Education And Debate

A difficult case: Diagnosis made by hallucinatory voices

BMJ 1997; 315 doi: http://dx.doi.org/10.1136/bmj.315.7123.1685 (Published 20 December 1997) Cite this as: BMJ 1997;315:1685
  1. Ikechukwu Obialo Azuonye, consultant psychiatrista
  1. a Adult Mental Health Unit, Lambeth Healthcare NHS Trust, London, SW9 9NT

Introduction

A previously healthy woman began to hear hallucinatory voices telling her to have a brain scan for a tumour. The prediction was true; she was operated on and had an uneventful recovery.

No previous illnesses

Born in continental Europe in the mid-1940s the patient settled in Britain in the late 1960s. After a series of jobs, she got married, started a family, and settled down to a full time commitment as a housewife and mother. She rarely went to her general practitioner as she enjoyed good health and had never had any hospital treatment. Her children had also been in good health.

In the winter of 1984, as she was at home reading, she heard a distinct voice inside her head. The voice told her, “Please don't be afraid. I know it must be shocking for you to hear me speaking to you like this, but this is the easiest way I could think of. My friend and I used to work at the Children's Hospital, Great Ormond Street, and we would like to help you.”

AB had heard of the Children's Hospital, but did not know where it was and had never visited it. Her children were well, so she had no reason to worry about them. This made it all the more frightening for her, and the voice intervened again: “To help you see that we are sincere, we would like you to check out the following”—and the voice gave her three separate pieces of information, which she did not possess at the time. She checked them out, and they were true, but this did not help because she had already come to the conclusion …

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