Positive and useful auditory vocal hallucinations: prevalence, characteristics, attributions, and implications for treatment.

OBJECTIVE: Auditory hallucinations that are viewed by patients as positive and useful may be barriers to treatment-seeking. The aim was to assess prevalence, impact, and course of, and attributions to, these voices in psychotic and non-psychotic patients. METHOD: One hundred thirty-one patients of a Voices Clinic and 65 members of the Dutch Resonance Foundation were assessed with the Positive and Useful Voices Inquiry. Data were analyzed using Pearson's chi-square, one-way anova, and Crohnbach's alpha statistics. RESULTS: First voices are most often reported as negative. Positive voices occur more among non-psychotic subjects, but the specific characteristics and diagnosis are not significantly associated. Lifetime prevalence of positive and useful voices ranged between 40% and 60%, with varied prevalence rates over time. Positive voices are experienced by subjects as direct addresses in the third person. Perceived control of voices is significantly associated with the wish to preserve them. Attribution of protective power to positive voices has the strongest association with positive experience. CONCLUSION: Many patients express a desire to preserve these voices. Voice characteristics do not allow for validly discriminating psychotic from non-psychotic disorders.

[Positive and negative auditory vocal hallucinations]. / Positieve en nuttige auditieve vocale hallucinaties.

BACKGROUND: Modern psychiatry emphasises the negative aspects of hearing voices. However, experience shows that some patients find these voices positive or useful. AIM: To describe the life-time prevalence of hearing voices in a group of patients and the course of this phenomenon and to find out whether these patients find the hearing of voices positive and/or useful. METHOD: The study population consisted of patients and former patients of the Voices Outpatient Department of the Groningen University Medical Centre. For this study the Positive and Useful Voices Inquiry, a self-report questionnaire was developed. RESULTS: The life-time prevalence of positive voices was 52%, whereas the life-time prevalence of useful voices was 40%. In the majority of patients the number of positive voices decreased and the number of useful remained the same. Positive voices provided protection, reassurance or companionship. Useful voices gave advice, assist with daily activities or decision-making. Thirty two percent of the patients wished to continue hearing positive voices, 40% wished to continue hearing useful voices. These wishes were correlated to patients feeling that they have control over these voices. CONCLUSION: The prevalence of positive and useful voices is quite considerable and is therefore therapeutically relevant. A substantial proportion of the patients wishes to continue hearing these types of voices.