Hallucinations

It is part of psychiatric folklore that people with schizophrenia act in response to hallucinations but the latter's significance in contributing to criminal behaviour remains uncertain/75) Command hallucinations and their influence on violent behaviour have been studied with conflicting results. For example, in a cohort of outpatients with schizophrenia Zisook et a/.(76) found that those with command hallucinations were no more violent than matched controls. In a sample of forensic patients Rogers et a/.(77> reported that the content of command hallucinations were more violent than other types, and that nearly half the sample reported acting on them with unquestioning obedience. There may be specific factors giving added significance to certain command hallucinations. Cheung et a/.(78) compared violent and non-violent inpatients with schizophrenia and found that violent patients were more likely to experience negative emotion, tone, and content with their hallucinations, although violence was not associated with command hallucinations. Junginger (79) found that compliance with the hallucination was associated with less dangerous commands and with identification by the patient of the commanding voice.

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