Relation between command hallucinations and dangerous behavior.

This article presents an updated review of studies on the relation between command hallucinations and dangerous behavior. The author reviewed all studies published between 1966 and 1997 according to MEDLINE and between 1974 and 1997 according to PSYCLIT. Forty-one studies were found, of which 82.9 percent dealt with the relation between command hallucinations and dangerous behavior. Of these studies, 32.3 percent were controlled, and they were grouped into three partially overlapping classes: those concerned with violent behavior, those concerned with suicidal behavior, and those concerned with mediating variables. Most of these studies agreed on the non-existence of an immediate relation between command hallucinations and dangerous (violent or suicidal) behavior. Even though the studies were divided about the existence of a relation between severity/dangerousness of command content and compliance with the commands, there was agreement about the existence of a direct relation between compliance with commands and both benevolence and familiarity of commanding voice. It seems that the research and knowledge available to date on this subject is both scant and methodologically weak. Future study should probably concentrate on mediating factors, such as appraisal and coping attitudes and behaviors.