Attributions for hallucinations in bipolar affective disorder.

BACKGROUND: Attributions for hallucinations in the "schizophrenia" spectrum disorders have been subject to extensive investigation; however, in comparison very little is known about attributions for hallucinations in the bipolar disorders spectrum. AIMS: This preliminary study is an attempt to investigate attributions for hallucinations in bipolar disorder with regard to prevalence, modality and mood state. METHOD: Forty participants were recruited from a larger randomized control trial into CBT for bipolar disorder and asked to provide information related to attributions for hallucinations both in and out of episode. Data was collected using a specially designed instrument based on the Belief about Voices Questionnaire (BAVQ). RESULTS: Just under half of the participants reported experiencing true hallucinations during their illness. Participants tended to report visual hallucinations in mania and auditory hallucinations in depression. The vast majority of participants attributed hallucinations to illness when out of episode, and unlike in previously reported analyses of attributions for hallucinations in the schizophrenia spectrum, malevolent/omnipotent attributions were comparatively rare. CONCLUSIONS: Attributions for hallucinations in bipolar disorder may be clinically distinct from attributions previously observed in the schizophrenia spectrum, and CBT aimed at reducing the distress associated with these attributions may have to be tailored accordingly.