Surreal image of a person with a cracked mask.

The Voice Within: How Mental Health Relapse Unexpectedly Improved a Voice Disorder

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"A fascinating case study reveals the surprising connection between psychosis and dysphonia, offering new insights into mind-body interactions."

The human body and mind are intricately connected, often in ways we are only beginning to understand. A recent case study published in BMJ Case Reports highlights one such surprising connection: the temporary remission of functional dysphonia, a voice disorder, during a psychotic relapse. This unique case challenges conventional understandings of both psychotic and dissociative disorders, opening new avenues for research and treatment.

Functional dysphonia, also known as dissociative dysphonia, is a condition characterized by difficulty speaking or changes in voice quality without any underlying physical cause. It is often linked to psychological factors such as stress, anxiety, or trauma. Psychotic disorders, on the other hand, involve disturbances in thought, perception, and behavior, often including delusions and hallucinations. While these two types of conditions are typically considered separate, this case study suggests a potential interplay between them.

This article delves into the details of this intriguing case, exploring the potential mechanisms behind this unexpected improvement in voice during psychosis and discussing the implications for future research and clinical practice. Understanding this connection may lead to more holistic and integrated approaches to treating mental health and voice disorders.

A Curious Case: Voice Improvement During Psychosis

Surreal image of a person with a cracked mask.

The case study focuses on a 40-year-old man diagnosed with schizoaffective disorder in 1989 and functional dysphonia in 2011. Despite ongoing speech therapy, his dysphonia symptoms persisted and worsened during times of stress. However, during a psychotic relapse in February 2013, his dysphonia dramatically and completely resolved. This resolution was temporary, with the voice disorder gradually returning as the psychosis subsided.

Before diving deeper, it’s important to understand the man’s history and the context surrounding these events:

Diagnosis: Schizoaffective disorder since 2005, initially diagnosed as Bipolar Affective Disorder in 1989.
Substance Use: History of alcohol dependence and harmful use of psychoactive substances (primarily cannabis), but abstinent for 11 years.
Treatment: Primarily managed with lithium carbonate and risperidone since 1992.
Family History: Mother treated for probable bipolar disorder; father diagnosed with an anxiety disorder.
Voice Disorder Onset: Dysphonia began in January 2011, coinciding with increased stress from public music performances. Symptoms included hoarseness, a high-pitched, tremulous voice, and difficulty articulating words.

The man's sudden improvement in voice quality during his psychotic relapse was a surprise to both him and his treatment team. This unusual occurrence prompted a deeper exploration into the potential relationship between these seemingly unrelated conditions.

Looking Ahead: New Directions for Research and Treatment

This case study underscores the intricate relationship between mental health and physical well-being. Further research is needed to explore the connection between psychosis and dissociative disorders, potentially leading to more integrated and holistic treatment approaches. By understanding these complex interactions, healthcare professionals can better address the diverse needs of individuals experiencing these conditions, ultimately improving their quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/bcr-2013-201531, Alternate LINK

Title: Psychosis Improved Dysphonia

Subject: General Medicine

Journal: Case Reports

Publisher: BMJ

Authors: R. A. Murphy, B. Hallahan

Published: 2013-12-09

Everything You Need To Know

What is functional dysphonia, and why is it important to understand?

Functional dysphonia, also known as dissociative dysphonia, is a voice disorder characterized by difficulties in speaking or changes in voice quality without any identifiable physical cause. It is often associated with psychological factors such as stress, anxiety, or past trauma. Understanding functional dysphonia is important because it highlights how psychological distress can manifest physically, affecting speech and communication. Recognizing and addressing the underlying psychological factors is crucial for effective treatment and management of the condition.

What are psychotic disorders, and why are they significant in mental health?

Psychotic disorders involve disturbances in thought, perception, and behavior, often including delusions and hallucinations. These conditions significantly impair an individual's ability to function in daily life and maintain normal social interactions. Psychotic disorders are important because they represent severe mental health challenges that require comprehensive treatment, including medication, therapy, and social support. Understanding the interplay between psychotic symptoms and other conditions, like voice disorders, can lead to more integrated and effective treatment approaches.

What is schizoaffective disorder, and why is it considered a complex condition?

Schizoaffective disorder is a chronic mental illness characterized by a combination of symptoms from both schizophrenia and mood disorders (like bipolar disorder or depression). Individuals with schizoaffective disorder experience psychotic symptoms such as hallucinations or delusions, as well as mood episodes. It's a complex condition because it requires managing both psychotic and affective symptoms. Treatment typically involves a combination of medication, therapy, and supportive care to stabilize mood, reduce psychotic symptoms, and improve overall functioning and quality of life.

Why is the patient's history of substance use important to consider?

The case study reports the patient had a history of alcohol dependence and harmful use of psychoactive substances, primarily cannabis, but had been abstinent for 11 years. Substance use is significant in mental health because it can exacerbate symptoms of mental disorders, interfere with treatment effectiveness, and complicate the diagnostic process. A history of substance use requires careful consideration in treatment planning to address potential interactions with medications, manage withdrawal symptoms, and provide appropriate support for maintaining sobriety. This also speaks to the complexity of the case study. We are not told if the patient underwent any formal substance rehabilitation.

What are lithium carbonate and risperidone, and why are they relevant in this context?

Lithium carbonate and risperidone are medications commonly used to manage mood and psychotic symptoms in conditions like schizoaffective disorder and bipolar disorder. Lithium carbonate is a mood stabilizer that helps to prevent both manic and depressive episodes, while risperidone is an antipsychotic medication that reduces symptoms such as hallucinations and delusions. These medications are important for maintaining stability and preventing relapse in individuals with these disorders. However, they also have potential side effects that require careful monitoring and management by healthcare professionals.