Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Sep 22, 2016; 6(3): 372-380
Published online Sep 22, 2016. doi: 10.5498/wjp.v6.i3.372
Cognitive behavioural therapy for auditory hallucinations in schizophrenia: A review
Maria Pontillo, Franco De Crescenzo, Stefano Vicari, Maria Laura Pucciarini, Roberto Averna, Ornella Santonastaso, Marco Armando
Maria Pontillo, Stefano Vicari, Maria Laura Pucciarini, Roberto Averna, Ornella Santonastaso, Marco Armando, Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, 00165 Rome, Italy
Franco De Crescenzo, Department of Psychiatry and Psychology, Catholic University of Sacred Heart, 00168 Rome, Italy
Marco Armando, Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, 1211 Geneva, Switzerland
Author contributions: Pontillo M wrote the draft of the manuscript; all authors contributed to the sections of the manuscript, and edited, revised and approved the final version.
Conflict-of-interest statement: Authors declare no conflict of interests for this article. No financial support.
Data sharing statement: Please, note that our article is a secondary study and all the primary data are available to the public in the primary studies cited in the references.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Maria Pontillo, PhD, Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant’Onofrio 4, 00165 Rome, Italy. maria.pontillo@opbg.net
Telephone: +39-06-685927030 Fax: +39-06-68592450
Received: April 28, 2016
Peer-review started: April 28, 2016
First decision: June 16, 2016
Revised: July 26, 2016
Accepted: August 6, 2016
Article in press: August 9, 2016
Published online: September 22, 2016
Processing time: 143 Days and 21.8 Hours
Abstract
AIM

To provide an updated of recent findings about efficacy of cognitive-behavior therapy (CBT) in reduction of command hallucinations.

METHODS

PubMed/MEDLINE, Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, ClinicalTrial.gov searches were performed using the keywords “hallucinations”, “behavioural therapy” and “ cognitive therapy” in order to identify relevant articles published during the years of 2011 to 2016. No language limits were used. Studies conducted within control group, reviews, editorials, were excluded. Data on efficacy, acceptability and tolerability were extracted by three authors independently. Disagreements were resolved in a consensus meeting or by another reviewer.

RESULTS

A total of eight articles were eligible for inclusion. Two are randomized clinical trials (RCTs) and six are observational studies. The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations (AHs). Nevertheless, they considered different CBT models, particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations. As regards non RCT-studies, all papers included showed reduction on frequency and severity of AHs and distress related to them. However, the lack of content details within non-RCTs studies decreased their comparability. In terms of predictive variables, our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy. Indeed, negative symptoms showed a significant negative correlation on outcome.

CONCLUSION

Although more conclusive studies are still needed, we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.

Keywords: Auditory hallucinations; Cognitive-behavior therapy; Schizophrenia; Psychotic disorder; Treatment; Distress; Functional impairment

Core tip: Auditory hallucinations (AHs), especially command hallucinations, represent a special problem for the clinical management of schizophrenia and contribute significantly to distress and disability related to this disorder. The aim of this article is to review the current knowledge and evidence on the efficacy of cognitive-behavior therapy interventions in AHs.