Depression, beliefs, voice content and topography: A cross-sectional study of schizophrenic patients with auditory verbal hallucinations

Abstract

Twenty-one people diagnosed as schizophrenic by SCAN and hearing auditory hallucinations were assessed for depression and the nature of the voice content and beliefs about these using the Beck Depression Inventory, Beliefs About Voices Questionnaire, the Cognitive Assessment Schedule and the Topographical Voices Scale. Examples of content were rated as either derogatory or nonderogatory by the author and a blind rater, with a kappa of 0.6. Depression was linked to both derogatory voice content ( p =0.0004) and malevolent beliefs and/or resistance coping strategies ( p =0.0176) as well as voice intrusiveness and loudness. There was a positive relationship between SCAN depressive and positive symptoms ( p =0.013). A cognitive-behavioural model is proposed and it is recommended that schizophrenic hallucinators with derogatory content and/or malevolent beliefs are screened for depression and suicidal ideation.