We therefore decided to undertake an empirical qualitative and phenomenologically oriented investigation of experiential, existential, and developmental aspects of AVH in patients with schizophrenia. Consequently, the authors advocated future investigations to focus on broader contextual issues and co-occurring psychopathology.

A review of English-language literature by Waters and Fernyhough (2017) of 43 empirical studies comparing auditory and visual hallucinations between nonclinical samples, medical and neurological conditions, drug- or alcohol-related disorders, and major psychiatric disorders concluded that simple descriptive features discriminated poorly schizophrenia spectrum patients from other groups.

Jointly, the conceptual and empirical studies point to the complex nature of AVH. Moreover, several phenomenologically oriented studies of AVH focusing on descriptive issues in diagnostically mixed samples have been performed ( Daalman et al., 2011 Johns et al., 2014 Stanghellini et al., 2012 Woods et al., 2015). Conceptual issues have been addressed by different groups ( Henriksen et al., 2015 Pienkos et al., 2019 Ratcliffe, 2017 Upthegrove et al., 2016 Woods, 2017). Since these publications, a substantial literature has emerged. Three comprehensive reviews ( Larøi et al., 2012 McCarthy-Jones et al., 2013 Woods et al., 2014) have concluded that the field needs phenomenologically oriented qualitative and interdisciplinary research on the nature and diagnostic value of AVH. More generally, AVH is typically viewed as a well-defined entity in itself with certain quasi objective properties that can be unproblematically quantified, addressed without a need of considering more encompassing structures of subjectivity (consciousness) ( Henriksen et al., 2015 Leudar and Thomas, 2000 Parnas and Urfer-Parnas, 2017). In both DSM-5 and ICD-10, a hallucination is considered an erroneous perception ( e.g., in DSM-5, “a perception-like experience with the clarity and impact of a true perception but without the external stimulation of the relevant sensory organ”). In ICD-10, the presence of hallucinatory voices discussing the patient or commenting on the patient's thoughts or actions is sufficient to diagnose schizophrenia (if the duration criterion is fulfilled and the exclusion criteria are not met). The significance of these findings is briefly discussed in relation to the concept of insight, diagnosis of psychosis, and early detection.Īuditory verbal hallucinations (AVHs) form a central symptom in the current diagnosis of schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) ( American Psychiatric Association, 2013) and in the International Classification of Diseases, Tenth Revision (ICD-10) ( World Health Organization, 1990). The AVH in the majority of the patients was associated with other pathological subjective experiences. None of the patients considered themselves as being psychotic or severely mentally ill. Moreover, the term “voices” was typically appropriated by the patient during his contact with a psychiatric treatment facility. We found that on average the patients experiencing AVH for 6.5 years before disclosing the symptom to a psychiatrist. The focus was on the beginning of hallucinatory experiences, time to disclosure of the symptom, and the context surrounding the disclosure. In this study of mainly readmitted patients with the International Classification of Diseases, Tenth Revision, diagnosis of paranoid schizophrenia and experiencing AVH, we performed a qualitative, phenomenologically oriented interview study. Recent reviews on auditory verbal hallucinations (AVHs) advocate a qualitative and interdisciplinary research that not only is limited to single descriptive features, but also involves contextual issues and co-occurring psychopathology.

Pathfinder auditory hallucination