Hallucinations In Schizophrenic Patients Research Articles

Pemberian Terapi Okupasi : Menggambar untuk Mengontrol Halusinasi Pendengaran Pada Pasien Skizofrenia

Background: Hallucinations are often found in patients with mental disorders as one of the symptoms which hallucinations with depression are characterized by withdrawing and being alone. Giving occupational therapy can improve mental health, social inclusion and also respect yourself by keeping yourself busy doing useful activities. This descriptive case study aims to provide an overview of how occupational drawing therapy is used to control auditory hallucinations in schizophrenic patients. Method: This qualitative research uses descriptive case studies with a nursing process approach. One participant, namely a schizophrenic patient with nursing problems with sensory perception disorders, and auditory hallucinations. Results: After implementation, the patient showed a decrease in symptoms. In session 1, the patient draws hallucinatory voices, in session 2, the patient draws his feelings, in session 3, the patient draws his wishes. Initially, the patient was seen chatting to himself, smiling to himself, lacking eye contact, and being more aloof. After being given therapy, the patient seemed to stop talking and laughing to himself. Conclusion: Occupational drawing therapy can focus the patient's mind and solve the hallucinations that come.

Penerapan Terapi Generalis Halusinasi Untuk Menurunkan Tingkat Halusinasi Pada Pasien Skizofrenia Di RSJD Dr.RM. Soedjarwadi Klaten

Background: Hallucinations are false perceptual distortions that occur in maladaptive neurobiological responses, sufferers actually experience sensory distortions as real things and respond to them (Pardede, 2020). Generalist therapy is the application of standard scheduled nursing care that is applied to patients with the aim of reducing the mental nursing problems being handled. (Livana et al., 2020).Objective: To find out the results of implementing Generalist Therapy to Reduce the Level of Hallucinations in Schizophrenic Patients at RSJD Dr.RM Soedjarwadi Klaten.Method: The method used was a case study research design, the sample used was 2 respondents, the research instrument used was the AHRS observation sheet which was carried out before and after Hallucination Generalist Therapy was carried out. Findings: Before Generalist Hallucination Therapy Mr. A was in the category of severe hallucinations while Mr. P was in the category of moderate hallucinations. After Generalist Hallucination Therapy Mr. A was in the category of seeding hallucinations while Mr. P was in the mild category. Implication: There was a decrease in the level of hallucinations after the Hallucination Generalist Therapy was carried out on Mr. A and Mr.P which was carried out for 3 meetings.

Therapeutic Communication Strategies in Nursing Process of Angry, Anxious, and Fearful Schizophrenic Patients

Schizophrenia is a group of psychotic disorders with primary personality disorders, characteristic distortions of thought processes. Schizophrenic disorders are characterized by fundamental and characteristic distortions of thought and perception and incompatible or blunted effects. Anger, anxiety, and fear are the most common hallucinations in Schizophrenic patients. These feelings drive the continued negative behaviour of the Schizophrenic patient. The therapeutic communication technique in the nursing process is one of the techniques in the healing process of patients, especially those with mental disorders nursing problems. This study was conducted based on anxiety about the results of observations, preliminary research, and reports obtained about the number of therapy failures for Schizophrenic patients caused by communication errors during treatment. In this study, researchers aimed to determine the Therapeutic Communication of Nurses to Patients. This qualitative research uses a Quasy-experimental design using a One-Group Pre-Post Test Design research design. The conclusion emerged in the study that 22 people (88%) of respondents were in the Bad category in controlling negative thoughts. Meanwhile, three respondents (12%) have an excellent ability to control negative thoughts. There are also research results that show 3 variables that support effective and efficient therapeutic communication. These are Build Trust, Troubleshooting with Constructive Coping, and Giving Appreciation.

Pengaruh Terapi Aktivitas Kelompok (TAK) : Stimulus Persepsi Sesi 1-3 Terhadap Kemampuan Mengontrol Halusinasi Pendengaran Pada Pasien Skizofernia

Schizophrenia is a mental disorder characterized by abnormalities in the perception or expression of reality. One of the most common symptoms in schizophrenia is the appearance of hallucinations, which is about 70%. Purpose: This study is to effect Group Activity Therapy (TAK): Perception Stimulus sessions 1-3 on the Ability to Control Hearing Hallucinations in Schizophrenic Patients in Sebayang Room at Tampan Mental Hospital, Riau Province. This research research method is quantitative with a Quasi Experiment approach, conducted on 16 respondents from 03 to 13 March 2020 at the Tampan Mental Hospital, Riau Province. Researchers used the Auditory Hallucinations Rating Scale (AHRS) module and evaluation sheet before and after the intervention. The technique used univariate and bivariate analysis with Paired Sample T Test. The results showed a significant influence between Group Activity Therapy (TAK) Perceptual Stimulation of the Ability to Control Auditory Hallucinations, with a value of p = 0.01.

Penerapan Terapi Psikoreligius : Zikir Terhadap Tanda dan Gejala Serta Kemampuan Mengatasi Halusinasi

Introduction: Mental disorders are brain disorders characterized by disruption of emotions, thought processes, behavior and perceptions. Auditory hallucinations are hearing voices or noises in the form of less loud noises to clear words talking about the client, even to a complete conversation between two or more people where the client is told to do something that is sometimes dangerous. Useful Aim: This study aims to see the signs and symptoms of auditory hallucinations and the ability to overcome hallucinations in schizophrenic patients after being given psychoreligious therapy: dhikr in the Abung Kunang Community Health Center, North Lampung Regency. Research Methods: Using the method of giving nursing actions in the form of psychoreligious therapy: remembrance of 2 schizophrenic patients who experienced auditory hallucinations nursing problems. Reported in the form of case studies. Results: The results obtained were a decrease in signs and symptoms of hallucinations and an increase in the patient's ability to cope with hallucinations. Suggestion: Nurses are expected to provide the optimal application of psychoreligious therapy: dhikr to patients who have auditory hallucinations nursing problems.

The Effectiveness of Drawing Occupation Therapy on the Ability to Control Hallucinations in Schizophrenia: Literature Review

Hallucinations are a symptom of mental disorders during which the patient can experience changes in, or receive false messages from, sensory perceptions. Nursing approaches for patients suffering hallucinations are focused on physical, intellectual, emotional and socio-spiritual aspects. One of the therapeutic modalities in the management of schizophrenic patients with hallucinations is occupational therapy, such as drawing activities. The drawing activity aims to minimize the patient’s interaction with their own world; release thoughts, feelings, or emotions that have been affecting the behavior; provide motivation and entertainment; and distract the patient from the hallucinations experienced. The purpose of this study was to summarize the results of studies which explain that occupational drawing therapy can control hallucinations in schizophrenic patients. The research method used is literature review from the search results conducted through Google Scholar. 29 articles were obtained with a combination of the key words including ‘Occupational Therapy’, ‘Drawing’ and ‘Hallucination’ Then the researchers conducted a screening by focusing according to the topic of discussion, so that only 3 articles were obtained that met all the search criteria. The results showed that occupational therapy was effective in controlling hallucinations in schizophrenic patients. It is expected to be a reference in the provision of therapeutic modalities and further research development.
 
 Keywords: Schizofrenia, Hallucinations, Occupational Drawing Therapy

The Effects of Cognitive Therapy on Changes in Symptoms of Hallucinations in Schizophrenic Patients

Schizophrenia is a disease that affects various areas of individual function, including thinking, communicating,accepting, interpreting reality, feeling, and showing emotions. Non-pharmacological therapy given toovercome hallucinations of schizophrenic patients is cognitive therapy. The purpose of this study was todetermine the effect of cognitive therapy on changes in hallucinatory symptoms in schizophrenic patientsat Prof. Dr. M. Ildrem Mental Hospital in Medan. The design of this study is Quasi-Experimental OneGroup Pre and Post-test design, The study population was all hallucinatory patients with a total of 286 anda sample of 19 respondents. The sampling technique uses purposive sampling. Data collection tools usinga questionnaire that has been tested for validity. The statistical test used is the paired t test. The results ofthis study obtained the value of p = 0,000 (p <0.05). In conclusion, there is a significant effect on changes inhallucinatory symptoms in schizophrenic patients before and after cognitive therapy.

Pengaruh Terapi Psikoreligious: Dzikir dalam Mengontrol Halusinasi Pendengaran Pada Pasien Skizofrenia yang Muslim di Rumah Sakit Jiwa Tampan Provinsi Riau

Data from the American Psychological Association (APA) in 2010 and Riskesdas 2013 show that on the average world population has schizophrenia and 70% of schizophrenic patients experience hallucinations. One of the recommended therapies in an effort to control hallucinations is psychoreligious therapy: dhikr. The purpose of this study was to determine the effect of psycho-religious therapy: dhikr in controlling hallucinations in schizophrenia patients. The research method used is quantitative with a Quasy expriemental approach carried out on 20 respondents at the Tampan Mental Hospital, Riau Province. Researchers used the Auditory Hallucinations Rating Scale (AHRS) module and evaluation sheet before and after the intervention. The results showed that there was an effect of psychoreligious therapy: dhikr in controlling hallucinations in schizophrenic patients (p value = 0,000). The results of this study can be used as additional therapy in controlling hallucinations in patients with auditory hallucinations.

AUDITORY BRAINSTEM RESPONSE ABNORMALITIES IN SCHIZOPHRENIC PATIENTS WITH AUDITORY HALLUCINATIONS

Background : although the exact pathogenesis of auditory hallucinations is not yet known, some suggested the impairment of perception and processing of auditory information as a possible explanation. So, the aim of this study is to evaluate auditory pathways of schizophrenic patients using auditory brainstem responses (ABR). Methods : schizophrenic patients with auditory hallucinations and age and sex matched healthy non-relative controls were recruited in this case-control study. Scale for assessment of positive symptoms (SAPS) was used for rating the severity of hallucinations. Then, ABR recorded from all participants and the latencies of waves I, II, III, IV, V and inter-peak latencies (IPL) of waves I-III, III-V were analyzed on both sides. Chi squire and independent t tests were applied for statistical analysis. P-value≤0.05 was considered significant. Results : 39 patients and 35 controls were included. Latencies of waves III and V and IPL of III-V were significantly prolonged on the left side. Disease duration had no influence on the results. Conclusion : there is a link between abnormal ABRs and auditory hallucinations in schizophrenic patients that indicates dysfunction and abnormal asymmetry of auditory pathways in these patients.

Use of transcranial direct current stimulation for the treatment of auditory hallucinations of schizophrenia - a systematic review.

IntroductionAuditory hallucinations are defined as experiences of auditory perceptions in the absence of a provoking external stimulus. They are the most prevalent symptoms of schizophrenia with high capacity for chronicity and refractoriness during the course of disease. The transcranial direct current stimulation (tDCS) – a safe, portable, and inexpensive neuromodulation technique – has emerged as a promising treatment for the management of auditory hallucinations.ObjectiveThe aim of this study is to analyze the level of evidence in the literature available for the use of tDCS as a treatment for auditory hallucinations in schizophrenia.MethodsA systematic review was performed, searching in the main electronic databases including the Cochrane Library and MEDLINE/PubMed. The searches were performed by combining descriptors, applying terms of the Medical Subject Headings (MeSH) of Descriptors of Health Sciences and descriptors contractions. PRISMA protocol was used as a guide and the terms used were the clinical outcomes (“Schizophrenia” OR “Auditory Hallucinations” OR “Auditory Verbal Hallucinations” OR “Psychosis”) searched together (“AND”) with interventions (“transcranial Direct Current Stimulation” OR “tDCS” OR “Brain Polarization”).ResultsSix randomized controlled trials that evaluated the effects of tDCS on the severity of auditory hallucinations in schizophrenic patients were selected. Analysis of the clinical results of these studies pointed toward incongruence in the information with regard to the therapeutic use of tDCS with a view to reducing the severity of auditory hallucinations in schizophrenia. Only three studies revealed a therapeutic benefit, manifested by reductions in severity and frequency of auditory verbal hallucinations in schizophrenic patients.ConclusionAlthough tDCS has shown promising results in reducing the severity of auditory hallucinations in schizophrenic patients, this technique cannot yet be used as a therapeutic alternative due to lack of studies with large sample sizes that portray the positive effects that have been described.

EEG Theta Power and Coherence to Octave Illusion in First-Episode Paranoid Schizophrenia with Auditory Hallucinations

Background: The exact mechanism behind auditory hallucinations in schizophrenia remains unknown. A corollary discharge dysfunction hypothesis has been put forward, but it requires further confirmation. Electroencephalography (EEG) of the Deutsch octave illusion might offer more insight, by demonstrating an abnormal cerebral activation similar to that under auditory hallucinations in schizophrenic patients. Methods: We invited 23 first-episode schizophrenic patients with auditory hallucinations and 23 healthy participants to listen to silence and two sound sequences, which consisted of alternating 400- and 800-Hz tones. EEG spectral power and coherence values of different frequency bands, including theta rhythm (3.5-7.5 Hz), were computed using 32 scalp electrodes. Task-related spectral power changes and task-related coherence differences were also calculated. Clinical characteristics of patients were rated using the Positive and Negative Syndrome Scale. Results: After both sequences of octave illusion, the task-related theta power change values of frontal and temporal areas were significantly lower, and the task-related theta coherence difference values of intrahemispheric frontal-temporal areas were significantly higher in schizophrenic patients than in healthy participants. Moreover, the task-related power change values in both hemispheres were negatively correlated and the task-related coherence difference values in the right hemisphere were positively correlated with the hallucination score in schizophrenic patients. Limitations: We only tested the Deutsch octave illusion in primary schizophrenic patients with acute first episode. Further studies might adopt other illusions or employ other forms of schizophrenia. Conclusion: Our results showed a lower activation but higher connection within frontal and temporal areas in schizophrenic patients under octave illusion. This suggests an oversynchronized but weak frontal area to exert an action to the ipsilateral temporal area, which supports the corollary discharge dysfunction hypothesis.

IS 6. Trials in psychiatry

Psychiatric disorders like depression, anxiety and schizophrenias are currently mainly treated with pharmacotherapeutic and psychotherapeutic methods. The success measured as improvement of symptoms under pharmacotherapeutic and psychotherapeutic treatment strategies is surprisingly good with high effect sizes (>0.8) in randomized controlled trials. However, there is still room and need for improvement. Non-invasive brain stimulation methods like repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are increasingly applied (1) in combination with neuroimaging methods like fMRI, NIRS or EEG in order to better understand the pathophysiological background of the above-mentioned psychiatric disorders or disorder-related symptoms and (2) as an alternative or add-on therapeutic approach. Evidence from multiple studies with rTMS and in the last years also with tDCS points to a major role of a dysfunction of the lateral prefrontal cortex in depression and anxiety and of the temporal cortex in auditory hallucinations in schizophrenic patients. Treatment protocols with rTMS and tDCS focussing on a functional improvement of these brain regions in the respective disorders provide first evidence for a therapeutic application. Both rTMS and tDCS are of increasing importance as methods for an improved understanding of the brain pathophysiology underlying depression, anxiety and schizophrenias as well as methods suitable for a direct therapeutic application in these disorders.

Repetitive transcranial magnetic stimulation in the treatment of auditory hallucinations in schizophrenic patients

Since 1999, most studies have confirmed the initial positive results in the treatment of auditory verbal hallucination (AVH) with repetitive transcranial magnetic stimulation (rTMS) targeted to the classical site in the left temporo-parietal region. However, recent literature has tempered the initial interest in this treatment, requiring a new review on this topic. From the four meta-analyses, the latest reported a moderate effect size of 0.54. Two recent controlled studies, not included in the meta-analyses, failed to observe a significant improvement of AVH after 1 Hz rTMS. While almost all trials have studied the effects of low-frequency rTMS (1Hz), two recent procedures using high-frequency (20 Hz) or continuous theta burst stimulation showed promising results. The interest in using cerebral imaging to increase the efficacy of rTMS in the treatment of AVH has not been clearly demonstrated. Using rTMS to treat auditory hallucinations now seems less promising than it did 10 years ago because of the variable clinical effects and the high level of placebo responders. Evidence is still lacking concerning the maintenance treatment and the neurobiological underpinnings of rTMS efficacy, underscoring the need for further studies.

P14.14 Treatment of hallucinations in schizophrenic patients with repetitive transcranial magnetic stimulation

P14.14 Treatment of hallucinations in schizophrenic patients with repetitive transcranial magnetic stimulation

Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study

BackgroundSchizophrenia is a chronic and disabling disease that presents with delusions and hallucinations. Auditory hallucinations are usually expressed as voices speaking to or about the patient. Previous studies have examined the effect of repetitive transcranial magnetic stimulation (TMS) over the temporoparietal cortex on auditory hallucinations in schizophrenic patients. Our aim was to explore the potential effect of deep TMS, using the H coil over the same brain region on auditory hallucinations.Patients and methodsEight schizophrenic patients with refractory auditory hallucinations were recruited, mainly from Beer Ya'akov Mental Health Institution (Tel Aviv university, Israel) ambulatory clinics, as well as from other hospitals outpatient populations. Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions. Deep TMS was applied using Brainsway's H1 coil apparatus. Patients were evaluated using the Auditory Hallucinations Rating Scale (AHRS) as well as the Scale for the Assessment of Positive Symptoms scores (SAPS), Clinical Global Impressions (CGI) scale, and the Scale for Assessment of Negative Symptoms (SANS).ResultsThis preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%).ConclusionsIn this study, we have demonstrated the potential of deep TMS treatment over the temporoparietal cortex as an add-on treatment for chronic auditory hallucinations in schizophrenic patients. Larger samples in a double-blind sham-controlled design are now being preformed to evaluate the effectiveness of deep TMS treatment for auditory hallucinations.Trial registrationThis trial is registered with clinicaltrials.gov (identifier: NCT00564096).

Variación en el gen del transportador de serotonina y alucinaciones auditivas en la psicosis

To study the role of the serotonin transporter gene (SLC6A4) in the emotional processing of auditory hallucinations can be particularly important to better understand the pathophysiology of auditory hallucinations. Moreover, a poly-morphism located in this gene (5-HTTLPR) has been previously associated with different disorders related to altered emotional responses. The aim of this study was to evaluate the relationship between different polymorphisms of the SLC6A4 gene and different aspects of auditory hallucinations in schizophrenic patients, with a special consideration toward the emotional response to auditory hallucinations. Two samples of 224 patients with auditory hallucinations and 346 healthy subjects were studied. AH were assessed in patients through the PSYRATS scale for auditory hallucinations. Several polymorphisms located within the SLC6A4 gene were analysed through case-control comparisons as well as association analyses with different parameters of auditory hallucinations. No differences were found between patients and controls for any of the analysed polymorphisms (p > 0.05). However, the evaluation of auditory hallucinations parameters showed that the low expressing alleles of the 5-HTTLPR polymorphism were associated with higher levels of intensity of the distress caused by auditory hallucinations (p = 0.049 corrected for the item 'intensity of distress'). There was also a trend with the parameter disruption (p = 0.06 corrected). These two items of the PSYRATS scale are directly related to the emotional dimension of auditory hallucinations. In contrast, we did not observe any association with items related to other dimensions of auditory hallucinations. Our results support a possible role of the serotonin transporter in the emotional response to auditory hallucinations.

Two-day treatment of auditory hallucinations by high frequency rTMS guided by cerebral imaging: A 6 month follow-up pilot study

Background Recently, repetitive Transcranial Magnetic Stimulation (rTMS) has been introduced as an alternative treatment for auditory hallucinations in schizophrenic patients that fail to respond to antipsychotics. Until now, application of rTMS has been at low frequency, and most commonly applied to the left temporoparietal cortex. This 6-month follow-up pilot study was performed to demonstrate the efficacy of high frequency rTMS guided by anatomical and functional Magnetic Resonance Imaging (MRI). Methods Eleven patients with schizophrenia (DSM-IV) were treated with high frequency (20 Hz) rTMS delivered over 2 days; they were then followed for 6 months. The target area was identified by fMRI as the highest activation cluster along the posterior part of the left superior temporal sulcus from the BOLD signal of each subject during a language task. Results A significant reduction in global severity and frequency of auditory hallucinations between baseline and post-treatment day 12 was observed. Auditory hallucinations were entirely relieved at 6-month follow-up in 2 patients. The treatment was well tolerated in all patients. Conclusions This is the first study reporting successful treatment of auditory hallucinations with 20 Hz rTMS. The efficacy at short term, the strength of the clinical response, the persistence of therapeutic effect over a 6-month follow-up, the safety profile, and the short duration of treatment present a considerable therapeutic gain compared to low frequency rTMS.

Disembodied hallucinatory voices: Comment on Sommer et al., 2008 Brain 131, 3169-77

Sir, Sommer et al . (2008) recently reported increased activation of the right anterior insula during auditory verbal hallucinations in schizophrenic patients, and they related this observation to the negative emotional content and low linguistic complexity of the disembodied voice reported by the patients. They regarded the asymmetric activation in the right insula as the most significant finding. I support their interpretation, but I believe that another finding in their data deserves strong emphasis, because it significantly extends the functional interpretation of their results. Recent evidence indicates that the anterior insula and the anterior cingulate cortices on both sides of the brain are tightly interconnected to form a ‘core control network’ that is involved in all cognitive, emotional and attentional processes in normal …

Chronic Auditory Hallucinations in Schizophrenic Patients: MR Analysis of the Coincidence between Functional and Morphologic Abnormalities

To prospectively evaluate if functional magnetic resonance (MR) imaging abnormalities associated with auditory emotional stimuli coexist with focal brain reductions in schizophrenic patients with chronic auditory hallucinations. Institutional review board approval was obtained and all participants gave written informed consent. Twenty-one right-handed male patients with schizophrenia and persistent hallucinations (started to hear hallucinations at a mean age of 23 years +/- 10, with 15 years +/- 8 of mean illness duration) and 10 healthy paired participants (same ethnic group [white], age, and education level [secondary school]) were studied. Functional echo-planar T2*-weighted (after both emotional and neutral auditory stimulation) and morphometric three-dimensional gradient-recalled echo T1-weighted MR images were analyzed using Statistical Parametric Mapping (SPM2) software. Brain activation images were extracted by subtracting those with emotional from nonemotional words. Anatomic differences were explored by optimized voxel-based morphometry. The functional and morphometric MR images were overlaid to depict voxels statistically reported by both techniques. A coincidence map was generated by multiplying the emotional subtracted functional MR and volume decrement morphometric maps. Statistical analysis used the general linear model, Student t tests, random effects analyses, and analysis of covariance with a correction for multiple comparisons following the false discovery rate method. Large coinciding brain clusters (P < .005) were found in the left and right middle temporal and superior temporal gyri. Smaller coinciding clusters were found in the left posterior and right anterior cingular gyri, left inferior frontal gyrus, and middle occipital gyrus. The middle and superior temporal and the cingular gyri are closely related to the abnormal neural network involved in the auditory emotional dysfunction seen in schizophrenic patients.

Near-infrared spectroscopy for the guidance of inhibitory rTMS treatment of auditory verbal hallucinations in schizophrenic patients

Background and aimsAuditory verbal hallucinations (AVHs) are among the most frequent and disabeling symptoms of schizophrenic diseases. In approximately one quarter of patients, AVHs have to be considered as therapy-refractory with regard to pharmacological treatment options. This group of patients may benefit from a treatment protocol with repetitive Transcranial magnetic stimulation (rTMS) aiming on an inhibition of AVH-associated increased activity of auditory brain areas in the temporal cortex. However, optimal protocols for the guidance and control of such innovative treatment regimens are still lacking.MethodsWe propose the application of a non-invasive optical imaging technique (functional Near-Infrared Spectroscopy; fNIRS) for the measurement of the AVH-related activity of the auditory cortex, for the guidance of the rTMS-treatment and for the control of a treatment success on the brain metabolic level.ResultsIn the reported patient, NIRS measurement indicated AVH-related activity in the left auditory cortex which strongly decreased after a period of three weeks with daily inhibitory rTMS treatment, in parallel with drastically diminished AVHs.ConclusionsThis is the first report of a NIRS-guided and –controlled inhibitory rTMS treatment of therapy-refractory AVHs in a schizophrenic patient. Given the excellent clinical applicability of the applied methods, the combination of fNIRS and rTMS might have the potential to establish new treatment options in psychiatry aiming on the modulation of pathological regional brain activity patterns.