Persaud R, Marks I
Institute of Psychiatry, London.
Br J Psychiatry. 1995 Jul;167(1):45-50. doi: 10.1192/bjp.167.1.45.
Many patients complain less of their auditory hallucinations per se than of lack of control of the experiences. There is reason to believe that a non-distraction (exposure) approach could help patients gain more control over persistent auditory hallucinations and teach them that their experience is a form of thinking and has no external source. This study is a pilot test of that idea.
Five DSM-III-R schizophrenic outpatients with medication-resistant auditory hallucinations improved with a mean of 31 hour-long sessions over 3 months of therapist-guided exposure to their hallucinations and situations likely to evoke them.
Improvement was greatest in patients' anxiety and sense of control over their hallucinations, less in social use of leisure and hallucinating time.
These mildly encouraging pilot results warrant a controlled study of exposure for drug-resistant chronic auditory hallucinations and other psychotic experiences which are associated with anxious avoidance.
许多患者抱怨的与其说是幻听本身，不如说是对这些体验缺乏控制感。有理由相信，一种非分心（暴露）方法可以帮助患者更好地控制持续性幻听，并让他们明白自己的体验是一种思维形式，并非来自外部。本研究就是对这一想法的初步测试。
五名符合《精神疾病诊断与统计手册第三版修订版》（DSM-III-R）标准的精神分裂症门诊患者，他们对药物治疗耐药的幻听症状，在3个月内平均接受了31次为时1小时的治疗，治疗师引导他们暴露于幻听及可能引发幻听的情境中。
患者在焦虑和对幻听的控制感方面改善最为明显，在休闲社交使用和幻听时间方面改善较少。
这些初步结果虽略显鼓舞人心，但仍需进行对照研究，以探讨暴露疗法对耐药性慢性幻听及其他与焦虑回避相关的精神病体验的效果。
