School of Medicine and Health Sciences Poster Presentations

Title

Auditory Hallucinations in a Deaf Patient: A Case Study

Poster Number

283

Document Type

Poster

Publication Date

3-2016

Abstract

Background: To date, one case report of auditory hallucinations in a deaf patient has been published. Larger population-level assessments estimate that psychotic disorders occur equally in both hearing and non-hearing populations. There are a few distinct difficulties in making the diagnosis of a thought disorder in a non-hearing patients. Language-deprived deaf patients display difficulties with language that mimic the types of language production errors seen in patients with thought disorders. The majority of deaf children are born to hearing parents resulting in early language deprivation and interference with the ability to infer the mental states of others and to recognize affect. These language production errors include limited vocabulary, lack of sequential organization to stories, inappropriate syntax, excessive use of gesture, emotional disconnectedness and social withdrawal. The added difficulty of using an American Sign Language (ASL) interpreter further complicates the clinical picture. Interpreter subjectivity can lead to the reformulation and repetition of questions. The assessment tools currently utilized to diagnose thought disorders are verbal and standardized for hearing patients.

Case Presentation: Our patient was a 20 year old woman with a history of congenital deafness presenting with an attempted suicide by drowning who reported auditory hallucinations (AH) and past commanding visual hallucinations (CVH). Clinical interviews were conducted through a translator certified in American Sign Language (ASL). Our patient had been diagnosed with deafness at the age of two years old. AH were narrations of the patient’s actions and were not command in nature. AH were present during her clinical time with our team. She was not able to discern the gender of the voice, tone or intonation of the voice. The patient also reported CVH of a shadow shape that gestured for her to hurt herself in different ways. These CVH were not present while the patient was in our care. The AH and CVH did not cause her significant distress.

Discussion: It is important to critically assess the tools that are currently used to diagnose thought disorders in deaf patients. These many challenges may further exacerbate the health disparities seen in the deaf community.

Conclusion: Our patient met the criteria for major depressive disorder while in our care. This case highlights the importance of the development of assessment tools and cultural competence to enhance the diagnosis and treatment of non-hearing patients with mood and thought disorders.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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Presented at: GW Research Days 2016

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Auditory Hallucinations in a Deaf Patient: A Case Study

Background: To date, one case report of auditory hallucinations in a deaf patient has been published. Larger population-level assessments estimate that psychotic disorders occur equally in both hearing and non-hearing populations. There are a few distinct difficulties in making the diagnosis of a thought disorder in a non-hearing patients. Language-deprived deaf patients display difficulties with language that mimic the types of language production errors seen in patients with thought disorders. The majority of deaf children are born to hearing parents resulting in early language deprivation and interference with the ability to infer the mental states of others and to recognize affect. These language production errors include limited vocabulary, lack of sequential organization to stories, inappropriate syntax, excessive use of gesture, emotional disconnectedness and social withdrawal. The added difficulty of using an American Sign Language (ASL) interpreter further complicates the clinical picture. Interpreter subjectivity can lead to the reformulation and repetition of questions. The assessment tools currently utilized to diagnose thought disorders are verbal and standardized for hearing patients.

Case Presentation: Our patient was a 20 year old woman with a history of congenital deafness presenting with an attempted suicide by drowning who reported auditory hallucinations (AH) and past commanding visual hallucinations (CVH). Clinical interviews were conducted through a translator certified in American Sign Language (ASL). Our patient had been diagnosed with deafness at the age of two years old. AH were narrations of the patient’s actions and were not command in nature. AH were present during her clinical time with our team. She was not able to discern the gender of the voice, tone or intonation of the voice. The patient also reported CVH of a shadow shape that gestured for her to hurt herself in different ways. These CVH were not present while the patient was in our care. The AH and CVH did not cause her significant distress.

Discussion: It is important to critically assess the tools that are currently used to diagnose thought disorders in deaf patients. These many challenges may further exacerbate the health disparities seen in the deaf community.

Conclusion: Our patient met the criteria for major depressive disorder while in our care. This case highlights the importance of the development of assessment tools and cultural competence to enhance the diagnosis and treatment of non-hearing patients with mood and thought disorders.