Command hallucinations and the prediction of dangerousness.
OBJECTIVE
Recent studies have supported the belief that command hallucinations can induce dangerous behavior. This study tried to replicate previous findings that compliance with the command was associated with delusions related to hallucinations and the ability to identify the hallucinated voice. This study also assessed the association between compliance and the dangerousness of the command, chronicity of illness, a diagnosis of schizophrenia, and past compliance with hallucinated commands.


METHODS
The most recent command hallucination reported by 93 psychiatric inpatients was rated for level of dangerousness and level of compliance with the command.


RESULTS
Subjects who experienced less dangerous commands or who could identify the hallucinated voice reported higher levels of compliance, although reported compliance with more dangerous commands was not uncommon. Commands experienced in the hospital were less dangerous than those experienced elsewhere and tended to be specific to the hospital environment. Subjects were less likely to comply with commands experienced in the hospital.


CONCLUSIONS
Based on their self-reports, psychiatric patients who experience command hallucinations are at risk for dangerous behavior. Ability to identify the hallucinated voice is a fairly reliable predictor of reported compliance. Level of dangerousness resulting from compliance with command hallucinations may be a function of the patient's environment.
Junginger
J
J
Department of Psychology, State University of New York at Binghamton 13902, USA.
D003617:Dangerous Behavior; D003702:Delusions / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D011336:Probability; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index