Evidence-Based Reviews

Hallucinations in children: Diagnostic and treatment strategies

Current Psychiatry. 2010 October;9(10):53-56

References

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Help children develop coping strategies to control auditory hallucinations such as:

Clinical Point

Children with visual hallucinations can learn to transform in their mind the frightful image to a funnier one

humming
listening to music
reading (forwards and backwards)
talking to others
exercising
singing
medication
ignoring the voices.

With normalization and other coping strategies, children with visual hallucinations can learn to transform in their mind the frightful image to a funnier one, which is less anxiety-provoking and gives them a sense of control.

Table 5

Suggestions for evaluating hallucinating children in the ED

Evaluate risk factors for suicidality
Rule out medical and neurologic causes, including substance abuse/intoxication
Identify underlying psychopathological, psychosocial, and cultural factors
Contact key adult informants for collateral information
Decide if hallucinations are psychotic or nonpsychotic
Reassure your patients that hearing voices does not mean that they are ‘crazy’
Evaluate hallucinations in the context of other features of psychoses (onset, frequency, severity, and chronicity)
Initiate psychotherapy and antidepressants if needed for patients with underlying depression, anxiety, or PTSD
ED: emergency department; PTSD: posttraumatic stress disorder Source: Reference 21

Related Resources

Bartels-Velthuis AA, Jenner JA, van de Willige G, et al. Prevalence and correlates of auditory vocal hallucinations in middle childhood. Br J Psychiatry. 2010;196(1):41-46.
Cepeda C. Psychotic symptoms in children and adolescents: assessment, differential diagnosis, and treatment. New York, NY: Routledge; 2007.

Drug Brand Names

Methylphenidate • Ritalin
Olanzapine • Zyprexa
Risperidone • Risperdal

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.