A Multinational Systematic Narrative Review of the Clinically Significant Features of Auditory Verbal Hallucinations: Implications for Early Intervention CBT.

Introduction: Auditory Verbal Hallucinations (AVH’s) are the most common form of hallucination occurring in psychosis (e.g. Waters et al., 2012). CBT for psychosis (CBTp) is the individual therapy with the greatest evidence base for this population (NICE, 2014) but treatment effects are moderate at best (Lincoln & Peters, 2019). These findings suggest a need to review the CBT model of psychosis by investigating what the clinically significant features of AVHs are, whether these are consistent across cultures, and whether these are captured within current CBTp models. This multinational review summarises the evidence for features of AVH’s in the early course of psychosis in the content, beliefs and topography domains that are associated with clinically important variables in the domains of the course of illness, co-morbidity, consequences of illness, cause of content and response to CBT treatment. Method: A systematic narrative review was conducted and registered on PROSPERO (CRD42021256220). Medline and Psychinfo databases were screened alongside a manual journal search of relevant journals to obtain new publications. The search was limited to English language [HCD(1] and updated until April 2023. Qualitative and quantitative studies were included with participants aged 18 and above diagnosed with psychosis and in the early course (mean