title: Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy?
abstract: Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls).
  
  
  
  Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale.
  
  
  
  Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group.
  
  
  
  These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.
authors.affiliation: Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Daalman
authors.affiliation: Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands.
authors.forename: K M J
authors.initials: KM
authors.lastname: Diederen
authors.affiliation: Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Hoekema
authors.affiliation: Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Lutterveld
authors.affiliation: Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands.
authors.forename: I E C
authors.initials: IE
authors.lastname: Sommer
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013067:Speech Perception / Q000502:physiology*
keywords: Hallucinations; need for mental healthcare; psychosis