Beliefs about voices and correlates in long-stay patients with persistent auditory hallucinations, diagnosed with schizophrenia

BackgroundHigh worldwide estimates of depression and suicidality in patients diagnosed with schizophrenia highlight the importance of understanding their associated factors for designing targeted interventions that can both improve distress symptoms and reduce suicide risk in this vulnerable population. In this regard, our study aims to assess the link between beliefs about voices, self-esteem, depression and suicidality in a sample of Lebanese long-stay patients with auditory hallucinations.MethodsThis study followed a cross-sectional design. Data has been gathered at the psychiatric hospital of the Cross, Lebanon, during the month of April 2022. Patients diagnosed with schizophrenia, aged >18 years, hospitalized for >1 year, clinically stable, and experiencing persistent auditory verbal hallucinations were included.ResultsSixty-one patients were experiencing auditory hallucinations and were therefore enrolled in the study. Their mean age was 56.05 ± 12.25 years (27.9% females); 42.6% of patients had suicidal ideation, 48.9% had depression. Multivariable analyses models showed that, after adjusting for confounders, higher omnipotence (Beta = .49) and emotional resistance (Beta = .92) remained strongly linked with more depression; while only higher depression (aOR = 1.17) remained significantly linked with increased likelihood of having suicidal ideation.DiscussionPending future longitudinal research, findings suggest that mental health professionals should not only assess the presence of auditory hallucinations but also pay attention to the patient’s beliefs about their voices, as they may be determinant in the development of depression. Therapeutic approaches targeting resistant and malevolent beliefs about voices may be highly beneficial as adjuvant to existing pharmacological and psychological interventions.