Fifteen minute consultation on children 'hearing voices': when to worry and when to refer.
M Elena Garralda
Archives of disease in childhood. Education and practice edition October 2015 DOI: 10.1136/archdischild-2014-307853 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Child psychiatry General paediatrics |
| Key findings | The authors argue that auditory hallucinations in children are usually simple and transient and common in the general population, becoming clinically significant mainly when they accompany a medical disorder or acute psychotic state, or when frequent, complex, distressing, and impairing. Treatment should address the underlying medical or psychiatric disorder, with psychological therapy first and antipsychotic medication only after that fails. |
Abstract
Auditory hallucinations are uncommon paediatric presentations, but they can be alarming and lead to emergency consultations. This review outlines the phenomenology of auditory hallucinations, their assessment and clinical significance. Auditory hallucinations are seen in the course of acute medical disorders, often together with decreased levels of consciousness, as in febrile illness and in toxic, neurologically compromised states; they can also be a feature of episodic neurological conditions such as migraine and temporal lobe epilepsy. Auditory hallucinations are key symptoms in psychiatric disorders such as schizophrenic and other psychotic states, but they can also present with depressive and anxiety disorders, and in the context of virtually every psychiatric disorder of childhood. In fact hallucinations--usually simple and transient--are common in the general child populations. Auditory hallucinations become clinically significant when they occur as part of a medical disorder or in the context of acute psychotic states and schizophrenia, when they are frequent, complex, distressing and cause impairment. The treatment of clinically relevant hallucinations is that of the primary medical or psychiatric disorder. Occasionally they require treatment in their own right with psychological treatments, and only when these have been tried and fail, a careful trial of antipsychotic medication may be appropriate.