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Advanced Technical IVT

command hallucinations

Auditory hallucinations that give direct orders or instructions to the patient, representing significant safety concerns.

Full Definition

Command hallucinations are a specific type of auditory hallucination where voices give direct orders, instructions, or commands to the patient. These hallucinations are particularly concerning because they may compel patients to engage in harmful behaviors toward themselves or others, especially when the patient has poor insight or feels compelled to obey the voices. Command hallucinations can range from benign instructions (such as to sit down or drink water) to dangerous commands involving self-harm, violence, or illegal activities. Assessment must determine the content of commands, the patient's relationship with the voices, history of compliance with commands, and current ability to resist. This symptom often requires immediate safety interventions and careful monitoring.

Usage

Usage note: Always assess and document the specific content of commands, patient's relationship to voices, and history of compliance for safety planning.

In Context

  • "The patient reported command hallucinations instructing her to harm her children, necessitating immediate safety planning and inpatient admission." — crisis intervention assessment
  • "Command hallucinations decreased in frequency and intensity after antipsychotic medication optimization." — treatment response documentation

Also known as

commanding voices imperative hallucinations

Don't confuse with

commentary hallucinations conversational hallucinations

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