Auditory Verbal Hallucinations in Children and Adolescents

Auditory verbal hallucinations (AVH) are common in children and adolescents
among the general population. In the majority of children AVH are transient,
but they can be associated with substantial suffering and problem behaviour. In
most children, the AVH will disappear within a few years. However, the
persistence of AVH is associated with lower cognitive abilities as well as the
development into more severe psychiatric disorders. Currently, it is unclear
which factors predict development and persistence of AVH and which factors
determine associated suffering and dysfunction in youth with AVH.

The major aim of this study is to reveal biological, psychological and social
factors that predict development of AVH in youth. A second aim is to reveal
which factors determine and predict percistence of AVH and associated distress
and dysfunction in youngsters with AVH. Comparing children with AVH to their
unaffected siblings provides the assessment of protecting factors against the
development of hallucinations.

In this longitudinal observational study, assessment at baseline includes
questionnaires, structured clinical interviewing, physical examination and
neuropsychological tests. All participants will receive re-assessments one,
three and five years after inclusion. Neuropsychocological tests will only be
assessed at baseline and at 5-year follow up.

All participating youngsters and their parents will be asked to fill in the
questionnaires about the child and theirselves either at home or during the
hospital visit, taking up to a total maximum of 55 minutes per child en 85
minutes for parents. Baseline and follow-up visits include screening for trauma
and life events (15min.) and a general physical examination (5min.) for all
children. Patients will also recieve an psychiatric evaluation (K-SADS 90min.)
and assessment of AVH characteristics (PSYRATS 20min). Testing of
neuropsychological functions (WISC or WAIS) will only be assessed at baseline
and at five year follow up and will take up to 90 minutes. Participants may
experience benefits from our study. We will perform a secure psychiatric en
(neuro)psychological check-up. Children and their parents will obtain feedback
on the results. If the results point out that an intervention is indicated,
treatment will be arranged at our Voices Clinic without delay. All participants
and their parents will be informed on the associated risks of drug abuse for
these vulnerable children. For the comparison group, which consists of
unaffected siblings, baseline and follow up assessment ensures early detection
and, when indicated, treatment.
The results of the proposed study will enable the selection of those
individuals with AVH at high risk for persistence of AVH and development of
psychopathology. These individuals can be offered early intervention, while the
youngsters with AVH without risk factors need not be bothered with hospital
visits.