On the phenomenology of auditory verbal hallucinations in affective and non-affective psychosis.
W. L. Toh, N. Thomas, Y. Hollander, S. Rossell
Psychiatry Research June 4, 2020 DOI: 10.1016/j.psychres.2020.113147 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional mixed-methods study Qualitative Peer reviewed |
|---|---|
| Sample size | 141 |
| Population | Adults with bipolar disorder, major depressive disorder, schizophrenia, or schizoaffective disorder who currently hear voices |
| Topics | Philosophy of mind |
| Citations | 22 |
| Key findings | Auditory verbal hallucinations share more phenomenological similarities than differences across diagnoses, but predictors of voice-related distress and functional impairment differ between affective and non-affective psychosis. |
Abstract
Phenomenological comparisons of auditory verbal hallucinations (AVHs) in affective versus non-affective psychosis have not been adequately documented. The current study aimed to: a) comprehensively describe AVH phenomenology by diagnosis and mood state, b) investigate significant predictors of voice-related distress and functional impairment, and c) conduct qualitative thematic analysis of participants' experiences. Participants were diagnosed with: a) bipolar disorder (n = 31), b) major depressive disorder (n = 34), c) schizophrenia (n = 50), or d) schizoaffective disorder (n = 26). Current voice-hearers were also subdivided into prevailing mood states: a) euthymic (n = 23), b) depressed (n = 51), or c) mania-mixed (n = 12). An in-depth, semi-structured interview was conducted, accompanied by mixed-methods analyses. Of the 34 AVH characteristics, significant group differences across diagnoses were identified only for frequency, number of voices, form of address, perceived location, level of conviction, beliefs regarding origin, and functional interference. Random forests modelling (RFM) showed experienced distress and functional interference were best predicted by discrete AVH variables. Qualitative thematic analysis revealed first-order themes: a) content, b) form, c) function, and d) non-voice. There were more similarities than differences in the phenomenology of AVHs across diagnoses, yet significant predictors of voice-related distress and functional impairment differed across affective and non-affective psychosis. This has important nosological and therapeutic applications.