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Intermediate Technical IVT

Command hallucination

Auditory hallucinations that instruct the patient to perform specific actions, posing significant safety risks.

Full Definition

Command hallucinations are a specific type of auditory hallucination in which the patient hears voices giving direct orders or instructions to perform certain behaviors. These can range from benign commands to dangerous instructions involving self-harm or harm to others. Assessment of command hallucinations requires immediate evaluation of the patient's ability to resist these commands and their potential for acting on them. Documentation should include the specific nature of commands, frequency, clarity, and the patient's response or compliance history, as this information is critical for risk assessment and safety planning.

Usage

Usage note: Always assess and document patient's ability to resist commands. Critical for risk assessment documentation.

In Context

  • "Patient reports command hallucinations instructing him to harm himself, requiring immediate safety precautions." — Emergency psychiatric evaluation
  • "The command hallucinations have decreased in frequency since medication adjustment." — Progress note

Also known as

commanding voices imperative hallucinations

Contrasted with

benign hallucinations non-command hallucinations

Don't confuse with

thought insertion obsessive thoughts delusions

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