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Mechanisms Underlying Auditory Hallucinations-Understanding Perception without Stimulus.

Tracy DK, Shergill SS - Brain Sci (2013)

Bottom Line: Disappointingly many AVH remain resistant to standard treatments and persist for many years.Our understanding of AVH remains incomplete though much progress has been made in recent years.We herein provide a broad overview and review of this.

View Article: PubMed Central - PubMed

Affiliation: Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK. derek.tracy@oxleas.nhs.uk.

ABSTRACT
Auditory verbal hallucinations (AVH) are a common phenomenon, occurring in the "healthy" population as well as in several mental illnesses, most notably schizophrenia. Current thinking supports a spectrum conceptualisation of AVH: several neurocognitive hypotheses of AVH have been proposed, including the "feed-forward" model of failure to provide appropriate information to somatosensory cortices so that stimuli appear unbidden, and an "aberrant memory model" implicating deficient memory processes. Neuroimaging and connectivity studies are in broad agreement with these with a general dysconnectivity between frontotemporal regions involved in language, memory and salience properties. Disappointingly many AVH remain resistant to standard treatments and persist for many years. There is a need to develop novel therapies to augment existing pharmacological and psychological therapies: transcranial magnetic stimulation has emerged as a potential treatment, though more recent clinical data has been less encouraging. Our understanding of AVH remains incomplete though much progress has been made in recent years. We herein provide a broad overview and review of this.

No MeSH data available.


Related in: MedlinePlus

Longitudinal trajectory of hallucinations in patients with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis and unipolar depression over a 20-year period. Adapted with permission from [138].
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brainsci-03-00642-f003: Longitudinal trajectory of hallucinations in patients with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis and unipolar depression over a 20-year period. Adapted with permission from [138].

Mentions: Prospective longitudinal outcome data focusing on AVH are less common than that on illness recovery more generally [6]. Goghari et al. [138] undertook the first prospective long-term follow-up, with 150 patients (schizophrenia 51; schizoaffective disorder 25; bipolar affective disorder with psychosis 25; unipolar depression 49) over twenty years at six different time points. The early presence of AVH predicted poorer outcome and hallucinatory intensity was correlated with reduced employment attainment in all groups. 54% of patients with schizophrenia and 20% of patients with schizoaffective disorders demonstrated either frequent or chronic hallucinations over the full study time-course (Figure 3). The authors reasonably hypothesise their data illustrates both how positive symptoms tend to wane with time (with the caveat that the initial samples were taken during hospitalisation), and also how nevertheless a significant illness burden from AVH remains, particularly in schizophrenia. Whilst negative and cognitive symptoms have generally been regarded as better predictors of subsequent impaired psychosocial attainment this data also demonstrated a relationship between AVH persisting in the initial few years of the study and poorer real-world functioning.


Mechanisms Underlying Auditory Hallucinations-Understanding Perception without Stimulus.

Tracy DK, Shergill SS - Brain Sci (2013)

Longitudinal trajectory of hallucinations in patients with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis and unipolar depression over a 20-year period. Adapted with permission from [138].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061847&req=5

brainsci-03-00642-f003: Longitudinal trajectory of hallucinations in patients with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis and unipolar depression over a 20-year period. Adapted with permission from [138].
Mentions: Prospective longitudinal outcome data focusing on AVH are less common than that on illness recovery more generally [6]. Goghari et al. [138] undertook the first prospective long-term follow-up, with 150 patients (schizophrenia 51; schizoaffective disorder 25; bipolar affective disorder with psychosis 25; unipolar depression 49) over twenty years at six different time points. The early presence of AVH predicted poorer outcome and hallucinatory intensity was correlated with reduced employment attainment in all groups. 54% of patients with schizophrenia and 20% of patients with schizoaffective disorders demonstrated either frequent or chronic hallucinations over the full study time-course (Figure 3). The authors reasonably hypothesise their data illustrates both how positive symptoms tend to wane with time (with the caveat that the initial samples were taken during hospitalisation), and also how nevertheless a significant illness burden from AVH remains, particularly in schizophrenia. Whilst negative and cognitive symptoms have generally been regarded as better predictors of subsequent impaired psychosocial attainment this data also demonstrated a relationship between AVH persisting in the initial few years of the study and poorer real-world functioning.

Bottom Line: Disappointingly many AVH remain resistant to standard treatments and persist for many years.Our understanding of AVH remains incomplete though much progress has been made in recent years.We herein provide a broad overview and review of this.

View Article: PubMed Central - PubMed

Affiliation: Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK. derek.tracy@oxleas.nhs.uk.

ABSTRACT
Auditory verbal hallucinations (AVH) are a common phenomenon, occurring in the "healthy" population as well as in several mental illnesses, most notably schizophrenia. Current thinking supports a spectrum conceptualisation of AVH: several neurocognitive hypotheses of AVH have been proposed, including the "feed-forward" model of failure to provide appropriate information to somatosensory cortices so that stimuli appear unbidden, and an "aberrant memory model" implicating deficient memory processes. Neuroimaging and connectivity studies are in broad agreement with these with a general dysconnectivity between frontotemporal regions involved in language, memory and salience properties. Disappointingly many AVH remain resistant to standard treatments and persist for many years. There is a need to develop novel therapies to augment existing pharmacological and psychological therapies: transcranial magnetic stimulation has emerged as a potential treatment, though more recent clinical data has been less encouraging. Our understanding of AVH remains incomplete though much progress has been made in recent years. We herein provide a broad overview and review of this.

No MeSH data available.


Related in: MedlinePlus