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The clinical presentation of command hallucinations in a forensic population
R Rogers1, J R Gillis, R E Turner
1Clarke Institute of Psychiatry, University of Toronto, Ont., Canada.
The American Journal of Psychiatry
|October 1, 1990
Summary
Patients with command hallucinations often obey orders without question. These individuals also experience more aggressive and self-punishing hallucinatory content compared to other psychotic patients.
Area of Science:
- Forensic Psychiatry
- Clinical Psychology
- Psychopathology
Background:
- Command hallucinations are a specific symptom of psychosis.
- Understanding their characteristics is crucial for patient safety and treatment.
Purpose of the Study:
- To compare patients with command hallucinations to other psychotic groups.
- To analyze the content and obedience related to command hallucinations.
Main Methods:
- A forensic population was divided into three groups: command hallucinations (N=25), non-command hallucinations (N=24), and no hallucinations (N=16).
- Global Assessment Scale and Social Behavior Rating Schedule were used to measure impairment.
Main Results:
- No significant differences in overall impairment were found between groups.
- Command hallucination group reported more aggressive, dependent, and self-punishing themes.
- Nearly half of the command hallucination group denied or did not report their hallucinations.
- 44% of patients with command hallucinations reported unquestioning obedience.
Conclusions:
- Command hallucinations are associated with specific, often negative, content.
- Patients may not report command hallucinations, impacting assessment and safety.
- Unquestioning obedience to command hallucinations is prevalent in a significant portion of patients.