Behavioral management of command hallucinations to harm in schizophrenia

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Auditory hallucinations and command hallucinations are core symptoms of schizophrenia.
• Managing these symptoms, particularly those involving harm, is crucial for patient safety and quality of life.
• Behavioral strategies offer a potential avenue for symptom management in persistent auditory hallucinations.

Purpose of the Study:

• To assess the impact of a 10-session behavioral management course on command hallucinations.
• To evaluate changes in the characteristics and intensity of auditory hallucinations.
• To measure alterations in anxiety and depression levels among adult outpatients with schizophrenia.

Main Methods:

• A 10-session course teaching behavioral strategies for managing auditory hallucinations was administered.
• Prevalence of command hallucinations to harm self or others was measured at baseline, end of course, and 1-year post-course.
• Standardized questionnaires assessed hallucination characteristics, intensity, anxiety, and depression pre- and post-intervention.

Main Results:

• Command hallucinations to harm self decreased from 44% to 24% immediately post-course and remained stable at 1-year follow-up.
• Command hallucinations to harm others decreased from 21% to 16% post-course and 17% at 1-year follow-up.
• Significant improvements were observed in hallucination characteristics, intensity, anxiety, and depression, sustained at 1-year.

Conclusions:

• A 10-session behavioral management course is effective in reducing command hallucinations in schizophrenia.
• The positive effects on hallucination management, anxiety, and depression are durable, lasting at least one year.
• Behavioral interventions represent a valuable therapeutic option for managing persistent auditory hallucinations in schizophrenia.