Auditory hallucinations in schizophrenic and affective disorder Nigerian patients: phenomenological comparison

Although auditory hallucinations are universal phenomena, they show cultural and ethnic variation. We set out to study some differences between auditory hallucinations in Nigerian patients and their foreign counterparts. We also investigated the usefulness of auditory hallucinations in distinguishing between schizophrenia and affective disorders. A semi-structured interview was used to obtain information from 89 patients with auditory hallucinations who met ICD-10 criteria for either schizophrenia or affective psychoses and 10 others with organic mental disorders. Responses were compared with respect to the frequency, form and content of the hallucinatory voices as well as the languages spoken. In this sample, voices speaking exclusively in a foreign language were uncommon. Voices commanding and those discussing patients in the third person were the commonest in schizophrenic patients but not as frequent as in a similar group of patients in the UK studied by other authors. In patients with schizophrenia, voices were more likely to discuss the patient, whereas in affective disorders, voices were more likely to evoke fear, and patients were more likely to carry out commands. In conclusion, only three features of auditory hallucinations distinguished between schizophrenic and affective psychoses patients. Auditory hallucinations may be less harassing in Nigerian schizophrenic patients than in their UK counterparts. These hallucinations are most often perceived in the individual's mother tongue, with or without additional use of English, even when the patients have been 'westernized' through education and religion.