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Background: We still know little about whether and how the auditory hallucinations associated with serious psychotic disorder shift across cultural boundaries., Aims: To compare auditory hallucinations across three different cultures, by means of an interview-based study., Method: An anthropologist and several psychiatrists interviewed participants from the USA, India and Ghana, each sample comprising 20 persons who heard voices and met the inclusion criteria of schizophrenia, about their experience of voices., Results: Participants in the U.S.A. were more likely to use diagnostic labels and to report violent commands than those in India and Ghana, who were more likely than the Americans to report rich relationships with their voices and less likely to describe the voices as the sign of a violated mind., Conclusions: These observations suggest that the voice-hearing experiences of people with serious psychotic disorder are shaped by local culture. These differences may have clinical implications., (Royal College of Psychiatrists.)