Persistent auditory hallucinations despite hearing aid use in bilateral sensorineural hearing loss without evidence of psychosis

Abstract

Auditory hallucinations are frequently linked to the onset of psychotic disorders, especially when accompanied by delusions or disorganized thinking. However, hallucinations may also arise from non-psychiatric causes. Hearing loss is often underrecognized as a contributing factor, since reduced auditory input can produce perceptual experiences that mimic psychosis. This case report presents a woman in her 50s with bilateral sensorineural hearing loss who experienced persistent auditory hallucinations for more than 3 years. She maintained insight, normal daily functioning, and exhibited no other features of a primary psychotic disorder. Neuroimaging was unremarkable, and multiple antipsychotic trials yielded minimal benefit. Despite improved auditory input with hearing aids, her hallucinations persisted, highlighting that symptoms related to sensory deprivation may not resolve immediately after hearing correction. This case illustrates how sensory deprivation-related hallucinations can be misdiagnosed as psychiatric illnesses, resulting in unnecessary interventions. It underscores the importance of early identification of sensory impairments and interdisciplinary collaboration when clinical presentations deviate from typical psychiatric conditions.