Independent course of childhood auditory hallucinations: A sequential 3-year follow-up study

TLDR

Childhood hallucinations of voices occur in a variety of contexts and have variable long‑term outcomes. The study aimed to track the course of voice experiences over three years in children with and without a need for mental health care. Eighty children (mean age 12.9 years) were assessed at baseline for voice characteristics, attributions, psychopathology, life events, coping, and professional care, and these data were used to predict the 3‑year course and patient status. Sixty percent of children stopped hearing voices over three years; persistence was linked to higher severity and frequency, anxiety/depression, unclear triggers, and more intrusive and omnipotent appraisals, while those needing care reported greater influence on behavior and negative affect.

Abstract

Background Childhood hallucinations of voices occur in a variety of contexts and have variable long-term outcomes. Aim To study the course of experience of voices sequentially over a 3-year period in those with and those without a need for mental health care (patient status). Method In a group of 80 children of mean age 12.9 years (s.d.=3.1), of which around 50% were not receiving mental health care, baseline measurement of voice characteristics, voice attributions, psychopathology, stressful life events, coping mechanisms and receipt of professional care were used to predict 3-year course and patient status. Results The rate of voice discontinuation over the 3-year period was 60%. Patient status was associated with more perceived influence on behaviour and feelings and more negative affective appraisals in relation to the voices. Predictors of persistence of voices were severity and frequency of the voices, associated anxiety/depression and lack of clear triggers in time and place. Conclusions Need for care in the context of experience of voices is associated with appraisal of the voices in terms of intrusiveness and ‘omnipotence’. Persistence of voices is related to voice appraisals, suggesting that experience of voices by children should be the target of specific interventions.