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.


METHODS
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.


CONCLUSIONS
Many patients express a desire to preserve these voices. Voice characteristics do not allow for validly discriminating psychotic from non-psychotic disorders.
Jenner
J A
JA
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. j.a.jenner@psy.umcg.nl
Rutten
S
S
Beuckens
J
J
Boonstra
N
N
Sytema
S
S
D000328:Adult; D000339:Affect; D004644:Emotions; D005260:Female; D006212:Hallucinations / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D012959:Socioeconomic Factors