Hallucinations in adolescent inpatients with post-traumatic stress disorder and schizophrenia: similarities and differences

Objective: This study compares the phenomenology of hallucinations in a series of hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and schizophrenia. Methods: Subjects admitted to a tertiary adolescent inpatient unit were screened for hallucinations. Those reporting hallucinations were asked standardized questions relating to these experiences. Hallucinations in subjects with a primary diagnosis of schizophrenia or PTSD were compared. Results: Hallucinations in both schizophrenia and PTSD have similar form and content. Frequent, vivid, realistic, external hallucinations occurred in both disorders. Hallucinations in PTSD were usually derogatory and related to self-harm, but not direct reflections of traumatic events. Patients with PTSD reported greater emotional distress, self-harm and suicidal ideation than those with schizophrenia. Conclusions: This case series suggests that the phenomenology of hallucinations in adolescents with schizophrenia and PTSD is similar.