Auditory hallucinations

Second person


Second order hallucinations are auditory hallucinations in which a voice appears to address the patient in the second person. For example the voice may be talking directly to the patient - "You are going to die" - or the voice may be telling the patient to do some action - "kill him". These types of auditory hallucinations are not diagnostic in the same way as third person auditory hallucinations, but the content of the hallucination, and the patient's reaction to it, may help in diagnosis.

In a depressive psychosis the comments from the auditory hallucination may be derisory ("you are useless"), and the patient may accept them as being justified. A schizophrenic may experience second person hallucinations but may resent the comments that the voice makes. These interpretations of the content of the hallucination and the patient's reaction are only indicators to the possible psychiatric diagnosis.

Third person

Third person hallucinations are auditory hallucinations in which patients hear voices talking about themselves, referring to them in the third person, for example "he is an evil person".

This type of auditory hallucination is particularly associated with schizophrenia, but can occur in affective disorders. Such voices may be experienced as commenting on the patient's intended actions - "he wants to kill her", or describing his current actions - "he is trying to sleep now". A running commentary by voices is most suggestive of schizophrenia.

Echo de la pensee

Echo de la pensee is the phenomenon where a patient hears voices which echo thoughts just after they have occurred to the patient.

This symptom is suggestive of schizophrenia.


Gedankenlautwerden is an hallucination where a patient hears voices which anticipate what he or she is about to think, or which state what the patient is thinking as he thinks it. Sadly there is no convenient word in English to describe this phenomenon.

It is a symptom suggestive of schizophrenia.

Gedankenlautwerden literally means thoughts becoming loud.