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The Experience of Patients with Schizophrenia Treated with Repetitive Transcranial Magnetic Stimulation for Auditory Hallucinations

DOI: 10.1155/2013/183582

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Abstract:

Introduction. Auditory hallucinations are a common symptom experience of individuals with psychotic disorders and are often experienced as persistent, distressing, and disruptive. This case series examined the lived experiences of four individuals treated (successfully or unsuccessfully) with low-frequency (1?Hz) rTMS for auditory hallucinations. Methods. A phenomenological approach was used and modified to involve some predetermined data structuring to accommodate for expected cognitive impairments of participants and the impact of rTMS on auditory hallucinations. Data on thoughts and feelings in relation to the helpful, unhelpful, and other effects of rTMS on auditory hallucinations, on well-being, functioning, and the immediate environment were collected using semistructured interviews. Results. All four participants noted some improvements in their well-being following treatment and none reported a worsening of their symptoms. Only two participants noted an improvement in the auditory hallucinations and only one of them reported an improvement that was sustained after treatment completion. Conclusion. We suggest that there are useful findings in the study worth further exploration, specifically in relation to the role of an individual’s acceptance and ownership of the illness process in relation to this biomedical intervention. More mixed methods research is required to examine rTMS for auditory hallucinations. 1. Introduction Auditory hallucinations, that is, the experience of sound in the absence of external perceptual stimuli, are a common symptom of individuals with psychotic disorders such as schizophrenia and schizoaffective disorder. The prevalence of auditory hallucinations in schizophrenia is reported to be 75% [1]. Many of these individuals experience auditory hallucinations as persistent, distressing, and disruptive. Up to 30% of individuals with auditory hallucinations respond only partially or not at all to standard antipsychotic treatment [2, 3]. Shergill et al. [4] concluded in their review of psychological treatments for auditory hallucinations that, although these are of some benefit, they often result in improvement in the auditory hallucinations-associated distress, or control over the experience, rather than in elimination or reduction in auditory hallucinations. Low-frequency (1?Hz) repetitive transcranial magnetic stimulation (rTMS) in the left temporoparietal cortex (TPC) has been used for the treatment of refractory auditory hallucinations, with some success. This area has been targeted because previous neuroimaging research

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