PT - JOURNAL ARTICLE AU - M Elena Garralda TI - Fifteen minute consultation on children ‘hearing voices’: when to worry and when to refer AID - 10.1136/archdischild-2014-307853 DP - 2015 Oct 01 TA - Archives of disease in childhood - Education & practice edition PG - 233--237 VI - 100 IP - 5 4099 - http://ep.bmj.com/content/100/5/233.short 4100 - http://ep.bmj.com/content/100/5/233.full SO - Arch Dis Child Educ Pract Ed2015 Oct 01; 100 AB - Auditory hallucinations are uncommon paediatric presentations, but they can be alarming and lead to emergency consultations. This review outlines the phenomenology of auditory hallucinations, their assessment and clinical significance. Auditory hallucinations are seen in the course of acute medical disorders, often together with decreased levels of consciousness, as in febrile illness and in toxic, neurologically compromised states; they can also be a feature of episodic neurological conditions such as migraine and temporal lobe epilepsy. Auditory hallucinations are key symptoms in psychiatric disorders such as schizophrenic and other psychotic states, but they can also present with depressive and anxiety disorders, and in the context of virtually every psychiatric disorder of childhood. In fact hallucinations—usually simple and transient—are common in the general child populations. Auditory hallucinations become clinically significant when they occur as part of a medical disorder or in the context of acute psychotic states and schizophrenia, when they are frequent, complex, distressing and cause impairment. The treatment of clinically relevant hallucinations is that of the primary medical or psychiatric disorder. Occasionally they require treatment in their own right with psychological treatments, and only when these have been tried and fail, a careful trial of antipsychotic medication may be appropriate.