SYMPTOMS

What are hallucinations?

Hallucinations are experiences resembling real perceptions that occur without any external objective stimulus acting on the corresponding sensory organs. The individual genuinely perceives these experiences as originating from the external world or within their body, not as imagined, and cannot voluntarily terminate them at will.

What are auditory hallucinations?

Based on sensory types, hallucinations can be categorized into auditory, visual, olfactory/gustatory, tactile, and deep hallucinations. Auditory hallucinations may involve noises, music, or speech. Generally, only clearly discernible speech content holds diagnostic significance, while music or noises such as knocking or whistling provide little diagnostic value.

Individuals experiencing hallucinations or auditory hallucinations may undergo emotional fluctuations. If you suffer from these symptoms, in addition to managing them, you can improve your emotional state through lifestyle adjustments like meditation and exercise or seek counseling to overcome emotional distress. If someone around you experiences hallucinations or auditory hallucinations, offer them understanding and care.

What are verbal auditory hallucinations?

Auditory hallucinations may manifest as noises, music, or speech. The speech content can be clear or vague, ranging from single words to phrases or sentences.
The voices may directly address the patient (second-person hallucinations, e.g., "You are a sinner") or involve multiple voices discussing, commenting on, or arguing about the patient in the third person (e.g., "She is a promiscuous woman" followed by "No, she isn't").
Some patients report voices predicting their subsequent thoughts. At times, the voices articulate what they are currently thinking (thought echo) or repeat their thoughts immediately afterward (thought reverberation).

TREATMENT

Suspected auditory hallucinations, patient uncooperative, what to do?

When a patient exhibits obvious persistent auditory hallucinations, or behavioral patterns suggesting possible hallucinations, they should be taken to a psychiatric department as soon as possible for further evaluation of their specific condition.

• If the patient is unwilling to cooperate, persuasion to seek medical attention can focus on aspects such as sleep, mood, physical examination, or physical illness, while ensuring close supervision during the process.

• If the patient strongly refuses or even engages in violent conflicts with family members to resist treatment, consider organizing multiple family members to enforce hospitalization or seek assistance from local village/neighborhood committees or the police to ensure prompt psychiatric evaluation.

DIAGNOSIS

How to make a preliminary judgment about auditory hallucinations?

In reality, many patients are unwilling to disclose their hallucinatory experiences due to the influence of psychiatric symptoms (such as commanding auditory hallucinations like "Don't tell anyone or I'll make you pay" or persecutory delusions).
Certain behaviors may suggest the presence of hallucinations, such as talking to oneself, conversing with the air, cursing at nothing, or tilting the head to listen.
If a patient exhibits such behaviors, seek psychiatric evaluation as soon as possible.

Which hospital should you go to for hallucinations and auditory hallucinations?

For hallucinations, you can directly visit a psychiatric hospital or the psychiatric department of a general hospital for diagnosis and evaluation. Alternatively, you may first go to the neurology department of a general hospital to determine whether the hallucinations are caused by a physiological condition. After ruling out physiological causes, proceed to a psychiatric hospital or the psychiatric department of a general hospital for further treatment.

How are hallucinations and auditory hallucinations treated?

The treatment of hallucinations depends on the underlying condition causing them, and targeted therapy is required based on the specific diagnosis.

Common treatments for physiological conditions include medication, physical therapy, and surgery.

Common treatments for psychiatric disorders include medication, physical therapy, and psychotherapy.

POTENTIAL DISEASES

What diseases can auditory verbal hallucinations indicate?

• Third-person auditory hallucinations, thought echo, and thought reverberation are primarily seen in schizophrenia, where patients may express dissatisfaction or argue with the hallucinatory content.

• Second-person auditory hallucinations, especially when the content is commanding or directive (e.g., "You must not reveal your thoughts to them," "Jump from here"), are commonly associated with schizophrenia.

• Second-person auditory hallucinations may sometimes indicate depressive disorders (e.g., "You are a sinner"), particularly when the patient perceives the content as justified.

Do all hallucinations indicate abnormality?

Not all hallucinations signify abnormality. Hallucinations primarily occur in the following four situations:

• Organic brain diseases, such as temporal lobe lesions, may cause olfactory hallucinations, as well as disturbances of consciousness and toxic states (e.g., alcoholic hallucinosis).

• Healthy individuals may experience hypnagogic (before sleep) and hypnopompic (upon waking) hallucinations, or hallucinations due to sensory deprivation (e.g., deafness).

• Different emotional states may trigger hallucinatory experiences: For example, recently bereaved individuals may have hallucinations related to the deceased. Hallucinations consistent with mood or thought content may occur during depression or mania. These hallucinations are mood-congruent.

• Schizophrenia: Typically, recurrent verbal auditory hallucinations in a state of clear consciousness, with rich content beyond single words or phrases, hold significant diagnostic value for schizophrenia.