Psychological Medicine

Original Articles

The auditory hallucination: a phenomenological survey

Tony H. Nayania1 and Anthony S. Davida1 c1

a1 Department of Psychological Medicine and Neuropsychiatry, King's College Hospital and the Institute of Psychiatry, London


A comprehensive semi-structured questionnaire was administered to 100 psychotic patients who had experienced auditory hallucinations. The aim was to extend the phenomenology of the hallucination into areas of both form and content and also to guide future theoretical development. All subjects heard ‘voices’ talking to or about them. The location of the voice, its characteristics and the nature of address were described. Precipitants and alleviating factors plus the effect of the hallucinations on the sufferer were identified. Other hallucinatory experiences, thought insertion and insight were examined for their inter-relationships. A pattern emerged of increasing complexity of the auditory–verbal hallucination over time by a process of accretion, with the addition of more voices and extended dialogues, and more intimacy between subject and voice. Such evolution seemed to relate to the lessening of distress and improved coping. These findings should inform both neurological and cognitive accounts of the pathogenesis of auditory hallucinations in psychotic disorders.


c1 Address for correspondence: Dr A. S. David, Department of Psychological Medicine, Institute of Psychiatry, London SE5 8AF.