The Same or Different? A Phenomenological Comparison of Auditory Verbal Hallucinations in Healthy and Psychotic Individuals
The Same or Different? A Phenomenological Comparison of Auditory Verbal Hallucinations in Healthy and Psychotic Individuals
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DOI：
10.4088/jcp.09m05797yel
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发表时间：
2011-03-01
影响因子：
5.3
通讯作者：
Sommer, Iris E. C.
中科院分区：
文献类型：
--
作者：
Daalman, Kirstin;Boks, Marco P. M.;Sommer, Iris E. C.
目的：虽然听觉言语幻觉（AVHs）是精神分裂症的最典型特征，但它们的存在经常被描述为一个连续体，从严重精神病患者到分裂型人格障碍患者再到其他健康参与者。目前尚不清楚该光谱外边界的avh是否确实是相同的现象。此外，AVHs的特定特征可能是精神障碍的重要指标。方法：对118例精神病患者和11例其他健康人群每月至少发生一次房颤的房颤现象进行比较，探讨精神病患者和非精神病患者房颤的异同。这项研究于2007年9月至2010年3月在荷兰乌得勒支大学医学中心进行。使用精神病症状评定量表对AVHs的特征进行量化。结果：声音的感知位置（头内/头外）、声音的数量、响度和人格化在精神病患者和健康个体之间没有区别。健康组和精神病组之间最显著的差异是对AVHs内容的情绪效价、AVHs出现频率和正常对照组的AVHs出现频率（P值均< 0.001）。健康人群AVHs发病年龄明显低于正常人群（P < 0.001）。在我们的样本中，AVHs内容的负面情绪效价可以准确预测88%的参与者是否存在精神障碍。结论：光谱外边界的avh是否应视为同一现象尚不能确定，两者既有相似之处，也有不同之处。与精神病患者相比，健康受试者的AVHs发病年龄要小得多，这可能表明不同的病理生理。声音的情绪内容具有较高的预测价值，这意味着探究avh的情绪内容可能是诊断听声音个体精神障碍的关键一步。临床精神病学杂志2011；72(3):320-325 (C)版权所有2011年医师研究生出版社，Inc。
Objective: Whereas auditory verbal hallucinations (AVHs) are most characteristic of schizophrenia, their presence has frequently been described in a continuum, ranging from severely psychotic patients to schizotypal personality disorder patients to otherwise healthy participants. It remains unclear whether AVHs at the outer borders of this spectrum are indeed the same phenomenon. Furthermore, specific characteristics of AVHs may be important indicators of a psychotic disorder.Method: To investigate differences and similarities in AVHs in psychotic and nonpsychotic individuals, the phenomenology of AVHs in 118 psychotic outpatients was compared to that in 11 otherwise healthy individuals, both experiencing AVHs at least once a month. The study was performed between September 2007 and March 2010 at the University Medical Center, Utrecht, the Netherlands. Characteristics of AVHs were quantified using the Psychotic Symptoms Rating Scales Auditory Hallucinations subscale.Results: The perceived location of voices (inside/outside the head), the number of voices, loudness, and personification did not differentiate between psychotic and healthy individuals. The most prominent differences between AVHs in healthy and psychotic individuals were the emotional valence of the content, the frequency of AVHs, and the control subjects had over their AVHs (all P values < .001). Age at onset of AVHs was at a significantly younger age in the healthy individuals (P < .001). In our sample, the negative emotional valence of the content of AVHs could accurately predict the presence of a psychotic disorder in 88% of the participants.Conclusions: We cannot ascertain whether AVHs at the outer borders of the spectrum should be considered the same phenomenon, as there are both similarities and differences. The much younger age at onset of AVHs in the healthy subjects compared to that in psychotic patients may suggest a different pathophysiology. The high predictive value of the emotional content of voices implies that inquiring after the emotional content of AVHs may be a crucial step in the diagnosis of psychotic disorders in individuals hearing voices. J Clin Psychiatry 2011;72(3):320-325 (C) Copyright 2011 Physicians Postgraduate Press, Inc.