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.
Comparable studies
Other qualitative studies on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Qualitative thematic analysis of the phenomenology of near-death experiences Cardiac arrest survivors | 2018 | Qualitative study | n = 34 |
| Phenomenology and Sequelae of 3,4-Methylenedioxymethamphetamine Use Psychiatrists who had taken MDMA | 1992 | Qualitative study | n = 20 |
| A phenomenology of meditation-induced light experiences: traditional buddhist and neurobiological perspectives American Buddhist practitioners | 2014 | Qualitative study | |
| Evoking the ineffable: The phenomenology of extreme sports. Extreme sports participants across three continents, including BASE jumping, big wave... | 2017 | Qualitative study | n = 15 |
| Phenomenology and content of the inhaled N, N-dimethyltryptamine (N, N-DMT) experience. Naturalistic inhaled N,N-DMT experiences posted to the r/DMT Reddit community | 2022 | Qualitative analysis | n = 3,778 |
Citations in the library
Cited by 6
- Hearing voices and other altered perceptual experiences across psychotic, mood, and anxiety disorders: from phenomenology and mechanisms to future directions. Schizophrenia September 29, 2025
- Intersections of phenomenology, voice beliefs and distress in bipolar disorder: a comparison with schizophrenia. Behavioural and Cognitive Psychotherapy 2024
- The Phenomenology of Visual and Other Nonauditory Hallucinations in Affective and Nonaffective Psychosis: A Mixed Methods Analysis. The Journal of Nervous and Mental Disease April 1, 2024
- From neuronal to mental topography - Neurophenomenology of auditory hallucinations. Translational Psychiatry November 21, 2025
- Relational Therapies for People Who Hear Voices: Operationalisation and Current Status of an Emergent Group of Psychological Therapies. Schizophrenia Bulletin January 16, 2026
and 1 more in the library
Cites 8
- Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatrica Scandinavica May 2016
- Auditory verbal hallucinations in bipolar disorder (BD) and major depressive disorder (MDD): A systematic review. Journal of Affective Disorders September 15, 2015
- Experiences of hearing voices: analysis of a novel phenomenological survey. The Lancet Psychiatry March 31, 2015
- Studying hallucinations within the NIMH RDoC framework. Schizophrenia Bulletin July 2014
- Auditory verbal hallucinations in persons with and without a need for care. Schizophrenia Bulletin July 2014
and 3 more in the library