The more patients know about who they are being asked to see, the less anxiety and fear of the unknown they will experience. In addition, it would be important to humanize the mental health professional. You can make reference to the mind-body connection or terms such as "holistic" or "multi-disciplinary approach" which are recognized and accepted in today's culture. Instead, you can emphasize that optimal treatment of hearing loss necessitates a team approach. When first referencing the patient's emotional pain, do not use loaded words such as "mental health," or "psychotherapy", as these words may be experienced by patients as assaults to their self-esteem and integrity.
It would be important to normalize (de-stigmatize) the referral. However, in my experience, unless the referral is made in a careful and compassionate manner, it will likely result in non-adherence by patients and may damage your relationship. The first step for differential diagnosis is referral to a mental health professional. For example, even in normal persons, hallucinations and illusions are not uncommon between waking and sleeping states: so-called hypnagogic hallucinations. The context and timing of the auditory experience is crucial for differential diagnosis. These may overlap to some degree with tinnitus or paracusis as they may be indistinct sounds, like the wind blowing or vague humming. However, there is another nosological category called "pseudo-auditory hallucinations." These are not clearly articulated voices or music, as in true auditory hallucinations, but are typically more vague and not understandable. These auditory hallucinations are a sign of mental illness, such as psychotic disorder or schizophrenia. In contrast, people with auditory hallucinations typically imagine hearing more complex auditory phenomena, such as clear and articulate voices saying certain things, well-defined singing or music. It occurs in the normal population, particularly with those who have hearing loss, or who have experienced head injury or other assaults to one's nervous system. How do you differentiate tinnitus from auditory hallucination? What is the best management for this kind of patient - referral to psychologist or psychiatrist? Or can you manage the same as you would manage tinnitus? AnswerĪs you know, tinnitus is typically a simple sound or a monotone: e.g., ringing, clicking, banging, buzzing, or pulsating sound. She has normal hearing but she claims that she can hear an old lady's voice without the presence of external stimulus.
Question I have a patient who has paracusis (auditory hallucination).
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