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跨精神病性障碍、心境障碍和焦虑障碍的幻听及其他感知觉改变体验:从现象学、机制到未来方向

Hearing voices and other altered perceptual experiences across psychotic, mood, and anxiety disorders: from phenomenology and mechanisms to future directions.

作者信息

Toh Wei Lin, Richards Sophie, Fernyhough Charles, Longden Eleanor, Moseley Peter, Ramachandran Padmavati, Thomas Neil, Rossell Susan Lee

机构信息

Centre for Mental Health & Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia.

Department of Psychology, Alfred Hospital, Melbourne, VIC, Australia.

出版信息

Schizophrenia (Heidelb). 2025 Sep 29;11(1):121. doi: 10.1038/s41537-025-00673-3.

Abstract

While voice-hearing in psychosis has received much attention, perceptual experiences in other sensory modalities and psychiatric conditions have remained relatively overlooked. The present review aimed to address this gap by providing an overview of voices/altered perceptual experiences (APE) across psychotic, mood and anxiety disorders in terms of phenomenological characteristics, biopsychosocial mechanisms, etiological models and therapeutic interventions. Where possible, lived experience perspectives and transcultural considerations were embedded. A narrative literature review was conducted. Knowledge pertaining to voices in psychosis formed the foundation, broadened to include other sensory modalities and diagnostic conditions. Quality assessment demonstrated an excellent rating of 12/12. Notable findings related to: (i) phenomenological heterogeneity in voices/APE within individuals and across diagnostic conditions, with multisensory/multimodal experiences relatively widespread; (ii) existing mechanistic studies mainly focusing on the role of trauma and neurocognition in voices; (iii) prevailing explanatory models mostly focusing on voices; (iv) a need for emerging interventions to extrapolate to encompass broader therapeutic applications; and (v) wide-ranging specificity issues and transcultural considerations to be addressed. Future research should invest in appropriate assessment tools as well as ensuring methodological consistency in mechanistic studies. Incorporating lived experience perspectives and meaningfully embedding transcultural considerations in theoretical and empirical ways are also essential.

摘要

虽然精神病性状态下的幻听受到了广泛关注,但其他感觉模态和精神疾病中的感知体验却相对被忽视。本综述旨在填补这一空白,通过从现象学特征、生物心理社会机制、病因模型和治疗干预等方面,对精神病性、心境和焦虑障碍中的幻听/感知觉改变体验(APE)进行概述。在可能的情况下,纳入了生活体验视角和跨文化考量。进行了一项叙述性文献综述。关于精神病性状态下幻听的知识构成了基础,并扩展到包括其他感觉模态和诊断情况。质量评估显示评分为12/12,结果优异。显著发现包括:(i)个体内部和不同诊断情况之间幻听/APE的现象学异质性,多感官/多模态体验相对普遍;(ii)现有的机制研究主要关注创伤和神经认知在幻听中的作用;(iii)主流解释模型大多聚焦于幻听;(iv)需要新兴干预措施扩展到更广泛的治疗应用;(v)存在广泛的特异性问题和跨文化考量需要解决。未来研究应投入合适的评估工具,并确保机制研究中的方法一致性。以理论和实证方式纳入生活体验视角并切实融入跨文化考量也至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ade/12480513/71fb495240af/41537_2025_673_Fig1_HTML.jpg

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