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Repetitive transcranial magnetic stimulation (rTMS) in schizophrenia with treatment-refractory auditory hallucinations and major self-mutilation

  • Psychiatry and Preclinical Psychiatric Studies - Short communication
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Abstract

Major self-mutilation is one of the most hazardous complications encountered in psychiatric patients, and is generally associated with auditory verbal hallucinations as part of a psychotic syndrome. This case report exemplarily discusses the treatment of such hallucinations with repeated (20 sessions) low-frequency (1 Hz) transcranial magnetic stimulation targeting areas of elevated metabolic activity in the temporo-parietal cortex (‘neuronavigated rTMS’), drawing upon experience concerning treatment of a patient with chronic auditory verbal hallucinations that had proved intractable to antipsychotic medication combined with cognitive behavioural therapy, and who had severed a forearm because of the content of these hallucinations. This example of major self-mutilation underscores the urgent requirement for effective management of chronic auditory verbal hallucinations in patients suffering from psychiatric disease, and neuronavigated rTMS represents an approach that deserves further exploration in this regard.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Torsten Schulz, Christoph Berger, Beate Krecklow, Paul Foley, Johannes Thome & Jacqueline Hoeppner

  2. Department of Nuclear Medicine, University of Rostock, Rostock, Germany

    Jens Kurth, Sarah Schwarzenboeck & Bernd Joachim Krause

Authors
  1. Torsten Schulz
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  2. Christoph Berger
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  3. Beate Krecklow
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  4. Jens Kurth
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  5. Sarah Schwarzenboeck
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  6. Paul Foley
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  7. Johannes Thome
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  8. Bernd Joachim Krause
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  9. Jacqueline Hoeppner
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Correspondence to Jacqueline Hoeppner.

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Schulz, T., Berger, C., Krecklow, B. et al. Repetitive transcranial magnetic stimulation (rTMS) in schizophrenia with treatment-refractory auditory hallucinations and major self-mutilation. J Neural Transm 122 (Suppl 1), 19–23 (2015). https://doi.org/10.1007/s00702-013-1151-5

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  • DOI: https://doi.org/10.1007/s00702-013-1151-5

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