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KMID : 0607519970050010082
Korean Journal of Psychosomatic Medicine
1997 Volume.5 No. 1 p.82 ~ p.88
The Clinical and Prognostic Significance of Command Hallucinations in Schizophrenic Patients
Yun Kyu-Wol

Abstract
Background: Patients with command hallucinations are commonly assumed to be at high risk for dangerous behavior. However the issue of whether command hallucinations hold any clinical relevance in schizophrenic patients has not been established.

Method: The author analyzed the clinical and research records of schizophrenic patients with auditory hallucinations who participated in outpatient research follow-up for 9 months after discharge. Patients with auditory hallucinations were classified as experiencing or not experiencing command hallucinations based on clinical psychiatric assessment.

Results: Of 63 patients with auditory hallucinations, 29(46%) reported the command hallucinations and these hallucinations often were violent in content(44.8%). Patients with command hallucinations were not significantly different from patients without command hallucinations on sociodemographic and clinical characteristics, and clinical or prognostic course variables, but patients with command hallucinations had significantly more short hospitalizations(less than one month) than patients without command hallucinations. 3 of the patients with command hallucinations who committed suicide during the follow up periods were died.

Conclusion: Command hallucinations may be frequent, and in most cases they have minimal influence on the outcome of schizophrenia, but if the patients with command hallucinations have a history of suicide attempts before admission, the possibility of suicide attempts by command hallucinations should be considered.
KEYWORD
Command hallucinations, Schizophrenia
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