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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An experiment is described in which people with auditory hallucinations were brought into contact with each other. On an evening television talk show, a patient--diagnosed several times as having schizophrenia--talked about her voices. Four hundred and fifty people who also were hearing voices reacted to the program by telephone. A questionnaire was sent to those who responded to the television program in order to get more information about their way of coping with the voices. From those who filled out the questionnaire, 20 people were selected who explained their experiences in a clear way. A meeting for people hearing voices was organized, and the 20 persons were invited to become the speakers. In this article the experiences described by the participants are reported as well as the many ways in which they coped with these experiences.
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PMID:Hearing voices. 274 84

Verbal auditory hallucinations are common in schizophrenia but little is known about how they arise. We have used single photon emission tomography (SPET) to measure regional cerebral blood flow with the aim of identifying brain areas that are especially active during auditory hallucinations. We scanned twelve men with schizophrenia while they were experiencing hallucinations. The subjects were rescanned under identical conditions when their hallucinations had resolved (mean 19 weeks later). Blood flow was significantly greater during hallucinations than in the non-hallucinating state in Broca's area (mean count density on SPET 1.18 [SD 0.04] vs 1.13 [0.06]; p < 0.001); flow was also higher during hallucinations in the left anterior cingulate cortex and regions in the left temporal lobe, but these differences did not achieve significance. The increased flow in Broca's area was not accounted for by changes in other clinical variables nor by changes in the dose of neuroleptic drugs. These findings suggest that the production of auditory hallucinations in schizophrenia is associated with increased activity in a network of cortical areas specialised for language.
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PMID:Increased blood flow in Broca's area during auditory hallucinations in schizophrenia. 810 15

As part of a World Health Organization collaborative study in 12 centres in developing and developed countries within defined urban and rural catchment areas with populations of 348,786 and 103,865, respectively, a total of 155 and 54 cases of first-onset schizophrenia, respectively, were identified over a 24-month period by a comprehensive and active recruitment of all cases. Approximately 50% of the subjects in both cohorts were in the age range of 15-24 years. There was a preponderance of males in the younger age group and of females in the older age group. The majority of cases had no family history and had shown good adjustment in childhood and adolescence. The onset was much more frequently acute and much less often insidious in our samples and (more so in the rural cohort), compared to the figure for all developed countries' sites. With regard to early manifestations of the disorder, there was a much higher incidence of loss of interest in appearance and cleanliness, being irritable and angry without reason, and loss of appetite, sleep or interest in sex in both of our samples, and of being excited or overactive for days or weeks in our rural cohort than in the developed countries' centres as a whole. On the other hand, claiming impossible things, behaving as if hearing voices and feeling persecuted, harmed or bewitched were much less frequent in our rural cohort than in the urban cohort or the developed countries' centres as a whole. With regard to the clinical diagnosis of schizophrenia, paranoid, hebephrenic/disorganized and residual types were under-represented in our samples (more so in the rural sample), and catatonic type and acute schizophrenic episode were over-represented compared to the developed countries' centres. Moreover, the proportion of subjects of CATEGO class S+ was lower in our samples. With regard to onset, early manifestations and clinical subtypes of schizophrenia, our rural cohort deviated most from developed countries' centres as a whole, with our urban sample falling in between, thus indicating the role of socio-cultural factors in general, and urbanization in particular, in these variables in schizophrenia.
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PMID:First-onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology. 942 39

The form and the content of chronic auditory hallucinations were compared in three cohorts, namely patients with schizophrenia, patients with a dissociative disorder, and nonpatient voice-hearers. The form of the hallucinatory experiences was not significantly different between the three groups. The subjects in the nonpatient group, unlike those in the patient groups, perceived their voices as predominantly positive: they were not alarmed or upset by their voices and felt in control of the experience. In most patients, the onset of auditory hallucinations was preceded by either a traumatic event or an event that activated the memory of earlier trauma. The significance of this study is that it presents evidence that the form of the hallucinations experienced by both patient and nonpatient groups is similar, irrespective of diagnosis. Differences between groups were predominantly related to the content, emotional quality, and locus of control of the voices. In this study the disability incurred by hearing voices is associated with (the reactivation of) previous trauma and abuse.
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PMID:Auditory hallucinations: a comparison between patients and nonpatients. 978 42

The aim of this study is to test the feasibility and the efficacy of a cognitive and behavior therapy manual for auditory hallucinations with persons suffering from schizophrenia in a French-speaking environment and under natural clinical conditions. Eight patients met ICD-10 criteria for paranoid schizophrenia, 2 for hebephrenic schizophrenia and 1 for schizoaffective disorder. All were hearing voices daily. Patients followed the intervention for 3 to 6 months according to their individual rhythms. Participants filled up questionnaires at pre-test, post-test and three months follow-up. The instruments were the Belief About Voice Questionnaire--Revised and two seven points scales about frequency of hallucinations and attribution of the source of the voices. Results show a decrease of voices' frequency and improvement in attributing the voices rather to an internal than to an external source. Malevolent or benevolent beliefs about voices are significantly decreased at follow-up as well as efforts at coping with hallucinations. Results should be interpreted with caution because of the small number of subjects. The sample may not be representative of patients with persistent symptoms since there is an over representation of patients with benevolent voices and an under representation of patients with substance misuse.
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PMID:[Cognitive-behavioral therapy for auditory hallucinations resistant to neuroleptic treatment]. 1520 53

Individuals with an Islamic background who suffer from hallucinations often attribute these to djinns, invisible beings. The treatment of these hallucinations is complicated by the patients' reluctance to discuss them, and by their doubts concerning the usefulness of a biomedical treatment for a problem which they experience as metaphysical in nature. In this clinical lesson, we present case studies of three Moroccan patients who attributed their hallucinations to djinns. The first was a 30-year-old factory worker whose compulsive complaints had started when he saw a white figure in the basement who asked him 'What are you doing here?' The psychiatric diagnosis was obsessive-compulsive disorder. The patient was prescribed cognitive behavioural therapy, an SSRI and a consultation by the imam, but he refused. The second patient was a 25-year-old unemployed man, who had auditory hallucinations, delusions, behavioural problems, and alcohol and cannabis abuse. He heard voices which he attributed to maleficent djinns. He was diagnosed with schizophrenia, but his compliance with antipsychotics was insufficient. The imam who was consulted reassured him that his complaints were not caused by djinns. After prolonged treatment with clozapine and cutting down on cannabis use the patient recovered sufficiently to be discharged. The third patient was a 26-year-old unemployed woman who was hearing voices that her imam thought were caused by a djinn. She was examined because of serious self-mutilation and was diagnosed with a schizoaffective disorder. Treatment with an antipsychotic, lithium and valproic acid and a consultation by a second imam, who found no signs of evidence of djinns, was successful. We recommend to ask individuals with an Islamic background specifically whether djinns might be involved, especially in cases of mental problems and unexplained symptoms, and to seek the cooperation of a qualified imam or traditional healer for treatment purposes.
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PMID:[Hallucinations attributed to djinns]. 2013 70

Hallucinations are a common presenting symptom in schizophrenia and other psychotic disorders. In particular, auditory hallucinations, such as hearing voices, are the most common type of hallucination described in schizophrenia, while visual hallucinations are less frequently seen. Hallucinations are also present in disorders that are not primarily psychotic in nature, including mood disorders, substance-induced disorders, and psychosis due to a general medical condition. However, it is extremely important to rule out general medical causes of hallucinations, as they are often treatable and reversible, and if left untreated, the underlying non-psychiatric disorders causing them can lead to irreversible damage. We present a case in which a 48-year-old woman with schizophrenia began to complain of visual disturbances. Because of her delusional interpretation of these disturbances, they were initially attributed to psychosis, but the disturbances were in fact found to be the result of a retinal detachment.
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PMID:Visual hallucinations from retinal detachment misdiagnosed as psychosis. 2143 Apr 95

Schizophrenia is associated with a wide range of symptoms. These include auditory hallucinations, delusions, and experiences that one is not in control of one's own thoughts and actions, but that they are inserted by an outside agency. It has been proposed that a disturbance in the sense of self may account for many of these symptoms. This disturbance in turn may be associated with source monitoring deficits. In other words, individuals with schizophrenia may misattribute the source of their own thoughts and actions to an outside agency, which then results in the experience of psychosis such as that of hearing voices. To explain the source monitoring deficits, it has been proposed that this illness involves impairment in corollary discharge mechanisms. Corollary discharge refers to preparation of sensory systems that will be affected by an action in advance of that action, which then allows this action to be recognized as one's own. Current research on corollary discharges suggests that they may involve the thalamus, which is notably affected in schizophrenia in terms of volume loss. Sleep abnormalities in this illness also suggest thalamic dysfunction as sleep spindles, which are markedly reduced in schizophrenia, require intact thalamocortical interactions. In this review, evidence is presented that suggests that propagation of corollary discharges and sleep spindles may be two mechanistically related processes as both involve trans-thalamic cortico-cortical interactions. These interactions may be impaired in schizophrenia and characterization of their mechanism may constitute a step towards developing a dynamic model of schizophrenia.
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PMID:Sleep abnormalities in schizophrenia may suggest impaired trans-thalamic cortico-cortical communication: towards a dynamic model of the illness. 2189

Numerous studies have found that hallucinatory experiences occur in the general population. But to date, few studies have been conducted to compare clinical and nonclinical groups across a broad array of clinical symptoms that may co-occur with hallucinations. Likewise, hallucination-like experiences are measured as a multidimensional construct, with clinical and subclinical components related to vivid daydreams, intrusive thoughts, perceptual disturbance, and clinical hallucinatory experiences. Nevertheless, these individual subcomponents have not been examined across a broad spectrum of clinically disordered and nonclinical groups. The goal of the present study was to analyze the differences and similarities in the distribution of responses to hallucination-like experience in clinical and nonclinical populations and to determine the relation of these hallucination-like experiences with various clinical symptoms. These groups included patients with schizophrenia, non-psychotic clinically disordered patients, and a group of individuals with no psychiatric diagnoses. The results revealed that hallucination-like experiences are related to various clinical symptoms across diverse groups of individuals. Regression analysis found that the Psychoticism dimension of the Symptom Check List (SCL-90-R) was the most important predictor of hallucination-like experiences. Additionally, increased auditory and visual hallucination was the only subcomponent that differentiated schizophrenic patients from other groups. This distribution of responses in the dimensions of hallucination-like experiences suggests that not all the dimensions are characteristic of people hearing voices. Vivid daydreams, intrusive thoughts, and auditory distortions and visual perceptual distortions may represent a state of general vulnerability that does not denote a specific risk for clinical hallucinations. Overall, these results support the notion that hallucination-like experiences are closer to a quasi-continuum approach and that total scores on these scales explain a state of vulnerability to general perceptual disturbance.
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PMID:Analysis of the multidimensionality of hallucination-like experiences in clinical and nonclinical Spanish samples and their relation to clinical symptoms: implications for the model of continuity. 2204 32

Auditory verbal hallucinations (AVH) are not only among the most common but also one of the most distressing symptoms of schizophrenia. Despite elaborate research, the underlying brain mechanisms are as yet elusive. Functional MRI studies have associated the experience of AVH with activation of bilateral language-related areas, in particular the right inferior frontal gyrus (rIFG) and the left superior temporal gyrus (lSTG). While these findings helped to understand the neural underpinnings of hearing voices, they provide little information about possible brain mechanisms that predispose a person to experience AVH, i.e. the traits to hallucinate. In this study, we compared resting state connectivity between 49 psychotic patients with chronic AVH and 49 matched controls using the rIFG and the lSTG as seed regions, to identify functional brain systems underlying the predisposition to hallucinate. The right parahippocampal gyrus showed increased connectivity with the rIFG in patients as compared to controls. Reduced connectivity with the rIFG in patients was found for the right dorsolateral prefrontal cortex. Reduced connectivity with the lSTG in patients was identified in the left frontal operculum as well as the parietal opercular area. Connectivity between the lSTG and the left hippocampus was also reduced in patients and showed a negative correlation with the severity of hallucinations. Concluding, we found aberrant connectivity between the seed regions and medial temporal lobe structures which have a prominent role in memory retrieval. Moreover, we found decreased connectivity between language-related areas, indicating aberrant integration in this system potentially including corollary discharge mechanisms.
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PMID:Resting state functional connectivity in patients with chronic hallucinations. 2297 Jan 30


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