Danger signs: command hallucinations in the D/deaf

Abstract

Purpose The purpose of this paper is to describe the lack of literature and research on command hallucinations (CHs) in D/deaf persons and make suggestions for assessment, instrument development and research into CHs in D/deaf persons. This is important since it is known that hallucinations are more common in persons with hearing impairment and because CHs are known to be associated not only with distress, but also suicide and homicide. Design/methodology/approach Articles on hallucinations and CHs in D/deaf persons are discussed in the context of existing literature on CHs in hearing persons. Findings When compared with the literature on hearing persons it is clear that very little is known about the prevalence of CHs in D/deaf persons and that there is a significant lack of research into emotional and behavioural responses to CHs in D/deaf persons. There is no knowledge about the effectiveness of cognitive behavioural therapy (CBT) for D/deaf persons who experience CHs. This is important since a CBT approach has been found to reduce risky compliance. Practical implications This paper makes recommendations for informed and evidence-based assessments of CHs in D/deaf persons; such assessments may have an important role in reducing risk and distress. Originality/value This is the first paper to review and consider CHs in D/deaf persons as a distinct clinical phenomenon. This paper makes recommendations for the assessment of D/deaf persons who experience CHs.

Assessment and Treatment of a Deaf Patient with Alcohol Use Disorder—Limitations and Special Considerations

“…8,28,29 Elderly patients who are deaf also have a higher risk of developing delirium. 8,28,30 Deaf patients may exhibit symptoms of psychosis in all sensory modalities, including auditory, somatic, tactile, olfactory, visual, and gustatory. 30 A clinician fluent in ASL and knowledgeable about Deaf culture is best qualified to assess and identify psychiatric symptoms in Deaf individuals who use ASL as a primary language.…”

“…Another reported seeing explosions of color on the wall and feeling them bend and twist when she touched them. Symptoms of hallucinations, especially command hallucinations, can be exhibited in reported auditory experiences, signing, finger spelling, gestures, lip patterns, and writing or texts 30 . Sometimes psychotic symptoms in deaf individuals have patterns similar to those of hearing patients but do not have the “sound qualities” that are reported by some hearing individuals 8 …”

“…8,28,30 Deaf patients may exhibit symptoms of psychosis in all sensory modalities, including auditory, somatic, tactile, olfactory, visual, and gustatory. 30 A clinician fluent in ASL and knowledgeable about Deaf culture is best qualified to assess and identify psychiatric symptoms in Deaf individuals who use ASL as a primary language. 9,31 Even for clinicians who have these skills, assessment can be challenging if a patient has language dysfluency.…”

“…Despite few studies, the available evidence suggests that deafness increases the risk of mental illness, including hallucinations or delusions, in adults 8,28,29 . Elderly patients who are deaf also have a higher risk of developing delirium 8,28,30 . Deaf patients may exhibit symptoms of psychosis in all sensory modalities, including auditory, somatic, tactile, olfactory, visual, and gustatory 30 …”

“…Elderly patients who are deaf also have a higher risk of developing delirium 8,28,30 . Deaf patients may exhibit symptoms of psychosis in all sensory modalities, including auditory, somatic, tactile, olfactory, visual, and gustatory 30 …”