Kuuloharhoja

Kuuloharhoja, or auditory hallucinations, are perceptions of sound without an external auditory source. They can involve voices, sounds, or music and may occur as single or multiple experiences. Voices may speak to the person, about them, or converse with each other, and the content can be distressing, neutral, or even comforting.

Causes and risk factors can be diverse. They are most commonly associated with schizophrenia spectrum disorders, bipolar disorder with psychotic features, and major depressive disorder with psychotic features. Substance-induced psychosis (for example from alcohol, stimulants, or cannabis), as well as neurological conditions such as epilepsy, dementia, brain lesions, and multiple sclerosis, can also produce kuuloharjoja. In some cases, severe sensory deprivation due to hearing loss or sleep deprivation can contribute to these experiences. They may occur in otherwise healthy individuals under high stress, but persistent, distressing experiences typically warrant clinical evaluation.

Clinical features and assessment focus on the nature and impact of the experiences. Auditory hallucinations are distinguished from imagined inner speech or misperceptions by their perceived external reality and often lack voluntary control. They can be verbal or nonverbal, repetitive or commanding, and vary in frequency and distress. Clinicians assess duration, intensity, emotional response, and safety, using structured interviews and, in research or specialized care, standardized scales.

Treatment and prognosis depend on the underlying condition. Management often includes antipsychotic medications when indicated, along with psychosocial interventions such as cognitive behavioral therapy for psychosis and coping strategies. Addressing contributing factors, such as treating hearing loss with amplification when present, is also important. Prognosis is variable; some people experience substantial improvement with treatment, while others require ongoing support.