![]() ![]() Visual hallucinations have often been linked to biological causes, such as organic disease and drug-induced psychosis, and have been considered uncommon in psychiatric samples. This special status of first rank symptoms has been removed in DSM-5, granting equal importance to hallucinations in any modality in diagnosing psychosis. Voices arguing and commenting were named “first rank” symptoms by Schneider, and were included in the DSM-IV as sufficient symptomatic criteria for a schizophrenia diagnosis. Auditory hallucinations are the most common, with commenting and commanding voices frequently reported. Hallucinations may be defined as perceptual experiences in the absence of external stimuli, and can involve several sensory modalities, such as auditory, visual, olfactory and tactile. Hallucinations are a major group of clinical symptoms with diagnostic significance in the psychosis spectrum disorders, and in first-episode psychosis (FEP) the majority of patients report hallucinatory experiences. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This work was supported by the Health Vest Trust, Norway (200202797-65 to I.J.) and the Regional Centre for Clinical Research in Psychosis (911313). Received: OctoAccepted: MaPublished: May 4, 2016Ĭopyright: © 2016 Solesvik et al. PLoS ONE 11(5):Įditor: Kenji Hashimoto, Chiba University Center for Forensic Mental Health, JAPAN (2016) Visual Hallucinations in First-Episode Psychosis: Association with Childhood Trauma. Although several studies showed clinical improvement, a specific reduction in hallucination severity has never been demonstrated.Citation: Solesvik M, Joa I, Larsen TK, Langeveld J, Johannessen JO, Bjørnestad J, et al. Electroconvulsive therapy (ECT) is considered a last resort for treatment-resistant psychosis. Consequently, TMS currently has the status of a potentially useful treatment method for auditory hallucinations, but only in combination with state of the art antipsychotic treatment. Several meta-analyses found significantly better symptom reduction for low-frequency repetitive TMS as compared with placebo. Transcranial magnetic stimulation (TMS) is capable of reducing the frequency and severity of auditory hallucinations. CBT aims at reducing the emotional distress associated with auditory hallucinations and develops new coping strategies. The success of CBT depends on the reduction of catastrophic appraisals, thereby reducing the concurrent anxiety and distress. Cognitive-behavioral therapy (CBT) can be applied as an augmentation to antipsychotic medication. ![]() Depot medication should be considered for all patients because nonadherence is high. For relapse prevention, medication should be continued in the same dose. Blood levels should be above 350-450 μg/ml for maximal effect. Clozapine is the drug of choice for patients who are resistant to 2 antipsychotic agents. If the drug of first choice provides inadequate improvement, it is probably best to switch medication after 2-4 weeks of treatment. Olanzapine, amisulpride, ziprasidone, and quetiapine are equally effective against hallucinations, but haloperidol may be slightly inferior. Only 8% of first-episode patients still experience mild to moderate hallucinations after continuing medication for 1 year. The first treatment option for hallucinations in schizophrenia is antipsychotic medication, which can induce a rapid decrease in severity. ![]() This article reviews the treatment of hallucinations in schizophrenia. ![]()
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