Command hallucinations among Asian patients with schizophrenia.
OBJECTIVE
The impact of command hallucinations on patients and the determinants of patients' compliance with them are still poorly understood. The extant literature is also divided on their association with violence. This study aimed to establish the prevalence of command hallucinations and to identify the factors that affect compliance with the commands, together with patients' coping methods.


METHODS
We recruited 50 consecutive male and 50 consecutive female schizophrenia inpatients who reported hearing voices in the 6 months prior to admission. We interviewed these patients, using a semistructured questionnaire. We collected information on the contents of their auditory hallucinations and their coping methods.


RESULTS
Of the patients, 53 (53%) reported command hallucinations. Of these 53 patients, 58% were women and 48% were men; 62% reported complying with the commands. They were also more likely to comply with nonviolent commands. A history of self-harm predicted compliance. Those patients who did not comply with the commands adopted various methods of coping, of which praying was the most common.


CONCLUSIONS
Command hallucinations are common in patients with schizophrenia. Patients with a history of self-harm need closer monitoring because they may be more likely to comply with these hallucinations. Assessment should also include the patient's own coping strategies, which can be incorporated into the treatment.
Lee
Theresa M Y
TM
Woodbridge Hospital-Institute of Mental Health, Republic of Singapore. Theresa_LEE@imh.com.sg
Chong
Siow Ann
SA
Chan
Yiong Huat
YH
Sathyadevan
Gangaharan
G
D000223:Adaptation, Psychological; D000328:Adult; D001208:Asia / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data*; D002170:Canada; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012559:Schizophrenia / Q000453:epidemiology / Q000208:ethnology*