Auditory verbal hallucinations in bipolar disorder (BD) and major depressive disorder (MDD): A systematic review.
Wei Lin Toh, Neil Thomas, Susan L. Rossell
Journal of Affective Disorders September 15, 2015 DOI: 10.1016/j.jad.2015.05.040 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Topics | Depression |
| Keywords | Auditory verbal hallucinations Bipolar disorder Mood disorders |
| Key findings | Across 14 publications, prevalence of auditory verbal hallucinations varied widely: 11.3-62.8% in bipolar disorder and 5.4-40.6% in major depressive disorder. Persecutory and grandiose delusions were especially common in bipolar disorder, and one neuroimaging study suggested increased fronto-temporal connectivity related to hallucinations in bipolar disorder. The authors argue these symptoms remain central but understudied. |
Abstract
Auditory verbal hallucinations (AVHs) are not uncommon in bipolar disorder (BD) and major depressive disorder (MDD), but there has been scant research in the area. The current paper aims to draw together and provide a critical overview of existing studies of AVHs in BD and MDD. A systematic review was undertaken using the search terms 'hallucinations' or 'hearing voices' in conjunction with 'bipolar disorder', 'mania' or 'manic-depressive' or 'major depressive disorder' or 'depression' or 'affective disorder' or 'mood disorder'. After applying a pre-defined set of inclusion criteria, 14 eligible peer-reviewed publications were accepted for further analysis. Prevalence rates of AVHs in BD (11.3-62.8%) and MDD (5.4-40.6%) varied. When psychotic features were examined, persecutory and grandiose delusions were especially common in BD (though the latter did not necessarily occur in conjunction with AVHs). A single known neuroimaging study has suggested increased fronto-temporal connectivity relating to AVHs in BD. Methodological challenges relating to fluctuations in mood states and limited use of validated instruments, coupled with post-episode recall bias, pose as specific barriers to the collection of meaningful phenomenological information. AVHs remains a central but largely understudied symptom in BD and MDD. Future research examining its phenomenology and clinical/neural correlates could bring about positive clinical implications as well as adapted therapeutic applications.
Comparable studies
Other systematic reviews and meta-analyses on depression, most cited first.
Citations in the library
Cited by 8
- On the phenomenology of auditory verbal hallucinations in affective and non-affective psychosis. Psychiatry Research June 4, 2020
- Voice-Hearing Across The Continuum: A Phenomenology of Spiritual Voices. Schizophrenia Bulletin September 1, 2022
- Robotically-induced auditory-verbal hallucinations: combining self-monitoring and strong perceptual priors. Psychological Medicine February 1, 2024
- Hearing voices and other altered perceptual experiences across psychotic, mood, and anxiety disorders: from phenomenology and mechanisms to future directions. Schizophrenia September 29, 2025
- ‘Linguistic Shrapnel’: Inner speech in borderline personality disorder and its relevance for self-familiarity. A philosophical review Phenomenology and the Cognitive Sciences November 11, 2025
and 3 more in the library
Cites 5
- A new phenomenological survey of auditory hallucinations: evidence for subtypes and implications for theory and practice. Schizophrenia Bulletin January 2014
- Relationship of metacognition, absorption, and depersonalization in patients with auditory hallucinations. British Journal of Clinical Psychology March 2012
- Dissociation, trauma, and the role of lived experience: toward a new conceptualization of voice hearing. Psychological Bulletin January 2012
- The same or different? A phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals. The Journal of Clinical Psychiatry March 2011
- Do we need multiple models of auditory verbal hallucinations? Examining the phenomenological fit of cognitive and neurological models. Schizophrenia Bulletin September 26, 2008