Objective: This study compares the phenomenology of hallucinations in a series of hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and schizophrenia.
Methods: Subjects admitted to a tertiary adolescent inpatient unit were screened for hallucinations. Those reporting hallucinations were asked standardized questions relating to these experiences. Hallucinations in subjects with a primary diagnosis of schizophrenia or PTSD were compared.
Results: Hallucinations in both schizophrenia and PTSD have similar form and content. Frequent, vivid, realistic, external hallucinations occurred in both disorders. Hallucinations in PTSD were usually derogatory and related to self-harm, but not direct reflections of traumatic events. Patients with PTSD reported greater emotional distress, self-harm and suicidal ideation than those with schizophrenia.
Conclusions: This case series suggests that the phenomenology of hallucinations in adolescents with schizophrenia and PTSD is similar.
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References
1.
van OsJHanssenMBijlRV. Strauss 1969 revisited: a psychosis continuum in the general population?. Schizophrenia Research2000; 45: 11–20.
2.
PretiABonventreELeddaVPetrettoDMasalaC. Hallucinatory experiences, delusional thought proneness and psychological distress in a nonclinical population. The Journal of Nervous and Mental Disease2007; 195: 484–491.
3.
DhosscheDFerdinandRVan der EndeJHofstaMVerhulstF. Diagnostic outcome of self-reported hallucinations in a community sample of adolescents. Psychological Medicine2002; 32: 619–627.
4.
YoshizumiTMuraseSHonjoSKanekoHMurakamiT. Hallucinatory experiences in a community sample of Japanese children. Journal of the American Academy of Child & Adolescent Psychiatry2004; 43: 1030–1036.
5.
SareenJCoxBJGoodwinRDAsmundsonGJG. Co-occurrence of posttraumatic stress disorder with positive psychotic symptoms in a nationally representative sample. Journal of Traumatic Stress2005; 18: 313–322.
6.
ShevlinMDorahyMAdamsonG. Childhood traumas and hallucinations: An analysis of the National Comorbidity Survey. Journal of Psychiatric Research2007; 41: 222–228.
7.
SpauwenJKrabbendamLLiebRWittchenHUvan OsJ. Impact of psychological trauma on the development of psychotic symptoms: Relationship with psychosis proneness. British Journal of Psychiatry2006; 188: 527–533.
8.
HavilandMGSonneJLWoodsLR. Beyond posttraumatic stress disorder: Object relations and reality testing disturbances in physically and sexually abused adolescents. Journal of the American Academy of Child and Adolescent Psychiatry1995; 34: 1054–1059.
9.
LipschitzDWinegarRHartnickE. Post traumatic stress disorder in hospitalised adolescents: psychiatric comorbidity and clinical correlates. Journal of the American Academy Child and Adolescent Psychiatry1999; 38: 385–392.
10.
ScottJNurcombeBSheridanJMcFarlandM. Hallucinations in adolescents with post-traumatic stress disorder and psychotic disorder. Australasian Psychiatry2007; 15: 44–48.
11.
HornsteinNPutnamF. Clinical phenomenology of child and adolescent dissociative disorders. Journal of the American Academy of Child and Adolescent Psychiatry1992; 31: 1077–1085.
12.
DellPFEisenhowerJW. Adolescent multiple personality disorder: a preliminary study of eleven cases. Journal of the American Academy of Child and Adolescent Psychiatry1990; 29: 359–366.
13.
NurcombeBMitchellWBegtrupRTramontanaMLaBarberaJPruittJ. Dissociative hallucinosis and allied conditions. Psychoses and Pervasive Developmental Disorders of Childhood and Adolescence, VolkmarFR. American Psychiatric Press, Washington, DC1996.
14.
CoonsPM. Clinical phenomenology of 25 children and adolescents with dissociative disorders. Child and Adolescent Psychiatric Clinics of North America1996; 5: 361–372.
15.
PutnamFW. Dissociative disorders in children: Behavioral profiles and problems. Child Abuse and Neglect1993; 17: 39–45.
16.
YungAR, McGorryPD, FranceySM, et al. PACE: a specialised service for young people at risk of psychotic disorders. Medical Journal of Australia2007, 187(7 Suppl): S43–S46.
17.
HonigARommeMEnsinkBEscherSPenningsMDevriesM. Auditory hallucinations: a comparison between patients and non-patients. The Journal of Nervous and Mental Disease1998; 18: 646–651.
18.
FamularoRKinscherffRFentonT. Psychiatric diagnosis of maltreated children: preliminary findings. Journal of the American Academy Child and Adolescent Psychiatry1996; 31: 863–867.
19.
KaufmanJBirmaherBBrentD. Schedule for Affective Disorders and Schizophrenia for School-age Children – Present and Life Time Version (KSADS-PL): initial reliability and validity data. Journal of the American Academy Child and Adolescent Psychiatry1997; 36: 980–987.
20.
KayS. Positive and Negative Syndromes in Schizophrenia. Brunner/ Mazel, New York1991.
21.
OverallJGorhamD. The Brief Psychiatric Scale. Psychological Reports1962; 10: 799–812.
22.
MiddletonWButlerJ. Dissociative Identity Disorder: an Australian series. Australian and New Zealand Journal of Psychiatry1998; 32: 794–804.
23.
HamnerMFruechCUlmerH. Psychotic features in chronic posttraumatic stress disorder and schizophrenia. Journal of Nervous and Mental Diseases2000; 188: 217–221.
24.
UcokABikmakS. The effects of childhood trauma in patients with first-episode schizophrenia. Acta Psychiatrica Scandinavica2007; 116: 371–377.
25.
JanssenIKrabbendamLBakM. Childhood abuse as a risk factor for psychotic experience. Acta Psychiatrica Scandinavica2004; 109: 38–45.
