For a Typology of Auditory Verbal Hallucinations Based on their Content
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ORIGINAL ARTICLE
For a Typology of Auditory Verbal Hallucinations Based on their Content Paul Franceschi 1 Received: 21 May 2020 / Accepted: 14 August 2020 / Published online: 24 August 2020 # Neuroscientia 2020
Abstract Auditory verbal hallucinations (AVHs) are a common symptom of schizophrenia. Studies have focused on a classification of AVHs, based on different criteria. Subtypes of AVHs have been defined, distinguishing according to whether they are internal/ external, single/multiple, unimodal/multimodal, benevolent/malevolent, permanent/intermittent, etc. The purpose of this study is to propose a classification of AVHs based on their content. We first identify the subtype that is directly associated with the polythematic delusions inherent in schizophrenia. Second, we distinguish subtypes related to other comorbid psychiatric disorders associated with schizophrenia in the patient: generalized anxiety disorder, depression, body dysmorphic disorder, etc. Finally, we suggest that such a differentiation could allow a correlative adaptation of the corresponding cognitive-behaviour therapy. Keywords Cognitive therapy . Delusions . Auditory verbal hallucinations . Schizophrenia . Comorbidity . Generalized anxiety disorder
In what follows, we will endeavour to propose a new classification, as far as we know, of auditory verbal hallucinations (AVHs), based on their content. Such a differentiation could allow a correlative adaptation of the corresponding cognitivebehaviour therapy (CBT). The AVHs are one of the major symptoms of schizophrenia. They are observed in about 70% of patients (Sartorius et al. 1986; Nayani and David 1996). Several studies have attempted to establish a classification of AVHs, based on different criteria. Subtypes of AVHs have been identified on the basis of various criteria. Among the criteria that have been proposed to classify AVHs, we can mention the following: according to whether the voices are internal or external (Upthegrove et al. 2016); according to whether the AVHs are single or multiple (Nayani and David 1996), i.e. according to whether the patient hears a single voice or the voices of several people; according to whether the AVHs are
* Paul Franceschi
1
Fontaine du Salario, Lieu-dit Morone, Ajaccio, France
unimodal or multimodal, i.e. whether or not they are associated with hallucinations in other sensory modalities (Chesterman and Boast 1994); whether the patient hears his/her own voice or foreign voices; whether the AVHs are perceived as benevolent or malevolent (Chadwick and Birchwood 1994); and whether the AVHs are permanent or intermittent (Larøi et al. 2012). The classification of AVHs that we will propose here is based on their content and will lead to distinguish the following: on the one hand, AVHs that are associated with a symptom inherent to schizophrenia and, in particular, delusional ideas; on the other hand, AVHs that relate to co-morbid psychiatric disorders encountered in the patient and associated with schizophrenia. Recent studies on CBT of auditory hallucin
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