Effect of Antipsychotic on the Dimension of Auditory Hallucination Among Patients with Schizophrenia

Abstract

INTRODUCTION: Auditory hallucination (AH) is the most common type of hallucinations in individuals with schizophrenia. Assessing the multidimensional aspects of AH provides more precise insights, particularly regarding associated psychological sequelae. This study aimed to examine the short-term effects of antipsychotics treatment on the emotional, cognitive and physical dimension of AH. MATERIALS AND METHODS: A total of 74 patients with schizophrenia with relapsing episodes were recruited. The Psychotic Symptoms Rating Scale subscale Auditory Hallucination.(PSYRATS-AH) was administered at baseline, and after 2 weeks and 4 weeks of treatment. Patients were treated with atypical, typical, or a combination of both types of antipsychotics. The emotional, cognitive and physical components of PSYRATS-AH were analysed. RESULTS: Most participants were Malay (89.2%), single (63.5%), unemployed (70%), and on atypical antipsychotic treatment (71.6%). At 4 weeks, there was a significant reduction in overall AH scores compared to baseline. Both atypical and combination antipsychotic regimen showed a significant difference in all three components, namely emotional (χ2=43.9, p<0.05 and χ2=27.8, p<0.05), cognitive (χ2=34.1, p<0.05 and χ2=19.0, p<0.05), and physical (χ2=39.5, p<0.05 and χ2=30.5, p<0.05). However, those on typical antipsychotic showed a poorer response in the physical  component (χ2=5.4, p>0.05). CONCLUSION: Atypical and combination antipsychotic regimen demonstrated greater effectiveness in improving the emotional, cognitive, and physical dimension of AH. Typical antipsychotics alone were less effective, particularly in addressing physical symptoms. These findings support the preferential  use of atypical antipsychotics managing the multidimensional aspects of AH in schizophrenia.