Dangerousness and command hallucinations: an investigation of psychotic inpatients.
M. E. Kasper, R. Rogers and P. A. Adams,
Bull. Amer. Acad. Psychiatry & the Law
24(2): 219-24, 1996.
Forensic consultations with psychotic inpatients frequently include issues of risk management, such
as dangerousness and civil commitment. An important dimension of these consultations is the role
of command hallucinations in producing an increased risk of aggressive behavior. In the present
study, psychotic patients with command hallucinations (N = 27) were compared with patients with
other hallucinations (N = 27) and with other psychotic patients (N = 30). The groups did not differ
on aggressive behavior or most nonhallucinatory symptoms. However, most patients (84.0%) with
command hallucinations had recently obeyed them. Among those with command hallucinations,
almost one-half had heard and attempted to obey messages of self-harm during the last month.