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Background: Living with the experience of hearing voices without trying to ignore or suppress them is referred to as accepting auditory verbal hallucinations (AVH). It varies depending on the phenomenology of AVH itself; some clients may find it challenging to acquire new coping mechanisms with the voices., Aim: Examine the association between the phenomenology of AVH and acceptance or autonomous action among clients with schizophrenia., Design: A descriptive correlational study was conducted on 200 clients with schizophrenia using the following instruments; Sociodemographic and clinical data tools, Psychotic Symptom Rating Scales (PSYRATS-AH), and Voices Acceptance and Action Scale (VAAS)., Results: Most patients have moderate to severe levels of AVH (95.5 %), with a mean score of 25.34. The emotional characteristics reflected the high mean score (11.24). A highly statistically negative correlation was found between the total Voices Acceptance and Action Scale and severity of AVH (P = -0.448, sig = 0.000). A predictable significant effect of user acceptance and autonomous actions response coping with decreasing the severity of AVH was found (adjusted r square = 0.196, sig = 0.000) and model equation = Severity of Verbal auditory hallucinations = 31.990-0.257 X Total of Voice Acceptance and Autonomous Action Scale (VAAS)., Conclusion: The severity of all phenomenological characteristics of AVH can be successfully reduced by using voice acceptance and autonomous action responses rather than resistance or engagement responses. Subsequently, it must be improved and learned by psychiatric nurses the patients with schizophrenia in the hospitals by applying Acceptance and Commitment Therapy as a crucial intervention., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The family of epidermal growth factor (EGF) including neuregulin-1 are implicated in the neuropathology of schizophrenia. We established a rat model of schizophrenia by exposing perinatal rats to EGF and reported that the auditory pathophysiological traits of this model such as prepulse inhibition, auditory steady-state response, and mismatch negativity are relevant to those of schizophrenia. We assessed the activation status of the auditory cortex in this model, as well as that in patients with schizophrenia, by monitoring the three neural activity-induced proteins: EGR1 (zif268), c-fos, and Arc. Among the activity markers, protein levels of EGR1 were significantly higher at the adult stage in EGF model rats than those in control rats. The group difference was observed despite an EGF model rat and a control rat being housed together, ruling out the contribution of rat vocalization effects. These changes in EGR1 levels were seen to be specific to the auditory cortex of this model. The increase in EGR1 levels were detectable at the juvenile stage and continued until old ages but displayed a peak immediately after puberty, whereas c-fos and Arc levels were nearly indistinguishable between groups at all ages with an exception of Arc decrease at the juvenile stage. A similar increase in EGR1 levels was observed in the postmortem superior temporal cortex of patients with schizophrenia. The commonality of the EGR1 increase indicates that the EGR1 elevation in the auditory cortex might be one of the molecular signatures of this animal model and schizophrenia associating with hallucination., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To explore the phenomenology of auditory verbal hallucinations (AVHs) in a clinical sample of young people who have a 'non-psychotic' diagnosis., Methods: Ten participants aged 17-31 years with presentation of emotionally unstable personality disorder or post-traumatic stress disorder and frequent AVHs were recruited and participated in a qualitative study exploring their subjective experience of hearing voices. Photo-elicitation and ethnographic diaries were used to stimulate discussion in an otherwise unstructured walking interview., Results: 'Non-psychotic' voices comprised auditory qualities such as volume and clarity. Participants commonly personified their voices, viewing them as distinct characters with which they could interact and form relationships. There appeared to be an intimate and unstable relationship between participant and voice, whereby voices changed according to the participants' mood, insecurities, distress and circumstance. Equally, participants reacted to provocation by the voice, leading to changes in mood and circumstance through emotional and physical disturbances. In contrast to our previous qualitative work in psychosis, voice hearing was not experienced with a sense of imposition or control., Conclusions: This phenomenological research yielded in-depth and novel accounts of 'non-psychotic' voices which were intimately linked to emotional experience. In contrast to standard reports of voices in disorders such as schizophrenia, participants described a complex and bi-directional relationship with their voices. Many other features were in common with voice hearing in psychosis. Knowledge of the phenomenology of hallucinations in non-psychotic disorders has the potential to inform future more successful management strategies. This report gives preliminary evidence for future research.

Background: Functional connectivity abnormalities between Broca's and Wernicke's areas and the putamen revealed by functional magnetic resonance imaging (fMRI) are related to auditory hallucinations (AH). In long-term schizophrenia, reduced white matter structural integrity revealed by diffusion imaging in left arcuate fasciculus (connecting Broca's and Wernicke's areas) is likely related to AH. The structural integrity of connections with putamen and their relation to AH are unknown. Little is known about this relationship in first-episode psychosis (FEP), although auditory transcallosal connections were reported to play a role. White matter in the Broca's-Wernicke's-putamen language-related circuit and auditory transcallosal fibers was examined to investigate associations with AH in FEP., Methods: White matter connectivity was measured in 40 FEP and 32 matched HC using generalized fractional anisotropy (gFA) derived from diffusion spectrum imaging (DSI)., Results: FEP and HC did not differ in gFA in any fiber bundle. In FEP, AH severity was significantly inversely related to gFA in auditory transcallosal fibers and left arcuate fasciculus. Although the right hemisphere arcuate fasciculus-AH association did not attain significance, the left and right arcuate fasciculus associations were not significantly different., Conclusions: Despite overall normal gFA in FEP, AH severity was significantly related to gFA in transcallosal auditory fibers and the left hemisphere connection between Broca's and Wernicke's areas. Other bilateral tracts' gFA were weakly associated with AH. At the first psychotic episode, AH are more robustly associated with left hemisphere arcuate fasciculus and interhemispheric auditory fibers microstructural deficits, likely reflecting mistiming of information flow between language-related cortical centers., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Aims and Objectives: To develop a Chinese version of Auditory Hallucination Risk Assessment Scale and evaluate its psychometric properties., Background: Auditory hallucination, a common symptom in schizophrenia, has the potential to cause harm to patients and the people around them. However, there has been a paucity of suitable instrument developed in Asian region that can comprehensively and reliably assess its risk and inform interventions., Design: This study involved 2 stages, the development of the Auditory Hallucination Risk Assessment Scale (AHRAS) and testing the psychometric properties of AHRAS. We followed STROBE guidelines in reporting the study., Methods: Auditory Hallucination Risk Assessment Scale items were developed based on Symptom Management Theory, systematic literature review and findings of a qualitative study on the experience of auditory hallucinations. The items were evaluated by content validity. Auditory Hallucination Risk Assessment Scale was then tested for construct validity, concurrent validity, predictive validity, internal consistency and test-retest reliability in a convenience sample of 156 patients with a diagnosis of schizophrenia., Results: The final version of AHRAS has nine items. Two factors were extracted from AHRAS, which explained 57.74% of the total variance. The score of AHRAS was strongly correlated with that of the Psychotic Symptom Rating Scales-Auditory Hallucinations. The area under the curve was 0.90 for the overall AHRAS score. Sensitivity (86.5%) and specificity (80.0%) were maximal for a mean overall AHRAS score of 13.5, suggesting that this is an appropriate threshold for differentiation. Cronbach's alpha coefficient for internal consistency was 0.82, and intra-class correlation coefficient for test-retest reliability was 0.84., Conclusions: Auditory Hallucination Risk Assessment Scale has good reliability and validity. It can be used in clinical settings in China and beyond to assess the risk of auditory hallucinations., Relevance to Clinical Practice: Auditory Hallucination Risk Assessment Scale can serve as a tool for nurses and other healthcare professionals to identify patients with high-risk auditory hallucinations, monitor the changes of risk and inform nursing interventions., (© 2020 John Wiley & Sons Ltd.)

Background: Depressive symptoms and auditory hallucinations (AHs) are often accompanied by gray matter volume (GMV) alterations in schizophrenia. However, little is known about the effects of concurrent depressive symptoms and AHs on the GMV of patients with schizophrenia., Aim: To investigate the pathological features of gray brain matter in patients with first-episode untreated schizophrenia (FUSCH) who have concurrent moderate-to-severe depressive symptoms and AHs (FUSCH-DAH)., Methods: The Calgary Depression Scale for Schizophrenia (CDSS) and Auditory Hallucinations Rating Scale (AHRS) were adopted. Voxel-based morphometry (VBM)-based GMV analyses were used to measure cortical alterations. FUSCH-DAH patients were compared to FUSCH patients with depressive symptoms but without AHs, denoted as FUSCH-D, along with healthy controls., Results: GMV reductions were more substantial in the FUSCH-DAH patients than FUSCH-D patients or healthy controls. Both FUSCH-DAH and FUSCH-D groups showed GMV reductions of the parietal, frontal, and temporal lobes, which were not apparent in the healthy controls. Compared to FUSCH-D patients, FUSCH-DAH patients demonstrated more substantial GMV reductions in the Broca area, Wernicke region, insular lobe, and prefrontal lobe. The GMV reductions were 1.06% and 0.58% in FUSCH-DAH and FUSCH-D patients, respectively, as compared with the healthy controls., Conclusions: This is the first report showing that concurrent depressive symptoms and AHs leads to severe GMV deterioration in FUSCH-DAH patients. Hence, there is a reciprocal relationship between AHs and depressive symptoms in FUSCH-DAH patients. However, the potential additive effects of concurrent AHs and depressive symptoms require further investigation in order to identify future targeted therapies for schizophrenia., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first-episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV)., Methods: FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle-to-moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle-to-moderate VHs [FUSCHSAMV, 28 patients]; and middle-to-moderate AHs combined with middle-to-moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment., Results: In the pilot study, the rate of GMV reduction showed an inverted U-shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow-up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction-related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate., Conclusions: These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice., (© 2020 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.)

Atypical spontaneous activities in resting-state networks may play a role in auditory hallucinations (AHs), but networks relevant to AHs are not apparent. Given the debating role of the default mode network (DMN) in AHs, a parietal memory network (PMN) may better echo cognitive theories of AHs in schizophrenia, because PMN is spatially adjacent to the DMN and more relevant to memory processing or information integration. To examine whether PMN is more relevant to AHs than DMN, we characterized these intrinsic networks in AHs with 59 first-episode, drug-naïve schizophrenics (26 AH+ and 33 AH-) and 60 healthy participants in resting-state fMRI. We separated the PMN, DMN, and auditory network (AN) using independent component analysis, and compared their functional connectivity across the three groups. We found that only AH+ patients displayed dysconnectivity in PMN, both AH+ and AH- patients exhibited dysfunctions of AN, but neither patient group showed abnormal connectivity within DMN. The connectivity of PMN significantly correlated with memory performance of the patients. Further region-of-interest analyses confirmed that the connectivity between the core regions of PMN, the left posterior cingulate gyrus and the left precuneus, was significantly lower only in the AH+ group. In exploratory correlation analysis, this functional connectivity metric significantly correlated with the severity of AH symptoms. The results implicate that compared to the DMN, the PMN is more relevant to the AH symptoms in schizophrenia, and further provides a more precise potential brain modulation target for the intervention of AH symptoms., (© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals, Inc.)

There is a growing recognition in psychosis research of the importance of hallucinations in modalities other than the auditory. This has focused attention on cognitive and neural processes that might be shared by, and which might contribute distinctly to, hallucinations in different modalities. In this article, I address some issues around the modality-generality of cognitive and neural processes in hallucinations, including the role of perceptual and reality-monitoring systems, top-down and bottom-up processes in relation to the psychological and neural substrates of hallucinations, and the phenomenon of simultaneous multimodal hallucinations of the same entity. I suggest that a functional systems approach, inspired by some neglected aspects of the writings of A. R. Luria, can help us to understand patterns of hallucinatory experience across modalities and across clinical and non-clinical groups. Understanding the interplay between modality-general and modality-specific processes may bear fruit for improved diagnosis and therapeutic approaches to dealing with distressing hallucinations.

In order to study the application of multi-modal magnetic resonance imaging (MRI) fusion technology in schizophrenia, a 4-way multi-modal fusion method based on mCCA+jICA is used to fuse the local consistency and functional network connection of resting-state functional MRI, gray matter volume of structural MRI, and partial anisotropy of diffusion MRI four characteristics of large sample of schizophrenic patients in multi-site China, trying to find out the common characteristics of function and structure of significant differences between schizophrenia and healthy controls. It is found that compared with normal people, schizophrenic patients show higher local consistency, lower gray matter volume, lower functional network connectivity and decreased white matter integrity in the anterior thalamic radiation, upper bundle and other bundles in brain areas such as basal ganglia network, hippocampus and prominence network. There is a significant correlation between a thalamocortical perceptual loop and auditory hallucination in schizophrenia, and there is a high degree of spatial consistency and commonality among the three MRI features. The higher the volume of gray matter in the dorsolateral and medial prefrontal cortex is, the higher the integrity of white matter fibers such as corticospinal tract, superior longitudinal tract and anterior thalamic radiation is, the higher the digital backward score is, and the better the working memory ability of the subjects is.

Multimodal fusion has been regarded as a promising tool to discover covarying patterns of multiple imaging types impaired in brain diseases, such as schizophrenia (SZ). In this article, we aim to investigate the covarying abnormalities underlying SZ in a large Chinese Han population (307 SZs, 298 healthy controls [HCs]). Four types of magnetic resonance imaging (MRI) features, including regional homogeneity (ReHo) from resting-state functional MRI, gray matter volume (GM) from structural MRI, fractional anisotropy (FA) from diffusion MRI, and functional network connectivity (FNC) resulted from group independent component analysis, were jointly analyzed by a data-driven multivariate fusion method. Results suggest that a widely distributed network disruption appears in SZ patients, with synchronous changes in both functional and structural regions, especially the basal ganglia network, salience network (SAN), and the frontoparietal network. Such a multimodal coalteration was also replicated in another independent Chinese sample (40 SZs, 66 HCs). Our results on auditory verbal hallucination (AVH) also provide evidence for the hypothesis that prefrontal hypoactivation and temporal hyperactivation in SZ may lead to failure of executive control and inhibition, which is relevant to AVH. In addition, impaired working memory performance was found associated with GM reduction and FA decrease in SZ in prefrontal and superior temporal area, in both discovery and replication datasets. In summary, by leveraging multiple imaging and clinical information into one framework to observe brain in multiple views, we can integrate multiple inferences about SZ from large-scale population and offer unique perspectives regarding the missing links between the brain function and structure that may not be achieved by separate unimodal analyses., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Transcranial alternating current stimulation (tACS) modulates endogenous neural oscillations in healthy human participants by the application of a low-amplitude electrical current with a periodic stimulation waveform. Yet, it is unclear if tACS can modulate and restore neural oscillations that are reduced in patients with psychiatric illnesses such as schizophrenia. Here, we asked if tACS modulates network oscillations in schizophrenia. We performed a randomized, double-blind, sham-controlled clinical trial to contrast tACS with transcranial direct current stimulation (tDCS) and sham stimulation in 22 schizophrenia patients with auditory hallucinations. We used high-density electroencephalography to investigate if a five-day, twice-daily 10Hz-tACS protocol enhances alpha oscillations and modulates network dynamics that are reduced in schizophrenia. We found that 10Hz-tACS enhanced alpha oscillations and modulated functional connectivity in the alpha frequency band. In addition, 10Hz-tACS enhanced the 40Hz auditory steady-state response (ASSR), which is reduced in patients with schizophrenia. Importantly, clinical improvement of auditory hallucinations correlated with enhancement of alpha oscillations and the 40Hz-ASSR. Together, our findings suggest that tACS has potential as a network-level approach to modulate reduced neural oscillations related to clinical symptoms in patients with schizophrenia., (Copyright © 2018 Elsevier Inc. All rights reserved.)

This study was to investigate the association of auditory hallucinations and anxiety symptoms with depressive symptoms in patients with schizophrenia for three months. The participants (N = 189) were evaluated using Characteristics of Auditory Hallucination Questionnaire (CAHQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II. Forty-two participants suffered from depressive symptoms at both baseline and 3-month follow-up. Higher CAHQ and BAI at both periods predicted depressive symptoms at three-month end. Being male, increased severity of CAHQ and BAI were risk factors of depressive symptoms. Psychiatric professionals must educate patients to manage auditory hallucinations and anxiety symptoms to decrease depressive symptoms., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Recent MRI studies have shown that schizophrenia is characterized by reductions in brain gray matter, which progress in the acute state of the disease. Cortical circuitry abnormalities in gamma oscillations, such as deficits in the auditory steady state response (ASSR) to gamma frequency (>30-Hz) stimulation, have also been reported in schizophrenia patients. In the current study, we investigated neural responses during click stimulation by BOLD signals. We acquired BOLD responses elicited by click trains of 20, 30, 40 and 80-Hz frequencies from 15 patients with acute episode schizophrenia (AESZ), 14 symptom-severity-matched patients with non-acute episode schizophrenia (NASZ), and 24 healthy controls (HC), assessed via a standard general linear-model-based analysis. The AESZ group showed significantly increased ASSR-BOLD signals to 80-Hz stimuli in the left auditory cortex compared with the HC and NASZ groups. In addition, enhanced 80-Hz ASSR-BOLD signals were associated with more severe auditory hallucination experiences in AESZ participants. The present results indicate that neural over activation occurs during 80-Hz auditory stimulation of the left auditory cortex in individuals with acute state schizophrenia. Given the possible association between abnormal gamma activity and increased glutamate levels, our data may reflect glutamate toxicity in the auditory cortex in the acute state of schizophrenia, which might lead to progressive changes in the left transverse temporal gyrus., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

Several meta-analyses have assessed the response of patients with schizophrenia with auditory verbal hallucinations (AVH) to treatment with repetitive transcranial magnetic stimulation (rTMS); however, the placebo response has never been explored. Typically observed in a therapeutic trial, the placebo effect may have a major influence on the effectiveness of rTMS. The purpose of this meta-analysis is to evaluate the magnitude of the placebo effect observed in controlled studies of rTMS treatment of AVH, and to determine factors that can impact the magnitude of this placebo effect, such as study design considerations and the type of sham used.The study included twenty-one articles concerning 303 patients treated by sham rTMS. A meta-analytic method was applied to obtain a combined, weighted effect size, Hedges's g. The mean weighted effect size of the placebo effect across these 21 studies was 0.29 (P < .001). Comparison of the parallel and crossover studies revealed distinct results for each study design; placebo has a significant effect size in the 13 parallel studies (g = 0.44, P < 10(-4)), but not in the 8 crossover studies (g = 0.06, P = .52). In meta-analysis of the 13 parallel studies, the 45° position coil showed the highest effect size. Our results demonstrate that placebo effect should be considered a major source of bias in the assessment of rTMS efficacy. These results fundamentally inform the design of further controlled studies, particularly with respect to studies of rTMS treatment in psychiatry., (© The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: The use of repetitive transcranial magnetic stimulation (rTMS) remains a promising therapeutic tool in the treatment of schizophrenia. Symptoms such as auditory hallucinations (AH) find contradictory results in many studies. Here we present an up-to-date systematic review and meta-analysis of rTMS in the treatment of AH in schizophrenia., Methods: We searched Pubmed-MEDLINE from 1999 to 2013 for double-blinded randomized sham-controlled trials that applied slow rTMS on the left temporoparietal cortex and assessed the outcome results using Hallucination Change Scale or Auditory Hallucination Rating Scale or Scale for Auditory Hallucinations (SAH). We identified 10 studies suitable for the meta-analysis., Results: We found a positive sized effect in favor of rTMS [random-effects model Hedges' g = 0.011, I-squared = 58.1%]. There was some variability between study effect sizes, but the sensitivity analysis concluded that none of them had sufficient weight to singularly alter the results of our meta-analysis., Discussion: rTMS appears to be an effective treatment for AH. The left temporoparietal cortex seems to be the area in which rTMS is effective. Although meta-analysis is a powerful analytical tool, more studies must be conducted in order to obtain a more expressive sample size to perform a more accurate analytical approach.

The aim of this study was to investigate whether deficits in auditory processing are associated with auditory hallucinations in patients with schizophrenia. It was hypothesised that individuals with a diagnosis of schizophrenia would demonstrate deficits in processing the spectral and temporal aspects of sound and that such deficits would be more pronounced in patients with a history of auditory hallucinations (hallucinators) than those without such a history (non-hallucinators). A community sample meeting clinical criteria for schizophrenia or schizoaffective disorder (19 hallucinators, 15 non-hallucinators) and a matched healthy control group (n=17) completed a broad range of auditory processing tasks involving pitch discrimination of modulated (temporal) and unmodulated (spectral) pure tones, auditory streaming and affective prosodic identification, as well as measures assessing current psychiatric symptoms. In all experimental tasks patients were impaired compared to controls. Specifically hallucinators performed worse than non-hallucinators and controls for pitch discrimination of unmodulated tones and auditory streaming, and both hallucinators and non-hallucinators performed significantly worse than controls for discrimination of modulated tones and affective prosody. These findings suggest that impaired temporal processing may contribute to general difficulties identifying affective speech prosody in patients with schizophrenia, while spectral processing deficits may specifically compromise melodic streaming in hallucinators, which combined with deficits in temporal processing, contribute to the experience of auditory hallucinations., (© 2013.)

Objective: To evaluate the effects of cognitive behavior therapy (CBT) combined with attention training technique(ATT) on auditory hallucinations of schizophrenia. Methods: Sixty schizophrenia patients with au- ditory hallucinations were recruited according to the criteria of International Classification of Diseases, tenth Edition (ICD-10). They were randomly divided into the CBT group (30 cases, 26 cases completed) and the CBT + ATT group (30 cases, 25 cases completed). The CBT group received only 4 weeks of cognitive behavioral intervention for auditory hallucinations, and the CBT + ATT group received 6 weeks of attention training technology intervention based on cognitive behavioral intervention. At baseline and after 12 weeks, the Psychotic Symptom Rating Scales- Auditory Hallucinations (PSYRATS-AH) and Scale of Social function in Psychosis Inpatients (SSPI) were used to evaluate the auditory hallucinations symptoms and social functioning of the two groups, and the Attentional Control Scale (ACS) was used to evaluate patients' attentional control ability of the CBT + ATT group. Results: After 12 weeks, the differences (post intervention score-baseline score) of PSYRATS-AH total scores [(-6.8±2.2) vs. (-4.2±1.5)], auditory hallucinations' frequency, duration, number of distresses, control of voices were lower in the CBT + ATT group than in the CBT group (Ps <0.05), and the differences of the SSPI total scores [(13.9 ± 2.9) vs. (11.6±4.2)] and scores of Factor I and Factor III were higher in the CBT + ATT group than in the CBT group (Ps <0.05). Conclusion: This study shows cognitive behavioral therapy combined with attention training technique could improve auditory hallucinations and social function more effectively in patients with schizophrenia [ABSTRACT FROM AUTHOR]

Schizophrenia is one of the most debilitating mental disorders. Auditory hallucinations, which are known to be closely related to interpersonal relationships, are the most common type of hallucinations observed in the course of schizophrenia. Virtual reality has been developing in various fields with the development of computerized technologies and has started to appear in the field of clinical psychology in the form of virtual reality therapies. Avatar therapy is among the interpersonal-based virtual reality therapy models that focus on auditory hallucinations among the symptoms of schizophrenia. The aim of avatar therapy is to enable the person to have control over auditory hallucinations. Within the scope of this review study; the past, present and future of schizophrenia treatment, effective intervention methods in the treatment of schizophrenia, virtual reality therapy, the main outlines of the avatar therapy model, the effectiveness studies of avatar therapy and ethical issues were discussed. The results of the research on the effectiveness of avatar therapy reveal the need for further research in this field.

Schizophrenia is one of the most debilitating mental disorders. Auditory hallucinations, which are known to be closely related to interpersonal relationships, are the most common type of hallucinations observed in the course of schizophrenia. Virtual reality has been developing in various fields with the development of computerized technologies and has started to appear in the field of clinical psychology in the form of virtual reality therapies. Avatar therapy is among the interpersonal-based virtual reality therapy models that focus on auditory hallucinations among the symptoms of schizophrenia. The aim of avatar therapy is to enable the person to have control over auditory hallucinations. Within the scope of this review study; the past, present and future of schizophrenia treatment, effective intervention methods in the treatment of schizophrenia, virtual reality therapy, the main outlines of the avatar therapy model, the effectiveness studies of avatar therapy and ethical issues were discussed. The results of the research on the effectiveness of avatar therapy reveal the need for further research in this field. [ABSTRACT FROM AUTHOR]

Entendre des voix est une expérience encore largement stigmatisée et interprétée sous le prisme de la psychopathologie. Pour autant, les personnes ayant ces vécus ne se reconnaissent pas nécessairement dans les classifications psychiatriques existantes. C'est ainsi qu'est né un mouvement social, baptisé Hearing Voices Movement, qui vise la réappropriation de ce phénomène d'entente de voix sur un versant normatif. À travers l'étude de ce mouvement, cet article revient sur les conceptualisations de l'entente de voix du point de vue de la psychiatrie et de l'approche phénoménologique. L'histoire de ce mouvement et les revendications sur lesquelles ce dernier s'est construit restent marquées par les rapports que ce mouvement entretient avec les approches cliniques. Des innovations terminologiques indiquent la volonté d'émancipation du champ psychiatrique. Les dernières décennies ont connu une transformation de la représentation de l'entente de voix qui permet de réfléchir à de nouvelles formes d'accompagnement par les professionnels de la santé, ce qui n'est pas sans soulever un certain nombre de problématiques cliniques nouvelles, notamment quant aux alliances possibles entre usagers et soignants. Voices hearing is still an stigmatized experience, generally interpreted through the prism of psychopathology. This experience remains associated with serious disorders, including schizophrenia. Today, the latest edition of the DSM-5 attests to the evolution of international psychiatric classifications regarding the place given to these phenomena. These transformations indicate an evolution of the caregiving body on this experience, even if the notion of psychopathological disorder still hovers. Furthermore, this article explores the conceptualization of hearing voices both from psychiatric and from phenomenological perspectives. Despite these recent nosographic developments, the care of people hearing voices has been the subject of criticism and controversy from users of psychiatry. Thus has emerged in this context a social movement, called Hearing Voices , which aim is the reappropriation of this phenomenon on a normative level. People with these experiences do not recognize themselves in existing psychiatric classifications. We review the burgeoning literature on which they rely, which tends to argue that voices are a fairly common experience that occurs independently of a mental illness. Added to this are the many criticisms regarding the care of people experiencing voices (psychiatric abuse, poor effectiveness of drug treatments with significant side effects, etc.). The voices are thus considered to carry meaning for the hearers and in order to understand this meaning, a dialogue seeks to be established with them. Distinctions are made on these experiences, since if some voices generate suffering or any form of pressure on individuals, this would not be the case for all voices where some would be positive or neutral. Distinctions are made on these experiences, since if voices generate suffering or any form of pressure on individuals, this would not be the case for all voices or some would be positive for people. Over the past several decades, this movement has grown globally as voices hearers and users of psychiatry from various countries have built their own organizations to defend the values of the movement on a national level. In addition, these people retrace their steps with the care services in order to offer support that they deem more appropriate to their needs. With this in mind, self-help groups for voice hearers have sprung up. There is a strong heterogeneity from one group to another. Some are carried by users, others by caregivers listening to the claims that have been made by the movement. However, this diversity makes it difficult to evaluate the effectiveness of this group. The creation of self-help groups for voice-hearers by caregivers is proof of their willingness to offer support that meets the needs that may have been claimed, but it raises new questions. Is it possible to elaborate on these experiences when the people who continue to "facilitate" the groups are the same people who have been linked to a form of abuse? The history of this movement remains marked by the relationship with the care approaches that have been proposed to it until today. This has led to a transformation of the representation of voice understanding on a transdiagnostic and neutral side. [ABSTRACT FROM AUTHOR]

Background: Auditory verbal hallucinations are not a unitary phenomenon and can be further differentiated into certain clinical characteristics, viz., frequency, intensity, control, tone, distractibility, distress, and clarity. These clinical characteristics manifest in varying degrees in different psychiatric disorders. Aim: To study the characteristics of auditory hallucinations in Indian patients with schizophrenia and bipolar affective disorder. Materials and Methods: By purposive sampling, 140 patients of schizophrenia and bipolar affective disorder each were included in the study. Subjects were assessed cross-sectionally using sociodemographic proforma and characteristics of auditory hallucination scale. Results: Characteristics of auditory hallucinations of schizophrenia patients were significantly different from those of bipolar affective disorder patients in the domains of frequency, intensity, tone, self-control, clarity, distractibility, and distress. Conclusion: Characteristics of auditory hallucinations differ in all domains between schizophrenia and bipolar affective disorder.

Background: The cognitive model of auditory hallucinations posits that the beliefs or appraisal of the voices plays an important role in the determination of consequent reactions. These beliefs are explored effectively through “Beliefs About Voices Questionnaire-Revised (BAVQ-R).” However, Hindi adaptation and psychometric evaluation of this tool are yet to be done. Hence, the present study aimed at translating the BAVQ-R in Hindi language and assessing the psychometric properties of the same. Methodology: The original version was translated in Hindi language using translation–back-translation method. This translated version of BAVQ-R was then administered to 51 schizophrenia patients with a history of active auditory hallucinations. All the participants were selected from Central India Institute of Mental Health and Neuro Sciences, Rajnandgaon (Chhattisgarh), using purposive sampling technique. Initially, the informed consent was taken from the patients, followed by the administration of the Hindi version of BAVQ-R and Psychotic Symptom Rating Scale (PSYRATS). Finally, the psychometric properties, e.g., internal consistency reliability, divergent validity, and convergent validity were calculated. Results: The internal consistency reliability was within the range of 0.6–0.94, as indicated by Cronbach's alpha. The divergent validity was high as malevolent voices and engagement feelings and behavior towards the voices were negatively correlated (r = −0.56, P < 0.01), and benevolent voices significantly negatively correlated with resistance feeling and behavior towards the voices (r = −0.74, P < 0.01). Convergent validity was measured by correlating the subscales of BAVQ-R with the dimensions of PSYRATS. Pearson's correlation indicated significant associations between the dimensions of the two scales. Conclusion: The Hindi version of BAVQ-R has good psychometric properties. The tool has good internal consistency along with high divergent and convergent validity.

Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels. [ABSTRACT FROM AUTHOR]

Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels.

Abstract The main symptoms of Meige's syndrome are involuntary eye blinking with muddled speech and uncontrollable contraction of the platysma muscle characterized by segmental, primarily oromandibular, dystonia (hyperkinesia). It can also develop after long‐term medication of first‐ and second‐generation antipsychotics. Here, we report the case of a Japanese female schizophrenic patient comorbid with Meige's syndrome and hyperthyroidism. We discuss the relationship between the three diseases, that is, schizophrenia, Meige's syndrome, and hyperthyroidism. Our intention is to consider the important role of the cerebral basal ganglia, where little attention has been given in regard to schizophrenia and Meige's syndrome. A part of this article was presented in a poster section at the joint congress of the 28th Annual Meeting of the Japanese Society of Clinical Neuropsychopharmacology and the 48th Annual Meeting of the Japanese Society of Neuropsychopharmacology held in 2018.

Amaç: Bu çalışmanın amacı, Toplum Ruh Sağlığı Merkezi (TRSM) ve poliklinikte takip edilen şizofreni tanılı hastalarda yaşanan sorunlar, işitsel varsanılar ve sosyal destek algısının belirlenmesidir.Gereç ve Yöntem: Karşılaştırmalı-tanımlayıcı tipte olan bu araştırma, iki TRSM ve bir üniversite hastanesi yetişkin psikiyatri polikliniğinde Ocak-Haziran 2017 tarihleri arasında yürütülmüştür. TRSM’de (n=33) ve poliklinikte (n=33) takip edilen toplam 66 hasta örneklemi oluşturmuştur. Araştırmanın verileri Hasta Bilgi Formu ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği ile toplanmıştır.Bulgular: TRSM ve poliklinik grubundaki hastalar yaş ortalaması, cinsiyet, eğitim durumu, medeni durum, evde birlikte yaşanan kişiler, ailede ruhsal hastalığı olan başka bir bireyin bulunması, hastalık ve tedavi ile ilgili özellikler açısından benzerdir. Hastaların çoğu hastalığın nedenini “bilmiyorum / hatırlamıyorum/ büyüler/ Allah tarafından oldu” şeklinde açıklamıştır. Poliklinik grubundaki hastaların çoğu (%78.6), TRSM grubundaki hastaların ise yarıdan biraz fazlası (%51.5 işitsel varsanıların nedenini “bilmiyorum / cinler/ büyüler/ çevredeki kötülükler” şeklinde açıklamıştır. Bu oranlar arasındaki fark istatistiksel olarak anlamlı bulunmuştur.Sonuç: TRSM’de takip edilen hastalar ile poliklinikten takip edilen hastalar, hastalığa bağlı yaşanan sorunlar ve baş etme özellikleri yönünden benzerlik göstermektedir.

La psychologie anglo-saxonne a produit un nombre conséquent d'études mettant en évidence l'implication de mécanismes psychologiques dans le développement et le maintien des hallucinations acoustico-verbales (HAVs), aussi appelées phénomène d'entente de voix. S'il est souvent considéré, pour des raisons historiques, que les HAVs sont une des caractéristiques principales des troubles psychotiques et notamment schizophréniques, les études épidémiologiques montrent que celles-ci sont également extrêmement prévalentes dans de nombreuses autres populations cliniques (e.g. trouble bipolaire, trouble de stress post-traumatique, trouble de personnalité borderline) et neurologiques (e.g. Maladie de Parkinson), tout comme au sein de la population générale. Cependant, les HAVs restent encore, en pratique courante, associées à la psychose, et d'un point de vue étiologique à des « dysfonctionnements neurobiologiques complexes ». L'objectif principal de cette revue est de faire une synthèse narrative et intégrative des différents modèles psychologiques faisant actuellement consensus sur les HAVs. Plus précisément, nous décrirons (1) le rôle des croyances à propos de l'expérience d'entente de voix et les croyances à propos de soi, (2) l'expérience d'entente de voix comme devant être comprise comme un phénomène fondamentalement relationnel entre l'entendeur de voix et la voix elle-même, (3) le rôle des émotions et des stratégies de régulation émotionnelle, et (4) le rôle des expériences passées traumatiques et de la dissociation. Nous terminons cette revue par une brève critique argumentée de la conception des HAVs telle qu'elle est actuellement adoptée en psychiatrie. Anglo-Saxon psychology has produced a significant number of studies showing the involvement of psychological mechanisms in the development and maintenance of auditory hallucinations (voice-hearing). Likewise, numerous studies have shown that hallucinations are also described in other psychiatric (e.g. post-traumatic stress disorder) and neurodegenerative (e.g. Parkinson's disease) clinical populations as well as in a minority of the general population. However, despite these advances, hallucinations are still considered as a specific characteristic of schizophrenia, which in most cases, is understood from a biological point of view. For this reason, in this review, we are specifically interested in the psychological models of auditory hallucinations from a transdiagnostic point of view. More specifically, we will describe (1) the role of beliefs about voices and self-schemas, (2) the experience of voice understood as a fundamentally relational phenomenon between the voice hearer and the voices, (3) the role of emotions and emotional regulation strategies, and, finally, (4) the role of past traumatic experiences and dissociation. Regarding the role of beliefs about voices and self-schemas, numerous studies are showing that more important than the experience of hearing voices it is how the individual appraisal their experience that will ultimately impact on how they will cope with the experiences and how they will feel about it (distressed or not). Voices appraised as malevolent and powerful are more often associated with avoidant, escape, confrontation, and compliance coping strategies. Moreover, they are also associated with higher levels of depression and anxiety regardless of the frequency of hallucinations and duration of the disorder. Besides the beliefs about the voices, how the individual perceives him/herself is also essential. It has been shown, for example, that the more individuals feel depressed and inferior in comparison to others in interpersonal relationships, the more inferior they feel about their voices. The relational approach proposed that the experience of voice understood as a fundamentally relational phenomenon between the voice hearer and the voices. Indeed, phenomenological studies have been able to show that voice-hearers describe voices as possessing human characteristics. As a result, voice-hearers often develop a relationship of virtual intimacy with their voices, which often seems to be complex and characterised by a certain ambivalence similar to the interpersonal relationships encountered in everyday life. Thus, current research suggests that it is essential to take into account these relational aspects when working with voice-hearers. Alongside cognitive and relational variables, emotional states and processes play a significant role in the development and maintenance of auditory hallucinations. Indeed, it has been shown that stress, anxiety and depression are predictors of hallucinations. Also, increased use of non-adaptive emotion regulation strategies may play a major role in the phenomenon of voice agreement. Studies have demonstrated that emotional regulation strategies such as experiential avoidance and abstract rumination seem to contribute to the increased frequency of hallucinations and associated distress. Finally, there is now strong evidence showing the involvement of past adverse experiences in the onset and content of hallucinations. In this framework, dissociation is seen as a protective mechanism that allows individuals to psychologically detach themselves from events that they cannot cope with. Consequently, the experience is attributed to external sources, ultimately leading to the phenomenon of voice-hearing. In summary, in this brief review, we have tried to present the best validated psychological models for understanding the experience of voice agreement. The goal is to provide information on how these psychological processes can help us to the adoption of a person-centred approach in mental health care that allows the person to describe their experiences in their own words and thus formulate an understanding of their suffering. [ABSTRACT FROM AUTHOR]

Background Interesting data and theories have emerged regarding auditory hallucinations (AHs) in patients with schizophrenia. The possibility that these patients may have changes in the anatomy of the auditory cortex and/or subcortical structures of the central auditory nervous system and present with deficits on audiological tests is important information to the audiology community. However, it seems clear that, in general, audiologists are not sufficiently aware of these findings. Purpose There are two main purposes of this article: (1) to educate audiologists about AHs related to schizophrenia and related issues, and (2) to encourage audiologists and hearing scientists to become involved in the evaluation and research of AHs. This fascinating disorder is one in which audiologists/hearing scientists are well suited to make a significant contribution. Research Design A review and synthesis of the literature was conducted. Relevant literature was identified through PubMed, Google Scholar, as well as independent book chapters and article searches. Keywords driving the searches were AHs, auditory illusions, verbal and musical hallucinations, schizophrenia, and central auditory disorders. Given the currency of the topic, the information collected was primarily between 1990 and 2020. Study Sample The review is organized around categorization, prevalence, models, mechanisms, anatomy, pathophysiology, and audiological correlates related to AHs. Data Collection and Analysis Searches were conducted using well-known search engines and manual searches by each author. This information on AHs was then analyzed collectively by the authors for useful background and relevance, as well as important for the field of audiology. Results Several anatomical, physiological, and functional imaging studies have shown compromise of the auditory cortex in those with schizophrenia and AHs. Potentially related to this, are studies that demonstrated sub-par performance on behavioral audiologic measures for this unique clinical population. These findings align well with the kind of hearing disorder for which audiologists are well-trained to make significant contributions. Conclusion Neurobiological and audiological evidence is accumulating on patients with schizophrenia and AH potentially rendering it as both an auditory and psychiatric disorder. Audiologists should consider expanding their horizon and playing a role in the clinical investigation of this disorder. [ABSTRACT FROM AUTHOR]

Background: Auditory verbal hallucinations are not a unitary phenomenon and can be further differentiated into certain clinical characteristics, viz., frequency, intensity, control, tone, distractibility, distress, and clarity. These clinical characteristics manifest in varying degrees in different psychiatric disorders. Aim: To study the characteristics of auditory hallucinations in Indian patients with schizophrenia and bipolar affective disorder. Materials and Methods: By purposive sampling, 140 patients of schizophrenia and bipolar affective disorder each were included in the study. Subjects were assessed cross-sectionally using sociodemographic proforma and characteristics of auditory hallucination scale. Results: Characteristics of auditory hallucinations of schizophrenia patients were significantly different from those of bipolar affective disorder patients in the domains of frequency, intensity, tone, self-control, clarity, distractibility, and distress. Conclusion: Characteristics of auditory hallucinations differ in all domains between schizophrenia and bipolar affective disorder. [ABSTRACT FROM AUTHOR]

Abstract Introduction Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first‐episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV). Methods FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle‐to‐moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle‐to‐moderate VHs [FUSCHSAMV, 28 patients]; and middle‐to‐moderate AHs combined with middle‐to‐moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment. Results In the pilot study, the rate of GMV reduction showed an inverted U‐shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow‐up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction‐related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate. Conclusions These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice.

Background: although the exact pathogenesis of auditory hallucinations is not yet known, some suggested the impairment of perception and processing of auditory information as a possible explanation. So, the aim of this study is to evaluate auditory pathways of schizophrenic patients using auditory brainstem responses (ABR). Methods: schizophrenic patients with auditory hallucinations and age and sex matched healthy non-relative controls were recruited in this casecontrol study. Scale for assessment of positive symptoms (SAPS) was used for rating the severity of hallucinations. Then, ABR recorded from all participants and the latencies of waves I, II, III, IV, V and interpeak latencies (IPL) of waves I-III, III-V were analyzed on both sides. Chi squire and independent t tests were applied for statistical analysis. Pvalue= 0.05 was considered significant. Results: 39 patients and 35 controls were included. Latencies of waves III and V and IPL of III-V were significantly prolonged on the left side. Disease duration had no influence on the results. Conclusion: there is a link between abnormal ABRs and auditory hallucinations in schizophrenic patients that indicates dysfunction and abnormal asymmetry of auditory pathways in these patients. [ABSTRACT FROM AUTHOR]

Objective To explore local changes of spontaneous brain activity related to auditory hallucination in schizophrenia using amplitude of low frequency fluctuation (ALFF). Methods 33 schizophrenia patients with (16) and without (17) auditory hallucination underwent resting functional MRI study. Values of ALFF were calculated and compared between the patients with and without auditory hallucination. Correlation analysis betwmen ALFF values and the severity of auditory hallucination was performed. Results The ALFF values were significantly lower in the occipital cortex and significantly higher in the left angular gyrus, supra marginal gyrus and superior temporal gyrus of patients with than that of patients without auditory hallucination. The correlation analysis showed that the ALFF value of left angular gyrus was positively correlated (P=0.006. R =0.550) and the ALFF value of the occipital cortex wras negatively correlated (P=0.007 , R=-0.53) writh severity of auditory hallucination. Conclusion The functional abnormalities of local spontaneous brain activity in the schizophrenia patients with auditory hallucination suggest that the auditory language processing function is over-activated and the visual information processing function is impaired. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine the experienced problems, auditory hallucinations, and perceived social support in patients with schizophrenia followed up in Community Mental Health Center (CMHC) and outpatient clinics. Materials and Methods: This comparative-descriptive study was carried out between January-June 2017 in an adult psychiatry outpatient clinic of a university hospital and two CMHCs. The sample consisted of 66 patients, followed up in CMHC (n=33) and outpatient clinic (n=33). The data of the study were collected using Patient Information Form and Multidimensional Scale of Perceived Social Support. Results: The average age, gender, educational status, marital status of the patients in CMHC and outpatient clinic group, the people living with them, and the presence of another individual with a mental disorder in the family were similarities in terms of the characteristics of the disorder and treatment. Most of the patients explained the cause of the disease as "I don't know/I don't remember/black magic/destiny given by God". Most of the patients in the outpatient clinic group (78.6%) and patients slightly more than half of CMHC group (51.5%) explained the cause of the hallucinations as "I don't know/gins/black magic/surrounding evils". The difference between these rates were found to be statistically significant. Conclusion: Patients followed up in CMHC and patients followed up in the outpatient clinic exhibited similarity in terms of problems experienced due to the disease and coping characteristics. [ABSTRACT FROM AUTHOR]

Objective To analyze the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) combined with Aripiprazole in the treatment of auditory hallucination in first-episode schizophrenia. Methods 60 schizophrenic patients in the hospital from May 2019 to April 2020 were selected and randomly divided into the observation group and the control group. During the treatment,3 patients withdrew from the study and 57 patients were included,including 29 patients in the observation group and 28 patients in the control group.The clinical efficacy and adverse reactions of the two groups were compared.Results There were no significant differences in the dosage and effective rate of aripiprazole between the two groups (P >0.05). At the end of 4 weeks, auditory hallucination rating scale (AHRS) score,positive and negative symptom scale (PANSS) total score and each factor score of the two groups were lower than those before treatment,and the differences were statistically significant (P <0.05). While the AHRS score, PANSS total score and each factor score of the observation group were not significantly different from those of the control group (P >0.05). After 2 weeks of treatment,the AHRS score of the observation group was lower than that before treatment, and lower than that of the control group,the differences were statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Low frequency rTMS combined with Aripiprazole is effective and safe in the treatment of auditory hallucination in first-episode schizophrenia. [ABSTRACT FROM AUTHOR]

Introduction: Transcranial Direct Current Stimulation (tDCS) is a non-invasive form of neuromodulation that delivers a constant low amplitude electric current to the scalp via electrodes. This study examines the effectiveness of add-on tDCS on auditory hallucination and insight in subjects with chronic schizophrenia, who continued to have auditory hallucination despite adequate trials with first- and second-generation antipsychotic medication. Methods: Thirty-two subjects with chronic schizophrenia having medication refractory auditory hallucination were selected from a tertiary center. The participants included 23 males and 9 females, with a mean age of 35.41 yrs., and the mean illness duration of 12.91 yrs. tDCS was carried out using 2 mA direct current, for 20 mins for five successive days, with two sessions per day (total 10 sessions), with the anode placed over left dorsolateral prefrontal cortex (DLPFC) and the cathode over left temporo-parietal junction (TPJ), and assessment done using Positive and Negative Syndrome Scale (PANSS), Auditory Hallucination Rating Scale (AHRS) and Becks Cognitive Insight Scale (BCIS) on day 0, day 5 and day 30. Results: There was a significant improvement in auditory hallucination on AHRS, PANSS, positive symptom domain of PANSS, and P3 subscale of PANSS after 10 sessions, that is on day 5, but the effect weaned off by day 30. There was no significant change in the negative symptoms and insight over the study period. Conclusion: We report that add-on tDCS was effective for a brief duration in medication refractory auditory hallucination in patients with chronic schizophrenia. The effect was not sustained, suggesting that tDCS does not induce long-lasting neuroplasticity in the brain. There was no significant improvement in negative symptoms and insight. The study kindles the idea of maintenance tDCS for auditory hallucinations. [ABSTRACT FROM AUTHOR]

Introduction: Auditory hallucination (AH) is often unexplored in depth in clinical practice. This study sought to ascertain the relationship between AH, depressive symptoms and quality of life (QOL) and its association with socio-demographic and clinical variables. Methods: This was a cross sectional study done in a psychiatry unit involving 60 schizophrenic patients between 18 to 60 years old. Psychotic Symptom Rating Scale - Auditory Hallucination subscale (PSYRATS-AH), Calgary Depression Scale for Schizophrenia (CDSS) and World Health Organization Quality of Life-Brief scale (WHOQOL-BREF) were used as instruments. Results: Alcohol intake was found to be significantly associated with the severity of AH. A significant moderate positive correlation was found between AH total score and CDSS (r=0.53, p<0.001) and moderately high correlation between emotional characteristics subscale with CDSS (r=0.651, p<0.005).The PSYRATS-AH dimensions; amount of distress (r=0.721, p<0.001) and intensity of distress (r=0.757, p<0.001) showed significant high correlation with CDSS. As for QOL, frequency of AH (r=-0.419, p<0.01) and CDSS (r=- 0.435, p<0.01) showed significant moderate negative correlation, while duration, loudness, amount and intensity of distress, disruption to life and controllability of voices had significant fair correlation with QOL. Multiple regression analysis revealed that the frequency of AH (p=0.047), controllability of AH (p=0.027) and depressive symptoms (p=0.001) significantly predict QOL. Conclusion: Our results demonstrated that each dimension of AH had different contributions towards depressive symptoms and the QOL in patients with schizophrenia. Therefore, appropriate treatment focusing on the specific dimension of AH not only may reduce depressive symptoms, but may also improve QOL of these patients. [ABSTRACT FROM AUTHOR]