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Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy?

Published online by Cambridge University Press:  10 March 2016

K. Daalman ,
K. M. J. Diederen ,
L. Hoekema ,
R. van Lutterveld  and
I. E. C. Sommer
K. Daalman
Affiliation:
Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht, Utrecht, The Netherlands Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
K. M. J. Diederen*
Affiliation:
Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht, Utrecht, The Netherlands Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, UK
L. Hoekema
Affiliation:
Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht, Utrecht, The Netherlands
R. van Lutterveld
Affiliation:
Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht, Utrecht, The Netherlands Center for Mindfulness, University of Massachusetts Medical School, Worcester, MA, USA
I. E. C. Sommer
Affiliation:
Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht, Utrecht, The Netherlands
*
*Address for correspondence: Dr K. M. J. Diederen, Department of Physiology, Development, and Neuroscience, University of Cambridge, Downing Street, Cambridge CB2 3DY, UK. (Email: k.diederen@gmail.com)
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Abstract

Background

Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15–35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls).

Method

Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale.

Results

Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group.

Conclusions

These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.

Keywords

Hallucinationsneed for mental healthcarepsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 9 , July 2016 , pp. 1897 - 1907
Copyright
Copyright © Cambridge University Press 2016 

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