[Are there verbal hallucinations in autism? Review from a historical and transparadigmatic perspective].

Researchers looked at whether people with autism experience hearing voices (verbal hallucinations), which is important for telling autism apart from other mental health conditions like schizophrenia. They couldn't find enough strong research evidence to say whether people with autism do or don't hear voices. However, their analysis suggests that if people with autism do hear voices, these experiences would be different from what happens in psychosis.

This review examined whether verbal hallucinations occur in autism, addressing an important differential diagnosis challenge between autism and childhood schizophrenia. The authors conducted a selective, unsystematic review of current evidence and analyzed the concept of verbal hallucinations from historical and psychoanalytic perspectives. The review found insufficient scientific evidence to draw strong conclusions about the presence or absence of verbal hallucinations in autism. However, historical analysis and psychoanalytic contributions suggest that verbal hallucinations may be absent in autism or, if present, would differ qualitatively from those in psychosis.

This distinction has important implications for differential diagnosis and pharmacotherapy decisions.

The lack of clear evidence regarding verbal hallucinations in autism highlights the need for careful diagnostic assessment. Clinicians should be cautious about differential diagnosis between autism and psychotic disorders, particularly regarding medication decisions that may be influenced by the presence or absence of hallucinations.

This was a selective and unsystematic review, which limits the comprehensiveness and reliability of findings. No sample size reported. The conclusions rely heavily on historical and theoretical perspectives rather than empirical evidence.

The differential diagnosis between autism and schizophrenia in childhood has been the subject of numerous controversies. Because verbal hallucinations could be one of the main clinical phenomena when establishing a differential diagnosis, the objective was to investigate the presence or absence of verbal hallucinations in autism. For this, a selective and unsystematic review of the current scientific evidence was carried out. Added to this, the phenomenon of hallucination, and mainly verbal hallucination, was conceptualized from a historical perspective; the relevance given to hallucinations in the delimitation of the mentioned nosographic constructs was broached; and verbal hallucinations in autism were analyzed comparing different paradigms, including contributions from psychoanalysis.

We observe that from the side of scientific evidence it is not possible to state strong conclusions regarding the presence or absence of verbal hallucinations in autism. In turn, the historical review of the concept of verbal hallucination from classical psychiatry together with contributions from psychoanalysis, invite us to think that one of the differential characteristics between autism and psychosis is the absence of verbal hallucinations in the first diagnosis, and that if there were hallucinations in autism, these would present different qualities from those of psychosis. We consider it highly relevant to be able to establish this differentiation in the hallucinatory phenomenon in autism, not only in order to establish a differential diagnosis between the two conditions, but also because of the implications that this could have in pharmacotherapy.