RT Journal Article SR Electronic T1 Fifteen minute consultation on children ‘hearing voices’: when to worry and when to refer JF Archives of disease in childhood - Education & practice edition JO Arch Dis Child Educ Pract Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 233 OP 237 DO 10.1136/archdischild-2014-307853 VO 100 IS 5 A1 Garralda, M Elena YR 2015 UL http://ep.bmj.com/content/100/5/233.abstract 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.