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Command hallucinations among Asian patients with schizophrenia
Theresa M Y Lee1, Siow Ann Chong, Yiong Huat Chan
1Woodbridge Hospital-Institute of Mental Health, Republic of Singapore. Theresa_LEE@imh.com.sg
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|February 1, 2005
Summary
Command hallucinations are prevalent in schizophrenia patients, with over half complying, especially with nonviolent commands. A history of self-harm increases compliance risk, necessitating closer monitoring and integrated coping strategies in treatment.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Command hallucinations (CH) in schizophrenia are poorly understood, with unclear links to violence and patient compliance.
- Existing literature lacks consensus on the prevalence and influencing factors of CH compliance.
Purpose of the Study:
- Determine the prevalence of command hallucinations in schizophrenia.
- Identify factors influencing patient compliance with CH.
- Explore patients' coping mechanisms for CH.
Main Methods:
- Recruited 100 schizophrenia inpatients (50 male, 50 female) reporting auditory hallucinations.
- Utilized semistructured questionnaires to gather data on hallucination content and coping strategies.
- Collected data on patient demographics and history, including self-harm.
Main Results:
- 53% of patients reported command hallucinations, with a higher prevalence in women (58%) than men (48%).
- 62% of patients complied with commands, particularly nonviolent ones. A history of self-harm was a significant predictor of compliance.
- Patients not complying commonly used prayer as a coping method.
Conclusions:
- Command hallucinations are a common symptom in schizophrenia patients.
- Patients with a history of self-harm require heightened monitoring due to increased compliance risk with CH.
- Integrating patient-reported coping strategies into treatment plans is recommended.