SU111. A Comprehensive Phenomenological Examination of Auditory Verbal Hallucinations (AVHs): A Comparison of Mood vs Psychotic Disorders

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Abstract Auditory verbal hallucinations (AVHs) refer to the perception of verbal utterances in the absence of corresponding external stimuli. These experiences encompass complex, multifaceted phenomena and often contribute to clinical distress, poor quality of life, and even suicidal ideation, especially in clinical populations. Though not uncommon in bipolar disorder (BD) and major depressive disorder (MDD), there has been scant AVH research in these areas. We therefore aimed to conduct a series of studies to elucidate the nature of AVH experiences in these mood disorders relative to schizophrenia (SCZ) and schizoaffective disorder (SZA). In Study 1, a systematic literature review was undertaken using specified search terms (ie, “hallucinations” or “hearing voices” in conjunction with “bipolar disorder,” “mania” or “manic-depressive” or “major depressive disorder” or “depression” or “affective disorders” or “mood disorder”). In Study 2, we recruited 117 clinical participants (BD = 27; MDD = 28; SCZ = 39; SZA = 23), and conducted in-depth, semistructured phenomenological interviews. Assessments amalgamated conventional psychosis measures, such as the Psychotic Symptoms Rating Scales (PYSRATS) and Scale for the Assessment of Positive Symptoms (SAPS), select items from the Mental Health Research Institute Unusual Perceptions Schedule (MUPS) as well as additional questions derived from consultations with expert clinicians and/or researchers in the field. In Study 1, 14 eligible peer-reviewed publications, selected on the basis of a set of predefined inclusion criteria, were analyzed. Two major conclusions were drawn: (1) AVHs remained a central but largely understudied symptom in these disorders, albeit with varying prevalence rates (BD = 11.3%–62.8%; MDD = 5.4%–40.6%) and (2) methodological challenges in existing studies limited collection of meaningful phenomenological information (Toh , 2015). In Study 2, participants were well-matched on major demographic and clinical variables, with the exception of age (BD = MDD SZA), and Voices Commenting (MDD < BD = SCZ). Largely similar physical characteristics, negative content, controllability, and distress were associated with voices across diagnoses, but AVHs in mood disorders tended to be less frequent and disabling than in psychotic disorders. Ongoing studies by our research group include similar phenomenological inquiry into hallucinations in other modalities (Study 3), associated delusional themes (Study 4), as well as longitudinal stability of these phenomena (Study 5planning).