Skip to main content Accessibility help
×
Home

Auditory hallucinations in adults with hearing impairment: a large prevalence study

  • M. M. J. Linszen (a1) (a2) (a3), G. A. van Zanten (a4), R. J. Teunisse (a5), R. M. Brouwer (a1), P. Scheltens (a2) and I. E. Sommer (a1) (a3) (a6)...

Abstract

Background

Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment.

Methods

Hallucination presence was determined in 1007 subjects aged 18–92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands. The presence and severity of hearing impairment were calculated using mean air conduction thresholds from the most recent pure tone audiometry.

Results

Out of 829 participants with hearing impairment, 16.2% (n = 134) had experienced auditory hallucinations in the past 4 weeks; significantly more than the non-impaired group [5.8%; n = 10/173; p < 0.001, odds ratio 3.2 (95% confidence interval 1.6–6.2)]. Prevalence of auditory hallucinations significantly increased with categorized severity of impairment, with rates up to 24% in the most profoundly impaired group (p < 0.001). The corrected odds of hallucination presence increased 1.02 times for each dB of impairment in the best ear. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%).

Conclusions

Our findings reveal that auditory hallucinations are common among patients with hearing impairment, and increase with impairment severity. Although more research on potential confounding factors is necessary, clinicians should be aware of this phenomenon, by inquiring after hallucinations in hearing-impaired patients and, conversely, assessing hearing impairment in patients with auditory hallucinations, since it may be a treatable factor.

Copyright

Corresponding author

Author for correspondence: Mascha MJ Linszen, E-mail: m.m.j.linszen@umcutrecht.nl

References

Hide All
Berrios, GE (1990) Musical hallucinations. A historical and clinical study. British Journal of Psychiatry 156, 188194.
Bexton, WH, Heron, W and Scott, RH (1954) Effects of decreased variation in the sensory environment. Canadian Journal of Psychology 8, 7076.
Blazer, DG, Domnitz, S and Liverman, CT, National Academies of Sciences, Engineering and Medicine (2016) Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Washington, D.C.: National Academies Press.
Clopper, C and Pearson, ES (1934) The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26, 404413.
Coebergh, JAF, Lauw, RF, Bots, R, Sommer, IEC and Blom, JD (2015) Musical hallucinations: review of treatment effects. Frontiers in Psychology 6, 814, 111.
Cole, MG, Dowson, L, Dendukuri, N and Belzile, E (2002) The prevalence and phenomenology of auditory hallucinations among elderly subjects attending an audiology clinic. International Journal of Geriatric Psychiatry 17, 444452.
Evers, S and Ellger, T (2004) The clinical spectrum of musical hallucinations. Journal of the Neurological Sciences 227, 5565.
ffytche, DH (2007) Visual hallucinatory syndromes: past, present, and future. Dialogues in Clinical Neuroscience 9, 173189.
Gates, GA and Mills, JH (2005) Presbycusis. The Lancet (London, England) 366, 11111120.
Hedden, T and Gabrieli, JDE (2004) Insights into the ageing mind: a view from cognitive neuroscience. Nature Reviews Neuroscience 5, 8796.
Hoare, DJ, Edmondson-Jones, M, Sereda, M, Akeroyd, Ma and Hall, D (2014) Amplification with hearing aids for patients with tinnitus and co-existing hearing loss. Cochrane Database of Systematic Reviews 1, 131.
ISO 8253-1:2010 (2010) Acoustics – Audiometric Test Methods – Part 1: Pure-Tone Air and Bone Conduction Audiometry. Geneva, Switzerland: International Organization for Standardization.
Larøi, F, Sommer, IE, Blom, JD, Fernyhough, C, Ffytche, DH, Hugdahl, K, Johns, LC, McCarthy-Jones, S, Preti, A, Raballo, A, Slotema, CW, Stephane, M and Waters, F (2012) The characteristic features of auditory verbal hallucinations in clinical and nonclinical groups: state-of-the-art overview and future directions. Schizophrenia Bulletin 38, 724733.
Lin, FR, Yaffe, K, Xia, J, Xue, Q, Harris, TB, Purchase-helzner, E, Satterfield, S, Ayonayon, HN, Ferrucci, L and Simonsick, EM (2013) Hearing loss and cognitive decline in older adults. JAMA Internal Medicine 173, 293299.
Linscott, RJ and van Os, J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine 43, 11331149.
Linszen, MMJ, Brouwer, RM, Heringa, SM and Sommer, IE (2016) Increased risk of psychosis in patients with hearing impairment: review and meta-analyses. Neuroscience & Biobehavioral Reviews 62, 120.
McCarthy-Jones, S and Davidson, L (2013) When soft voices die: auditory verbal hallucinations and a four letter word (love). Mental Health, Religion & Culture 16, 367383.
Mccarthy-Jones, S, Thomas, N, Strauss, C, Dodgson, G, Jones, N, Woods, A, Brewin, CR, Hayward, M, Stephane, M, Barton, J, Kingdon, D and Sommer, IE (2014) Better than mermaids and stray dogs? Subtyping auditory verbal hallucinations and its implications for research and practice. Schizophrenia Bulletin 40, 275284.
Robles Bayon, A, Tirapu de Sagrario, MG and Gude Sampedro, F (2017) Auditory hallucinations in cognitive neurology. Neurología (English Edition) 32, 345354.
Schakenraad, SMM, Teunisse, RJ and Olde Rikkert, MGM (2006) Musical hallucinations in psychiatric patients. International Journal of Geriatric Psychiatry 21, 394397.
Schneider, JM, Gopinath, B, McMahon, CM, Leeder, SR, Mitchell, P and Wang, JJ (2011) Dual sensory impairment in older age. Journal of Aging and Health 23, 13091324.
Smith, S (1962) Effects of sensory deprivation. Proceedings of the Royal Society of Medicine 55, 2931.
Sommer, IE, Roze, CM, Linszen, MMJ, Somers, M and van Zanten, GA (2014) Hearing loss; the neglected risk factor for psychosis. Schizophrenia Research 158, 266267.
Stevens, G, Flaxman, S, Brunskill, E, Mascarenhas, M, Mathers, CD and Finucane, M (2013) Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. European Journal of Public Health 23, 146152.
Subramaniam, M, Abdin, E, Vaingankar, J, Picco, L, Shahwan, S, Jeyagurunathan, A et al. (2016) Prevalence of psychotic symptoms among older adults in an Asian population. International Psychogeriatrics 28, 12111220.
Teunisse, RJ, Cruysberg, JR, Hoefnagels, WH, Verbeek, AL and Zitman, FG (1996) Visual hallucinations in psychologically normal people: Charles Bonnet's syndrome. The Lancet 347, 794797.
Teunisse, RJ and Olde Rikkert, MGM (2012) Prevalence of musical hallucinations in patients referred for audiometric testing. American Journal of Geriatric Psychiatry 20, 10751077.
Vanneste, S, Song, J-J and De Ridder, D (2013) Tinnitus and musical hallucinosis: the same but more. NeuroImage 82, 373383.
Vilhauer, RP (2015) Depictions of auditory verbal hallucinations in news media. International Journal of Social Psychiatry 61, 5863.
Vilhauer, RP (2017) Stigma and need for care in individuals who hear voices. International Journal of Social Psychiatry 63, 513.
von Elm, E, Altman, DG, Egger, M, Pocock, SJ, Gøtzsche, PC and Vandenbroucke, JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. The Lancet 370, 14531457.
Waters, F, Allen, P, Aleman, A, Fernyhough, C, Woodward, TS, Badcock, JC, Barkus, E, Johns, L, Varese, F, Menon, M, Vercammen, A and Laroi, F (2012) Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin 38, 683692.
World Health Organization (2014) Fact Sheet no. 282: Visual impairment and blindness. ( ). Accessed on September 14th, 2017.
World Health Organization (2015) Fact Sheet no. 300: Deafness and hearing loss. (). Accessed on September 14th, 2017.

Keywords

Type Description Title
WORD
Supplementary materials

Linszen et al. supplementary material 1
Linszen et al. supplementary material

 Word (79 KB)
79 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed