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See Inside Scientific American Mind Volume 24, Issue 4

Voice-Hearing by the Numbers

Auditory hallucination often carries a stigma of mental illness. Yet voice-hearing can manifest in otherwise healthy people at any age.
schizophrenia, hearing voices



Flickr/Marco Castellani

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Children and Adolescents  (under 19 years old)

Prevalence:
17 percent of children aged 9 to 12
7.5 percent of teenagers aged 13 to 18

Risk factors:
Maternal infection during pregnancy.
Intense trauma, such as extreme bullying or sexual abuse. Some researchers believe the voices may be a coping mechanism.

Outcomes:
The majority of adolescents who hear voices do not go on to develop psychosis; most children do not suffer significant behavioral or emotional consequences.

Patient history: “L.O.”
Female, age 11, has a history of headaches

“An accomplished sixth grader, she played on an advanced athletic team, was in a performance choir, and achieved straight A’s. The voices L.O. heard were ‘outside of her head,’ were critical, and usually came when she was working alone.”

Source: “Auditory Hallucinations in Nonpsychotic Children with Affective Syndromes and Migraines: Report of 13 cases,” by H. A. Schrier in Journal of Child Neurology, Vol. 13, No. 8; August 1998.


Adults (19 to 65 years old)

Prevalence:

  • 5 to 15 percent of adults; this is a higher percentage of the population than is diagnosed with schizophrenia (1 percent).  

Risk factors:

  • Hearing voices can accompany psychiatric disorders other than schizophrenia, including depression, post-traumatic stress disorder and bipolar disorder, as well as hearing loss and some forms of epilepsy.
  • Hallucinations associated with a psychotic disorder often set in around 21 years old.

Outcomes:

  • Voice hearing without psychosis typically does not produce major cognitive limitations. Individuals in this category may benefit from learning to interact with their voices in a psychologically adaptive way.
  • For patients with schizophrenia, a common intervention involves antipsychotic medications coupled with therapy aimed at minimizing the stress associated with hearing voices.

Patient history: “Mark”
Male, age 25, four-year history of schizophrenia

“Mark’s present symptoms mainly consist of auditory hallucinations: he hears three voices continuously, located outside of his head. The content of the voices is unpleasant. They comment negatively on his behavior (‘You are doing that wrong’) and on his self-concept (‘You are a failure’; ‘Everybody is staring at you’). Mark is distressed by the voices and he feels he has no control over the voices.”

Source: “Attention Training With Auditory Hallucinations: A Case Study,” by Lucia R. Valmaggia et al., in Cognitive and Behavioral Practice, Vol. 14, No. 2; May 2007.


Aging and Elderly (over 65 years old)

Prevalence:

  • 33 percent of aging individuals experience auditory hallucinations. Yet a 2002 survey of elderly subjects found only 2.5 percent of the hallucinations were voices. More common were humming, buzzing, shushing or tapping sounds.

Risk factors:

  • Neurological disorders, such as Parkinson’s or Alzheimer’s disease.
  • The death of a spouse; women are particularly susceptible to hallucinations in the months following a partner’s passing.

Outcomes:

  • In cases involving an underlying illness, the disease should be the primary focus.
  • When the hallucinations are a symptom of bereavement, the voices may be comforting and therefore may not warrant treatment.

Patient history: “Mrs. R.”
Female, age 74

“[Mrs. R.] hears the voices of ‘spirits’ in her home. She has stopped eating, has stopped going out and is extremely distressed by spirits. She was admitted to mental health hospital for 4 weeks and started on large dose of anti-psychotic medication…She suffers side effects affecting her movement and appearance—however the voices remain unchanged.”

Source: “Older People Who Hear Voices,” by David Storm, Cumbria Partnership NHS Foundation Trust http://www.workingtorecovery.co.uk/wp-content/uploads/2012/09/David-Storm.pdf

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