Auditory Hallucinations in Schizophrenia: A Family Perspective - Psychiatry

I would like to inquire about the issue of auditory hallucinations in family members?

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Hello Doctor, the article is a bit long QAQ.

The general situation is that my sister, who is being treated for schizophrenia, has recently been experiencing persistent auditory hallucinations.
She has been sending voice messages and texts to a classmate who has blocked her, believing she can perceive that classmate's thoughts and feelings, and wants to communicate with him.
My sister showed signs of illness starting in middle school (she has seen doctors and taken medication).
About five years ago, she secretly stopped taking her medication, which led to a more severe relapse, resulting in a hospital stay of over a month.
She is now attending regular follow-ups and receiving long-acting injections, and while she is somewhat stable with medication adherence, she has limited insight into her condition and still experiences some symptoms of auditory hallucinations (for example, hearing various 'inner thoughts' or having certain 'intuitions').
Sometimes she struggles to distinguish which thoughts are her own, and she often feels bored and seeks someone to talk to, frequently coming to find me (she tends to want to stay in my room all day).
Recently, however, she has started to close her bedroom door (which is also related to my occasional desire to do my own things).
When she talks on the phone, she sometimes closes the door, and I keep a discreet eye on her (she has previously chatted with some online friends who sent strange photos or tried to scam her, but she is now better at rejecting such interactions and has mostly stopped using dating apps).

This time, she told me that she has been sending voice messages to a boy she likes from her high school night school (she returned to school a few years after graduating from middle school, and her relapse after stopping medication also occurred during her senior year).
Since her relapse and discharge from the hospital, she still 'feels' that she and this boy have mutual feelings for each other, as if they are soulmates.
During her various hallucinations, she has also heard the boy speaking to her, and recently, while talking to me in the afternoon, she suddenly said to wait a moment because she needed to do something else, then closed the door and started sending voice messages to that boy.
It felt like she was responding to what she perceived as the 'boy's thoughts.'
Before this, my family and I thought she had been chatting with friends (whom she met through an online group for a 'mental health growth course,' and fortunately, the people she has met are generally supportive and encouraging).
I briefly checked her chat history and found that besides sending voice messages, she would suddenly send messages like 'What's wrong with you?' or 'I feel like you're not happy right now,' or 'Yeah, me too,' but in reality, the boy did not reply to any of her messages (he had blocked her on LINE a few years ago).
However, aside from this, my sister seems to be doing relatively well, appearing to be in a good mood because she has something to do and a new way to express or share herself.
She might also be aware that it looks a bit strange to others when she is alone sending voice messages to her phone, which is why she closes the door.
However, she often stays in there for an entire day (though she doesn't spend all day sending messages; sometimes she talks for a minute or two, and other times she shares bits of her life for half an hour, intermittently).
Occasionally, she comes out to chat for a bit and have a snack.

Although the doctor has mentioned that some people may experience symptoms occasionally due to changes in weather or other factors, I am still a bit concerned.
I wonder if this situation can be considered 'relatively stable,' or if it is simply a manifestation of symptoms that have always been present, now becoming apparent through this situation.
She just had a follow-up appointment last week, and I am unsure if this situation existed then.
She prefers to talk to the doctor alone during her visits, so I'm not certain if she mentioned it.
The next follow-up is in a month, so I wanted to consult you first to understand what this symptom might indicate.
If there are no other signs of relapse, is it sufficient to keep a close watch? I apologize for the lengthy message, and thank you for your help.
^ ^

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Yangyang, 30~39 year old female. Ask Date: 2024/01/19