Audiotape therapy for persistent auditory hallucinations

Article Abstract:

Antipsychotic drugs (neuroleptics) are commonly prescribed to treat auditory hallucinations, but do not always provide relief. A case report is presented of successful audiotherapy in a 60-year-old security guard with recurrent depressive psychosis and auditory hallucinations commanding him to kill himself. He had a 40-year history of recurrent depression, and had made five serious suicide attempts. During his last two-year hospital stay, he suffered cyclical depression and suicidal thoughts with frequent second-person auditory hallucinations in which a male voice would tell him to hang himself. Six trials of electroconvulsive shock therapy provided little relief. The hallucinatory attacks persisted despite trials of various antipsychotic and antidepressant medications and lithium. The patient made a tape of his own voice shouting back at the hallucinated one, which he played whenever he hallucinated. When this did not work, he taped soothing, pleasant memories of his family and past holidays. This second tape seemed to shorten the duration of hallucinations and make him feel better. To test his subjective impressions, a study design was implemented. Days were divided into alternating six-hour periods in which either the tape was played during hallucinations or was not played. He was asked to record both the duration and intensity of all auditory hallucinations for 35 days. Statistical analysis of the data he provided revealed that hallucinatory episodes lasted for an average of 4.4 minutes while listening to the tape, versus 22.2 minutes while not listening. Although the patient's depression did not subside, his audiotherapy continued to provide relief until he died of a heart attack 18 months later. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Usage, Prevention, Suicide, Suicide prevention, Psychotherapy, Tape recordings, Hallucinations and illusions, Hallucinations, Audio tapes, Audiotapes, Audio tapes in psychotherapy

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The COSTAR programme. 1: improving social networks of the long-term mentally ill

Article Abstract:

Most of the chronically mentally ill patients in the US are not hospitalized; there are fewer than 130,000 in-patients out of more than 2 million mentally ill patients nationwide. Most of the out-patients live in inner cities. There has been little research published on the effectiveness of mobile services for seriously ill out-patients in inner cities. The Community Support Treatment and Rehabilitation (COSTAR) is such a program. Staff establish contact with out-patients at home, in local cafes, or at social service agencies. These are generally patients who have failed to benefit from more traditional out-patient programs. The present investigation focused on 97 patients in the COSTAR program. Sociodemographic data were collected, a psychiatric rating scale was completed, social behavior was evaluated, mental status was assessed, and a social network schedule was done. An assessment of overall functioning was made as well. There were 52 long-contact (greater than one year) patients and 45 short-contact patients; the two groups were compared. While there were no differences symptoms, or in cognitive or overall functioning between the two groups, those in long-term contact with the COSTAR program showed improvement in the quality and quantity of social networks. A program such as COSTAR can help patients reduce social isolation, which, if left unchecked, can result in a cycle of poor community adjustment and further isolation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Innovations, Evaluation, Mentally ill persons, Mentally ill, Social networks, Community psychiatric services, Community mental health services

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