Psychological Interventions Targeting Auditory Hallucinations in Persons With Psychotic Disorders: A Systematic Review and Meta-Analysis.
Laura Fässler, Sarah Koop, Felix Opper et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed randomised trials of psychological and psychosocial interventions targeting auditory hallucinations in adults with schizophrenia spectrum disorders. Across 23 studies involving 2016 participants, interventions produced a small reduction in hallucination severity at posttreatment compared with controls (SMD, -0.18; 95% CI, -0.31 to -0.05; P = .007; NNT, 16), with low-certainty evidence. Benefits were also reported for several secondary outcomes. Avatar therapy had the largest subgroup effect on severity, while dropout and adverse-event reports suggested treatments were generally acceptable and tolerable.
Key findings
- Targeted interventions reduced auditory-hallucination severity versus controls at posttreatment (SMD, -0.18; 95% CI, -0.31 to -0.05; P = .007; NNT, 16; low-certainty evidence).
- Avatar therapy showed the largest subgroup effect on hallucination severity (SMD, -0.37; 95% CI, -0.51 to -0.22; P < .001).
- Effects were also observed for hallucination frequency and distress, total and positive symptoms, delusions, depression, and anxiety.
- Dropout rates and adverse-event reports indicated high treatment tolerability and acceptability.
Why it matters
Auditory hallucinations can cause substantial distress, and this synthesis suggests that targeted psychological approaches may reduce their severity and related symptoms. The overall effect was small and evidence certainty was low, while outcomes differed across approaches. These findings help frame the potential role of targeted interventions and identify the need to clarify which treatment characteristics are most useful.
What to keep in mind
Evidence certainty for the primary outcome was low, and effects varied substantially between therapeutic approaches.