory hallucinations, not necessarily a hallmark of psychotic disorder

F. Waters, J. D. Blom, R. Jardri, K. Hugdahl, I. E.C. Sommer

Research output: Contribution to journalEditorial

12 Citations (Scopus)

Abstract

Auditory hallucinations (AH) are often considered a sign of a psychotic disorder. This is promoted by the DSM-5 category of Other Specified Schizophrenia Spectrum And Other Psychotic Disorder (OSSSOPD), the diagnostic criteria for which are fulfilled with the sole presence of persistent AH, in the absence of any other psychotic symptoms. And yet, persistent AH are not synonymous with having a psychotic disorder, and should therefore not be uncritically treated as such. Many people who seek treatment for persistent AH have no other psychotic symptoms, have preserved reality-testing capacities, and will never develop a schizophrenia spectrum disorder. Instead, hallucinations may be the result of many different causes, including borderline personality disorder, post-traumatic stress disorder (PTSD), hearing loss, sleep disorders or brain lesions, and they may even occur outside the context of any demonstrable pathology. In such cases, the usage of the DSM-5 diagnosis of OSSSOPD would be incorrect, and it may prompt unwarranted treatment with antipsychotic medication. We therefore argue that a DSM-5 diagnosis of Schizophrenia Spectrum Disorder (or any other type of psychotic disorder) characterized by AH should require at least one more symptom listed under the A-criterion (i.e. delusions, disorganized speech, disorganized or catatonic behavior or negative symptoms). Adhering to these more stringent criteria may help to distinguish between individuals with persistent AH which are part of a psychotic disorder, for whom antipsychotic medication may be helpful, and individuals with AH in the absence of such a disorder who may benefit from other approaches (e.g. different pharmacological interventions, improving coping style, trauma-related therapy).

Original languageEnglish
Pages (from-to)529-536
Number of pages8
JournalPsychological Medicine
Volume48
Issue number4
DOIs
Publication statusPublished - 1 Mar 2018

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Hallucinations
Psychotic Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Antipsychotic Agents
Schizophrenia
Reality Testing
Borderline Personality Disorder
Delusions
Post-Traumatic Stress Disorders
Hearing Loss
Pharmacology
Pathology
Wounds and Injuries
Brain

Cite this

Waters, F. ; Blom, J. D. ; Jardri, R. ; Hugdahl, K. ; Sommer, I. E.C. / Auditory hallucinations, not necessarily a hallmark of psychotic disorder. In: Psychological Medicine. 2018 ; Vol. 48, No. 4. pp. 529-536.
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Auditory hallucinations, not necessarily a hallmark of psychotic disorder. / Waters, F.; Blom, J. D.; Jardri, R.; Hugdahl, K.; Sommer, I. E.C.

In: Psychological Medicine, Vol. 48, No. 4, 01.03.2018, p. 529-536.

Research output: Contribution to journalEditorial

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