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Ask the Mental Health Expert Archives 2001-2004

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Auditory Hallucinations

Q. Standard text books in psychiatry says that a person with sensory impairment like deafness can have auditory hallucinations. Can a person with early profound deafness (eg, in cases like cogenital cochlear aplasia) have auditory hallucination?

A. According to Barbara Haskins, M.D.--an expert in the field of deafness and psychiatric disorders--"Deaf patients can hear voices, even if they have been deaf from birth and have never heard sound...there is ongoing debate about the neural mechanisms for this." (See Psychiatric Times, December 2000; and Altshuler KZ, Am J Psychiatry 127:1521-26).

Dr. Haskins also reports the occurrence of auditory, visual, tactile, and olfactory hallucinations in deaf individuals with co-morbid schizophrenia. Interestingly, according to Haskins, some deaf people with schizophrenia will report seeing "Jesus signing to them", which Dr. Haskins describes as "...a unique...psychotic feature that seems to fall between a typical auditory hallucination of communicative input and a typical visual hallucination." She points out that a disease like rubella can produce both deafness and schizophrenia-like symptoms (Lim et al, 1995).

Work by du Feu & McKenna (Acta Psychiatr Scand 1999;99:453-9) confirms that "auditory hallucinations are a common phenomenon in profoundly prelingually deaf schizophrenic patients" (with onset of deafness prior to the age of 2). Of course, it is hard to know whether what a congenitally deaf individual describes as a voice is really the same phenomenon as that described by hearing individuals--but then, each of us has a realm of experience that can't really be shared directly with others. Perhaps brain imaging studies, such as SPECT and PET scans, will help clarify these puzzling phenomena.

April 2001

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