Auditory Verbal Hallucinations in Psychosis: Abnormal Perceptions or Symptoms of Disordered Thought?

Auditory verbal hallucinations (AVHs) are considered as hallmark symptoms of psychosis, more specifically of schizophrenia. A substantial body of evidence indicates that AVHs can be attributed to a disorganization of overall speech capacity in psychotic subjects. AVHs are associated with activation of cortical areas of the brain that are related to speech production and perception; “voices” in deaf patients seem to be about the message rather than the sound of it; the content of AVHs is often related to that of delusional ideas; the internal or external location of AVHs makes little diagnostic difference; AVHs are often related to the patient's subvocal speech, having identical content with that, and they have been theorized as a misattribution of inner speech (i.e., the patient's own thoughts) to external sources. The aforementioned evidence comes close to certain long-standing insights mainly of the French psychiatric (de Clérambault) and psychoanalytical (Lacan) school, according to which, 1) the outside world is perceived through normal language function, 2) a language disorder is central to schizophrenic phenomena, and 3) AVHs represent a fragmentation and autonomization of speech (thought) function in schizophrenic patients (de Clérambault: “hallucinations think”). Today, several authors agree that 1) operationalized definitions have led to an oversimplification of psychopathology, and 2) a more theoretically informed understanding ...
Source: The Journal of Nervous and Mental Disease - Category: Psychiatry Tags: Brief Report Source Type: research

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