Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T22:02:21.844Z Has data issue: false hasContentIssue false
  • English
  • Français

Command hallucinations, schizophrenia and sexual assaults

Published online by Cambridge University Press:  13 June 2014

Gareth Jones ,
Phil Huckle  and
Amgad Tanaghow
Gareth Jones
Affiliation:
University of Wales College of Medicine, Department of Psychological Medicine, Whitchurch Hospital, Cardiff CF4 7XB, Wales
Phil Huckle
Affiliation:
Glanrhyd Hospital, Bridgend CF31 4LN, Wales
Amgad Tanaghow
Affiliation:
Sully Hospital, South Glamorgan, Wales
Get access Rights & Permissions [Opens in a new window]

Abstract

Command hallucinations have been implicated in some cases of physical assault by patients with schizophrenia. This paper is, to our knowledge, the first in the literature to describe sexual assault and this form of psychopathology.

A brief series of four young male patients with schizophrenia who attempted and, in one case, succeeded in sexually assaulting young women as a direct response to command type or imperative auditory hallucinations is described.

All four patients had limited or no sexual experience prior to the incidents described and their illness has attacked them at their “psychological Achilles heel”.

All four had lengthy in-patient admissions and proved quite resistant to conventional treatments.

We would suggest that command hallucinations need to be taken very seriously: some patients do as their voices command.

Keywords

Sexual assaultschizophreniacommand auditory hallucinations
Type
Clinical & Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 9 , Issue 1 , May 1992 , pp. 47 - 49
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Bleuler, E. Textbook of psychiatry. Translated by Brill, AA. New York: MacMillan, 1930: 62.Google Scholar
2.Fish, F. Clinical psycopathology. Signs and symptoms in psychiatry. Bristol: John Wright and Sons, 1967: 19–33.Google Scholar
3.Yesavage, JA. Inpatient violence and the schizophrenic patient. Acta Psychiatr Scand 1983; 67: 353–57.CrossRefGoogle ScholarPubMed
4.Goodwin, DW, Alderson, P, Rosenthal, R. Clinical significance of hallucinations in psychiatric patients. Arch Gen Psychiatry 1971; 24: 76–80.CrossRefGoogle Scholar
5.Hellerstein, D, Frosch, W, Koenigsberg, HW. The clinical significance of command hallucinations. Am J Psychiatry 1987; 144: 219–21.Google ScholarPubMed
6.Akhtar, S, Thomson, JA. Schizophrenia and sexuality — a review and a report of 12 unusual cases — Part II. J Clin Psychiatry 1980; 41: 166–74.Google Scholar
7.Klaf, FS, Davies, CA. Homosexuality and paranoid schizophrenia: a survey of 150 cases and controls. Am J Psychiatry 1960; 116: 1070–75.CrossRefGoogle ScholarPubMed
8.Gittleson, NL, Levine, S. Subjective ideas of sexual change in male schizophrenics. Br J Psychiatry 1966; 112: 779–82.CrossRefGoogle ScholarPubMed
9. Anonymous. Sexual drive of patients in a psychiatric hospital [letter] BMJ 1988; 297: 561.CrossRefGoogle Scholar
10.Henn, FA, Herjanic, M, Vanderpearl, RH. Forensic psychiatry: profiles of two types of sex offenders. Am J Psychiatry 1976; 133: 694–96.Google ScholarPubMed
11.Allen, C. A textbook of psychosexual disorders. London: Oxford University Press, 1969.Google Scholar
12.Buckley, P, Walshe, G, Colchan, HA. Violence and schizophrenia — a study of the occurrence and clinical correlates of violence among schizophrenic patients. Irish Journal of Psychological Medicine 1990; 7: 152–58.CrossRefGoogle Scholar
13.Falloon, IRH, Talbot, RE. Persistent auditory hallucinations — coping mechanisms and implication for management. Psychol Med 1981; 11: 329–339.CrossRefGoogle Scholar