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• #AUDITORY HALLUCINATIONS SCHIZOPHRENIA FREE#

9 It has also been proposed that a single gene may be even responsible for hallucinatory experiences 10 implying that those who have not inherited such a gene may not experience auditory hallucinations, but still could experience other characteristic symptoms of schizophrenia. A mechanism involving two, three, or four loci cannot be ruled out even though there is no compelling support for such models. Relevant studies provide little support for the mechanism of single major locus inheritance. The multi-factorial polygenic model of schizophrenic disorders has received great support and signifies that genetic factors play a bigger role than environmental factors in familial transmission of these disorders. Patients’ Response to AVH 1.Anxiety and panic feelings Command hallucinations are more prevalent among forensic patients and contribute to their forensic status. Schizophrenia predisposes them to a greater risk of suicides and homicides. 8 Often, the content of such messages is negative thus, commanding AVHs are more distressing than commenting ones. Although the percentages differ in various studies, it is assumed that about 30% of patients have command hallucinations and they are seen as the ultimate betrayal of the mind. Specific dimensions of AVHs can give hints to the future likelihood of treatment resistance. 7 Evidence indicates that each patient responds differently to the voices, according to his/her evaluation of them (Table 1), which influences the degree of interventions. 5 AVHs are experienced by approximately 53% of schizophrenia sufferers 6 and are present in 28% of major affective disorders (Goodwin& Jamison. One in four schizophrenia sufferers experiences persistent AVH. Experiencing AVH has serious impact on the quality of life of the affected individual, and is a significant factor in prevalence of suicides among schizophrenic patients. There may be different variables of AVHs.

3 Parallel thinking is a source for thought insertion. Recently, neuro-quantologists have proposed that AVHs may be an objectification of parallel thinking/quantum thinking.

According to an integrated model of auditory hallucination (AHs) suggested by Waters et al, 2 AHs arise from an interaction between abnormal neural activation patterns that generate salient auditory signals and top-down mechanisms that include signal detection errors, executive and inhibition deficits, a tapestry of expectations and memories. Auditory hallucinations may be arising because of an interaction between biological predisposition, perceptual and cognitive factors.

Thus, patients need help to incorporate it. Derogatory voices are common representations of unconscious self-hatred that cannot stand up to the external world’s logic. AVH is a non-consensual, dynamic and psychologically charged experience and the voices often echo significant emotions. 1 From the patient’s perspective, AVHs are a subjective–objective phenomenon. Schizophrenia sufferers feel like abstract entities with non-animated bodies, often experiencing auditory verbal hallucinations (AVH) due to morbid “objectification” of inner dialogue. Keywords: Schizophrenia, hallucinations, clozapine, voice therapies, rTMS Antipsychotics are also reviewed, revealing that, despite having only modest anti-hallucinatory properties, they are essential for reducing the psychic pain and correcting the underlying psychotic process. In this work, different forms of non-pharmacological therapies are reviewed, including CBT, which has gained popularity as a psychological intervention and an efficacious form of voice therapy. Pharmacotherapy alone may not be the answer to refractory auditory hallucinations and a greater spectrum of non-pharmacological therapies is clearly needed. Recent years have witnessed an interest in the development of various forms of non-pharmacological approaches to addressing this problem alongside pharmacotherapy.

#AUDITORY HALLUCINATIONS SCHIZOPHRENIA FREE#

Thus, going forward research should focus on the discovery of a derivative of clozapine that is free from the haematological side-effects, as this could lead to remarkable advancements in the treatment of schizophrenia.

While clozapine seems to have the maximum anti-hallucinatory effect, some patients remain super-refractory even to clozapine treatment. The current psychotropic medications have only modest anti-hallucinatory effect and the efficacy of non-pharmacological therapies is not well established. Refractory auditory hallucinations warrant evidence-based pharmacological and non-pharmacological treatment strategies. Cite this article as: BJMP 2016 9(2):a914