3 September 2002, Press Release Royal College of Psychiatry:

The majority of children hearing voices stop reporting the experience over the course of three years, according to a new study.

Voice appraisals, and associated anxiety and depression, are better predictors of voice persistence than ‘traditional’ measures of psychotic symptoms and problem behaviour.

The aim of the study, published in a supplement to the September 2002 issue of the British Journal of Psychiatry , was to examine the course of experience of voices sequentially over a three-year period in children with and without a need for mental health care. Childhood hallucinations occur in a variety of psychiatric states, such as schizophrenia, anxiety and depression, migraine and trauma.

Long-term follow-up studies have suggested variable outcomes for hearing voices. It is known that there are pathological and non-pathological hallucinatory experiences.

A recent study found that around 8% of children reported hearing voices, of whom only a third had a psychiatric illness. In this study baseline measurements were made among a group of 80 children with an average age of 12.9 years who were hearing voices, of whom about half were not receiving mental health care.

Voice characteristics (e.g. volume, tone and frequency), voice attributions, psychopathology, stressful life events, coping mechanisms and receipt of professional care were then used to predict what would happen over the next three years.

It was found that rate of discontinuation of the voices over the three year period was 60%. Those children receiving mental health care more often reported the presence of emotional triggers to the voices and more often reported childhood adversity. They had more negative feelings about their voices, and more often felt that the voices influenced their emotions and behaviour.

There was no difference between those receiving and not receiving mental health care in terms of total coping score, but children receiving care made use less often of passive problem solving, like ignoring the voice, listening selectively or doing something. This is in line with the view that the need for care is related to the way the person interacts with their experience of voices, rather than just the experience itself.

Severity and frequency of the voices predicted whether they would persist over time, as did anxiety and depression associated with hearing the voices and lack of clear triggers of time and place for the voices. If children are able to identify triggers of time and place (e.g. hearing voices only at school, or when alone in their bedroom at night), they are more likely to overcome the experience than if the voices are around all the time. Children who need professional help are more likely to feel overpowered by the voices.

The more people the children had told about the voices, the more likely they were to persist. This suggests that the need for mental health care is to a large extent associated with the child’s (and parents’) appraisal of the voices rather than the perception itself. Having mental health care did not in itself make it more likely that the voices would stop. This may be because at the time of the study, most care appeared to be directed towards suppressing voices rather than coping with them.

The authors comment that as persistence of voices is related to voice appraisals, the experience of voices by children should be the target of specific interventions.


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