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Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology common cause common interventions?

机译：精神分裂症和创伤后应激障碍的听觉言语幻觉：常见的现象学常见的原因常见的干预措施？

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Auditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual’s personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed ‘dissociative AVH’) and AVH in schizophrenia (so-called ‘psychotic AVH’) needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.
机译：精神分裂症和创伤后应激障碍（PTSD）均发现听觉言语幻觉（AVH：“听见的声音”）。在本文中，我们首先证明这两种诊断中的AVH在质上有相似的现象。然后，我们证明精神分裂症中AVH​​的存在通常与更早地暴露于创伤性/情绪压倒性事件有关，正如PTSD中的定义。接下来，我们认为，在创伤后应激障碍和精神分裂症中，AVH的内容与早期创伤事件的发生方式相似，通常与情感压倒性事件具有直接或间接的主题联系，而不是直接重新体验。然后，我们根据PTSD的认知模型提出，记忆的重构性质可能能够解释创伤和AVH内容之间的这些关联的性质，例如威胁过度警惕和个人的个人目标。我们得出的结论是，在被诊断为AVH的精神分裂症患者中，有一个显着子集的现象和病因学经验与听取声音的PTSD患者相同。因此，我们建议将PTSD中的AVH（通常称为“分离性AVH”）和精神分裂症中的AVH（所谓的“精神病性AVH”）之间的铁幕拆除，因为这些经验通常是相同的。这意味着这些与创伤有关的AVH需要通用的经诊诊断策略。尽管抗精神病药已越来越多地用于治疗PTSD中的AVH，但我们认为PTSD和诊断为精神分裂症的患者中基于创伤的干预对于基于创伤的AVH的重要性。

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