Auditory Hallucinations: A Comparison between Patients and Nonpatients

TLDR

Onset of auditory hallucinations in most patients is typically preceded by a traumatic event or a trigger that reactivates earlier trauma. The study compared the form and content of chronic auditory hallucinations across schizophrenia patients, dissociative disorder patients, and nonpatient voice‑hearers. The form of hallucinations was similar across schizophrenia, dissociative disorder, and nonpatient groups, yet nonpatients reported predominantly positive voices and a sense of control, whereas patients experienced more negative content and emotional distress, indicating that hearing‑voice disability is linked to reactivation of past trauma.

Abstract

The form and the content of chronic auditory hallucinations were compared in three cohorts, namely patients with schizophrenia, patients with a dissociative disorder, and nonpatient voice-hearers. The form of the hallucinatory experiences was not significantly different between the three groups. The subjects in the nonpatient group, unlike those in the patient groups, perceived their voices as predominantly positive: they were not alarmed or upset by their voices and felt in control of the experience. In most patients, the onset of auditory hallucinations was preceded by either a traumatic event or an event that activated the memory of earlier trauma. The significance of this study is that it presents evidence that the form of the hallucinations experienced by both patient and nonpatient groups is similar, irrespective of diagnosis. Differences between groups were predominantly related to the content, emotional quality, and locus of control of the voices. In this study the disability incurred by hearing voices is associated with (the reactivation of) previous trauma and abuse.