Hallucinatory disorder, an original clinical picture? Clinical and imaging data.
OBJECTIVE
The aim of this study was to verify the existence of areas of clinical and neurofunctional homogeneity in a group of patients with auditory verbal hallucinations (AVHs) as an isolated symptom, attributable to what we have called "Hallucinatory Disorder" (HD) in an attempt to propose a clinical picture that is distinct from Schizophrenia.


METHODS
Nine patients clinically characterised by chronic AVHs were compared with nine schizophrenic patients using the Structured Clinical Interview for DSM-III-R, BPRS, PANSS, SAPS, SANS, HRS-A, HRS-D, CDSS, MMSE, CGI and PSYRATS. Both groups of patients and nine healthy subjects underwent EEG and SPECT examinations.


RESULTS
Considering the psychopathological dimensions of Schizophrenia, in the HD patients clinical evaluations revealed a mono-dimensional clinical profile, whereas all these dimensions contributed to the clinical picture of the schizophrenic patients. The SPECT data showed that the schizophrenic patients had a reduced rCBF in some areas of the right frontal lobe, while the HD patients did not show any area of hypoperfusion. The SPECT hyperperfusion data showed an activation pattern in the HD patients that was characterised by the involvement of various cortical and subcortical cerebral areas, similar to those found in studies of inner speech and auditory verbal imagery.


CONCLUSIONS
The two groups of patients present significant differences that seem capable of supporting the proposed hypothesis that HD may be an independent nosographical entity.
Clinical Psychiatry, Clinical Neuropsycopharmacology Unit, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. maurimc@policlinico.mi.it
Massimo C
MC
Mauri
Marco
M
Gaietta
Filippo
F
Dragogna
Isabel
I
Valli
Giancarlo
G
Cerveri
Giorgio
G
Marotta
D000328:Adult; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D007839:Functional Laterality / Q000502:physiology; D006212:Hallucinations / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012565:Schizophrenic Psychology; D009626:Terminology as Topic; D015899:Tomography, Emission-Computed, Single-Photon