Most commonly though, people diagnosed with schizophrenia will hear multiple voices that are male, nasty, repetitive, commanding, and interactive, where the person can ask the voice a question and get some kind of answer.”
Historically, classical composers felt that D minor was the most melancholy of the keys, suitable for lamentations, dirges and requiems. Aug 23, 2017
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Read More »Auditory hallucinations, or “hearing voices,” is one of the most prevalent symptoms of schizophrenia, reported by as many as 75% of patients.1 It is also seen in other psychiatric conditions, such as bipolar and unipolar depression and personality disorders, as well as in nonclinical populations. Auditory hallucinations in schizophrenia are heterogenous in nature. According to Simon McCarthy-Jones, PhD, associate professor in the Department of Psychiatry at Trinity College Dublin, Ireland, “Hearing voices is a varied experience. It can involve hearing single or multiple voices, whose identity the hearer may or may not know, who speak in turn or all at the same time, who may be saying new things or repeating what has been heard before, and who can give comments or commands, insults or encouragement. Most commonly though, people diagnosed with schizophrenia will hear multiple voices that are male, nasty, repetitive, commanding, and interactive, where the person can ask the voice a question and get some kind of answer.” According to Dr McCarthy-Jones, there are many theories as to what causes people to hear voices: Some focus on events that happened to the person,2 whereas others focus on brain changes less clearly linked to life events. Mark Hayward, PhD, DClinPsy, director of research and honorary senior research fellow at the University of Sussex, United Kingdom, adds, “The cause of auditory hallucinations is often, but not always, rooted in traumatic early experience. Almost all of our patients have experienced significant adversity for extended periods of their lives, and this adversity is often reflected in the identity of their voices. For example, the voice may be a mother or father who was neglectful or abusive, or bullies from school, and the comments they make may be critical and derogatory.” Unlike auditory hallucinations in nonclinical populations, which are largely neutral or positive, those in schizophrenia tend to be negative and controlling, taking a huge toll on the emotional well-being and quality of life of the individual. Depression, significant stress, and increased suicidal attempts have all been linked to the severity of auditory hallucinations in people with schizophrenia.3 “Hearing a repetitive stream of abuse from an unseen entity, which you may initially have no control over, can be extremely upsetting and can get in the way of you living your life,” explains Dr McCarthy-Jones. “Imagine trying to talk to your boss whilst your least favorite colleague whispers abuse in your ear.” According to Joshua Kantrowitz, MD, associate professor of clinical psychiatry at Columbia University Department of Psychiatry in New York City, “For most schizophrenia patients, antipsychotics are the treatment of choice and are effective for most patients.” However, he also points out that, “[a]bout 30% of patients have treatment-resistant auditory hallucinations, for which the standard of care is to increase the dose of antipsychotics,” which he believes may not be so effective. “Clozapine is sometimes effective for treatment-resistant symptoms, including auditory hallucinations.”
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Read More »“Patients who are distressed by hearing voices often have a complex range of needs and mental health problems that require a biopsychosocial approach to care and treatment,” explains Dr Hayward. “The choice of interventions for distressing voices should always be informed by the evidence base, and these interventions should be integrated into a comprehensive care/recovery plan. Moreover, the patient should be involved in the process of reviewing and selecting the interventions that best fit with their needs and preferences.”
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