Auditory hallucinations

Introduction Auditory hallucinations are a distorted or peculiar hearing, and there is no corresponding external acoustic stimulus for the auditory organs. The patient sometimes hears someone calling for help, but the sound does not exist in the actual external sound field. Auditory hallucinations are divided into critical auditory hallucinations, imperative auditory hallucinations, controversial auditory hallucinations and thinking sounds. 1Commental auditory hallucinations: When you hear others talking about yourself, the content of the arguments is negatively criticized, satirized, scolded, and framed. 2 Commanding auditory hallucinations: I hear a voice commanding myself to do something, such as beating, refusing to eat, committing suicide or self-injury. 3 Controversial auditory hallucinations: The content of auditory hallucinations has nothing to do with the patient himself. The patient hears arguments from two other people. Sometimes the content of the tongue war can be patient-centered. 4 Thinking sounds: While the patient feels the thinking activity, the words appearing in the brain with the same thinking activities appear with the thinking activities.

Cause

The causes of auditory hallucinations are psychological factors, such as excessive mental stress, certain diseases of the body, such as auditory central disorders or mental illness; drug effects, such as smoking or injecting excessive anesthetics, smoking marijuana and mischievous hallucinogenic substances, drug allergies, etc.

Physiological mechanism

The physiological mechanism of auditory hallucinations is not fully understood. Modern clinical research believes that auditory hallucinations are the result of the brain's auditory center processing errors. We are not facing a silent world. The normal human hearing transmits the internal and external sound signals correctly to the auditory center. The auditory hearers distort or exaggerate the sound signals due to obstacles in the auditory center, and even modify them according to subjective intentions. It is an auditory abnormality. I think that brain errors extract sound information from memory, and amplification can also lead to auditory hallucinations.

an examination

Related inspection

Hearing examination, brain CT examination

Auditory hallucinations are illusory perceptions that occur in the auditory organs and are common symptoms of mental patients - especially in schizophrenia. After a large amount of clinical data observation. The auditory hallucinations of patients with schizophrenia have the following characteristics;

(1), often appear in the early stages of the disease, but also in the development of the symptoms of the disease. In the early onset of schizophrenia, a small amount of monotonous auditory hallucinations may occur in the early stage. With the progress of the disease and the disease, the amount of auditory hallucinations gradually increases, and the content of auditory hallucinations is gradually enriched. At the beginning, the patient may be skeptical about the sound coming out of thin air, but with the increase in the amount of auditory hallucinations and the richness of the content, the image is realistic, he lost his ability to recognize himself in the auditory hallucination (called loss of self-awareness in psychiatry). And firmly believe. As for the acute onset of schizophrenia, a large number of content-rich auditory hallucinations may suddenly appear, and the patient may be subject to various abnormal thinking, emotions, and behaviors under the control of auditory hallucinations.

(2), the auditory hallucinations of schizophrenia are mostly true auditory hallucinations, but also pseudo-audio auditory. If the patient can tell you clearly. The sound is heard through his ears, and the sound is in the outside world, a certain distance from him. A patient with false auditory hallucinations will specifically say that the sound is not from the outside world, but in his mind or stomach.

(3) The content of auditory hallucinations is varied. The most common is the verbal auditory hallucination, where the patient hears the sound out of thin air. Because it is a true auditory hallucination, the patient can tell whether it is a voice of a few people, a man or a woman. The voice of the voice is the voice of a person who is familiar with him or a person who has never met. The content is varied, with imperative auditory hallucinations, deliberate auditory hallucinations, and deliberative auditory hallucinations. Its content is often unfavorable to the patient, such as arguing, or the patient has made a big mistake. It also orders patients to commit suicide or to surrender themselves.

(4), auditory hallucinations of schizophrenia, and other symptoms, especially delusions exist at the same time. If the patient hears the voice and tells him that someone wants to persecute him, the patient may have a sinister reverie on the basis of auditory hallucinations; some patients may have murderous delusions first, and may produce auditory hallucinations on the basis of murderous delusions; In a certain stage of the disease, only a single hallucinogenic symptom exists.

(5), the auditory hallucinations of schizophrenia, can be different from the country's disease types, such as paranoid schizophrenia patients' auditory hallucinations, often gradually produced and developed, often with delusions. Moreover, the number of auditory hallucinations is from a small to many, and the content has a development process from simple to rich. In the severe stage of the disease, the patient is convinced of the content of the auditory hallucination, so that the auditory hallucination dominates the patient's emotions, will and behavior, and a considerable number of patients refuse to expose their auditory hallucinations. Some paranoid patients seem to listen to what they are listening to, and sometimes they talk to themselves, as if they are talking, expressing anger, excitement, etc. We should be good at observing these behaviors. But when asked what they heard. The patient only replied: "Nothing" Sometimes, the patient is killed by the auditory hallucination and will not tell you directly. When doctors check this paranoid patient, they often need to express their feelings of compassion and concern. "How tired are you all day and noisy! Can you help me with something?" You work together and begin to expose his auditory hallucinations. The auditory hallucinations of paranoid patients often persist in the course of the disease, and only after treatment, the auditory hallucinations will gradually decrease and disappear. Youth-type schizophrenia can also have auditory hallucinations, but its characteristics are often sudden appearances, content is disorderly and not fixed, patients are willing to expose to auditory hallucinations, often waiting for you to ask, they cry to you and say: "I want When the emperor is, it is the voice that tells me..." The patient can be dominated by auditory hallucinations, suddenly impulsive, wounding, and destroying things. Auditory hallucinations can also occur in simple and stressed patients, but mostly monotonous, transient symptoms.

(6) The auditory hallucinations of schizophrenia often develop with the development of the disease and rarely disappear without treatment. After treatment, the auditory hallucinations gradually decreased as the condition improved, and the patient's attitude toward auditory hallucinations gradually became indifferent, and finally the auditory hallucinations disappeared. The reappearance of auditory hallucinations often indicates the fluctuations and recidivism of the disease.

(7), schizophrenia has not been thoroughly treated in the early stage, that is, it has developed into a chronic phase; or due to repeated recidivism of the disease, which eventually leads to a chronic state; some schizophrenia begins to develop, there is no acute attack and the symptoms are particularly serious. It has a slow onset and slow development, and it has a chronic characteristic throughout the disease process. If such chronic patients have auditory hallucinations, the hallucinations are characterized by fragments, monotony, stereotypes, and fixations, such as "You are a bad guy" and "You are a bad guy". At this time, the patient's attitude toward auditory hallucinations is extremely indifferent. The voice is also used to it. Therefore, the patient can go to work in the presence of auditory hallucinations, and participate in medical treatment and entertainment treatment during hospitalization. We call this phenomenon a "peaceful coexistence" between the patient and the auditory hallucination. Extremely stubborn, all kinds of treatments are difficult to eliminate. Some patients can have this residual auditory hallucination for life.

In summary, the auditory hallucinations of schizophrenia have their own unique characteristics, and we can use it as a basis for diagnosing or excluding schizophrenia according to the characteristics of auditory hallucinations. It is also possible to determine which stage of the disease is in the early, developing or chronic phase according to the law of occurrence and development of auditory hallucinations and the unique performance at different stages of the disease. The characteristics of auditory hallucinations can also be used as a reference for classifying disease types.

Differential diagnosis

Hearing sensation: The tympanic membrane muscle that maintains the tympanic membrane is dominated by the pterygoid nerve of the trigeminal nerve branch. The sacral muscle is dominated by the facial nerve, and the two muscles maintain an equilibrium relationship. When the facial nerve is paralyzed, the iliac muscle is paralyzed. Therefore, the tympanic membrane is relatively tense, the tympanic membrane tension is high, and the tiny sound produces strong vibration, which causes hypersensitivity. It is seen in the lesion of the facial nerve above the branch of the sacral muscle. Hearing impairment: refers to the structural defects of the auditory organs due to congenital or acquired causes, or some or all of the obstacles to the function, resulting in difficulty in listening or identifying the sound; the criteria for identification are as follows:

(1) After receiving a self-conscious pure tone hearing test, the hearing frequency of the good ear is more than 25 decibels.

(2) Those who are unable to accept the previous paragraph's self-conscious pure tone hearing test, who are determined by his or her perceptual hearing test.

Ear vestibular hearing imbalance: will stimulate the brain central system to affect the normal work of the pituitary gland. To make the brain feel anxious; under the influence of this anxiety, people are very sensitive to various unsatisfactory things and generate resistance, so these unsatisfactory events will be infinitely magnified, eventually leading to depression and senile anxiety. occur. Hearing fatigue: It is only a temporary physiological phenomenon, and the hearing organs are not damaged. If working under strong noise for many years, the inner auditory organs are often stimulated by strong noise, and this auditory fatigue will be fixed and will not return to normal, resulting in permanent hearing loss or hearing threshold shift. This phenomenon is called noise deafness. Hearing adaptation, short exposure time under strong noise, hearing threshold increased by more than 10dB, and can be recovered after leaving the noise environment for a few minutes. Generally, it is expressed as a decrease in the stimuli sound and the sound sensitivity similar to its frequency, but the decrease is generally temporary, and the sensitivity of the auditory organ returns to normal after a short time after the stimuli are stopped.

Auditory hallucinations are illusory perceptions that occur in the auditory organs and are common symptoms of mental patients - especially in schizophrenia. After a large amount of clinical data observation. The auditory hallucinations of patients with schizophrenia have the following characteristics;

(1) It occurs mostly in the early stages of the disease and can also occur during the development of the symptoms of the disease. In the early onset of schizophrenia, a small amount of monotonous auditory hallucinations may occur in the early stage. With the progress of the disease and the disease, the amount of auditory hallucinations gradually increases, and the content of auditory hallucinations is gradually enriched. At the beginning, the patient may be skeptical about the sound coming out of thin air, but with the increase in the amount of auditory hallucinations and the richness of the content, the image is realistic, he lost his ability to recognize himself in the auditory hallucination (called loss of self-awareness in psychiatry). And firmly believe. As for the acute onset of schizophrenia, a large number of content-rich auditory hallucinations may suddenly appear, and the patient may be subject to various abnormal thinking, emotions, and behaviors under the control of auditory hallucinations.

(2) The auditory hallucinations of schizophrenia are mostly true auditory hallucinations, and there may also be false auditory hallucinations. If the patient can tell you clearly. The sound is heard through his ears, and the sound is in the outside world, a certain distance from him. A patient with false auditory hallucinations will specifically say that the sound is not from the outside world, but in his mind or stomach.

(3) The content of auditory hallucinations is varied. The most common is the verbal auditory hallucination, where the patient hears the sound out of thin air. Because it is a true auditory hallucination, the patient can tell whether it is a voice of a few people, a man or a woman. The voice of the voice is the voice of a person who is familiar with him or a person who has never met. The content is varied, with imperative auditory hallucinations, deliberate auditory hallucinations, and deliberative auditory hallucinations. Its content is often unfavorable to the patient, such as arguing, or the patient has made a big mistake. It also orders patients to commit suicide or to surrender themselves.

(4) The auditory hallucinations of schizophrenia often coincide with other symptoms, especially delusions. If the patient hears the voice and tells him that someone wants to persecute him, the patient may have a sinister reverie on the basis of auditory hallucinations; some patients may have murderous delusions first, and may produce auditory hallucinations on the basis of murderous delusions; In a certain stage of the disease, only a single hallucinogenic symptom exists.

(5) The hallucinatory characteristics of schizophrenia can be different from the different types of diseases in the country. For example, the auditory hallucinations of paranoid schizophrenia patients are often gradually produced and developed, often accompanied by delusions. Moreover, the number of auditory hallucinations is from a small to many, and the content has a development process from simple to rich. In the severe stage of the disease, the patient is convinced of the content of the auditory hallucination, so that the auditory hallucination dominates the patient's emotions, will and behavior, and a considerable number of patients refuse to expose their auditory hallucinations. Some paranoid patients seem to listen to what they are listening to, and sometimes they talk to themselves, as if they are talking, expressing anger, excitement, etc. We should be good at observing these behaviors. But when asked what they heard. The patient only replied: "Nothing" Sometimes, the patient is killed by the auditory hallucination and will not tell you directly. When doctors check this paranoid patient, they often need to express their feelings of compassion and concern. "How tired are you all day and noisy! Can you help me with something?" You work together and begin to expose his auditory hallucinations. The auditory hallucinations of paranoid patients often persist in the course of the disease, and only after treatment, the auditory hallucinations will gradually decrease and disappear. Youth-type schizophrenia can also have auditory hallucinations, but its characteristics are often sudden appearances, content is disorderly and not fixed, patients are willing to expose to auditory hallucinations, often waiting for you to ask, they cry to you and say: "I want When the emperor is, it is the voice that tells me..." The patient can be dominated by auditory hallucinations, suddenly impulsive, wounding, and destroying things. Auditory hallucinations can also occur in simple and stressed patients, but mostly monotonous, transient symptoms.

(6) The auditory hallucinations of schizophrenia often develop with the development of the disease and rarely disappear without treatment. After treatment, the auditory hallucinations gradually decreased as the condition improved, and the patient's attitude toward auditory hallucinations gradually became indifferent, and finally the auditory hallucinations disappeared. The reappearance of auditory hallucinations often indicates the fluctuations and recidivism of the disease.

(7) schizophrenia has not been thoroughly treated in the early stage, that is, it has developed into a chronic phase; or because of repeated epidemics of the disease, it eventually leads to a chronic state; and some schizophrenia begins to develop, there is no stage of acute attack and particularly severe symptoms. It is slowly onset and slowly developing, and it has chronic characteristics throughout the disease process. If such chronic patients have auditory hallucinations, the hallucinations are characterized by fragments, monotony, stereotypes, and fixations, such as "You are a bad guy" and "You are a bad guy". At this time, the patient's attitude toward auditory hallucinations is extremely indifferent. The voice is also used to it. Therefore, the patient can go to work in the presence of auditory hallucinations, and participate in medical treatment and entertainment treatment during hospitalization. We call this phenomenon that the patient has peaceful coexistence with auditory hallucinations. Extremely stubborn, all kinds of treatments are difficult to eliminate. Some patients can have this residual auditory hallucination for life.

In summary, the auditory hallucinations of schizophrenia have their own unique characteristics, and we can use it as a basis for diagnosing or excluding schizophrenia according to the characteristics of auditory hallucinations. It is also possible to determine which stage of the disease is in the early, developing or chronic phase according to the law of occurrence and development of auditory hallucinations and the unique performance at different stages of the disease. The characteristics of auditory hallucinations can also be used as a reference for classifying disease types.

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