A patient has mentioned hearing a voice that seems connected to her own thinking. Before revealing the answer, decide how you would explore whether this is thought echo.

Ask precisely what the voice says in relation to what she is thinking: does it repeat or speak her own thoughts word for word, rather than commenting on her actions or holding an independent conversation, since this content match is the core defining feature. Establish the timing carefully, since this is the key distinguishing detail: is the voice simultaneous with the thought, or does it follow by a short, consistent delay? Ask whether she recognises the content as her own thought even though the experience feels like hearing an external voice, since this combination of recognised-own-content with external perceptual quality is characteristic, and check for other, related experiences such as running commentary or thought broadcasting occurring alongside it.