Visual hallucinations in psychiatry – what aren’t we seeing?

2021 ◽  
pp. 103985622110389
Author(s):  
Jeremiah Ayalde ◽  
Deborah Wearne ◽  
Sean Hood ◽  
Flavie Waters
Keyword(s):  
Psychotic Disorders ◽  
Psychiatric Disease ◽  
Visual Hallucinations ◽  
Visual Phenomena ◽  
The Subject

Objective: To increase awareness of practising clinicians and researchers to the phenomenological distinctions between visual hallucinations and trauma-based, dissociative, visual re-experiencing phenomena seen in psychiatric disease. Conclusions: The experience of visual hallucinations is not exclusive to psychotic disorders in psychiatry. Different forms of experiences that resemble visual hallucinations may occur in patients with a trauma background and may potentially affect diagnosis. Given the paucity of literature around the subject, it is imperative that further research aims to characterise the distinction between visual hallucinations in psychosis and visual phenomena associated with trauma.

scholarly journals Visual hallucinations associated with multimodal hallucinations, suicide attempts and morbidity of illness in psychotic disorders

2019 ◽  
Vol 208 ◽  
pp. 196-201 ◽  
Author(s):  
Virginie-Anne Chouinard ◽  
Ann K. Shinn ◽  
Linda Valeri ◽  
Philippe A. Chouinard ◽  
Margaret E. Gardner ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Visual Hallucinations

Treating chronically psychotic patients in nursing homes

2016 ◽  
Vol 33 (S1) ◽  
pp. S37-S37 ◽  
Author(s):  
J. Gauillard
Keyword(s):  
Nursing Home ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Psychiatric Hospitals ◽  
The Elderly ◽  
Sheltered Housing ◽  
Psychiatric Disease ◽  
Public Health Issue ◽  
Old Patients ◽  
Alzheimer Dementia

The increase of aging patients with schizophrenia becomes a public health issue. The exponential demography of the elderly, the improvement of cares associated with better physical follow-up directly impact the number of old patients with chronic psychiatric disease. Deinstitutionalization associated with a dramatic enhancement of ambulatory and community cares has led to a reduction of beds in psychiatric hospitals. When dependency occurs, due to physical comorbid illness or a worsening of the negative symptoms, psychiatric teams should find appropriate housing and no longer the psychiatric hospital. Nursing home and sheltered housing for the elderly dependent persons become a solution, but geriatric staffs are not always prepared to receive resident with schizophrenia and other psychotic disorders. They often are at a loss when faced with the expression of psychiatric symptoms or with the specificity of caring for often-younger patients whose behavior is different from older people with neurodegenerative disorders.How psychiatric teams could long-term assist the sheltered housing and nursing home and bring a psychiatric know-how within staffs often reluctant to deal with psychotic patients who could burden caregivers. How could they be trained to cope with complex cognitive functions impairments of schizophrenia, far from cognitive impairments of Alzheimer dementia? How to change the representation of psychiatric illness, which often leads to a double stigmatization (old age and madness)? Improving the quality of life of aging patients with severe chronic mental illness in homes for seniors is a great challenge for psychiatric teams in collaboration with geriatric caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.

Graphical Illustration and Functional Neuroimaging of Visual Hallucinations during Prolonged Blindfolding: A Comparison to Visual Imagery

Perception ◽  
10.1068/p6034 ◽  
2008 ◽  
Vol 37 (12) ◽  
pp. 1805-1821 ◽  
Author(s):  
Ruxandra Sireteanu ◽  
Viola Oertel ◽  
Harald Mohr ◽  
David Linden ◽  
Wolf Singer
Keyword(s):  
Mental Imagery ◽  
Functional Neuroimaging ◽  
Brain Activity ◽  
Visual Hallucinations ◽  
Related Activity ◽  
Healthy Female ◽  
Posterior Parietal ◽  
The Subject ◽  
Moving Patterns ◽  
Healthy Female Subject

Visual hallucinations can occur in healthy subjects during prolonged visual deprivation. We investigated the visual percepts and the associated brain activity in a 37-year-old healthy female subject who developed visual hallucinations during three weeks of blindfolding, and then compared this activity with the cortical activity associated with mental imagery of the same patterns. We acquired fMRI data with a Siemens 3T Magnetom Allegra towards the end of the deprivation period to assess hallucination-related activity, and again after recovery from blindfolding to measure imagery-related activity. Detailed subjective descriptions and graphical illustrations were provided by the subject after blindfolding was completed. The subject reported the occurrence of simple and elementary hallucinations, consisting of flashes and coloured and moving patterns during the period of blindfolding. Neural activity related to hallucinations was found in extrastriate occipital, posterior parietal, and several prefrontal regions. In contrast, mental imagery of the same percepts led to activation in prefrontal, but not in posterior, parietal, and occipital regions. These results suggest that deprivation-induced hallucinations result from increased excitability of extrastriate visual areas, while mentally induced imagery involves active read-out under the volitional control of prefrontal structures. This agrees with the subject's report that visual hallucinations were more vivid than mental imagery.

Hallucinations

1998 ◽  
Vol 86 (3) ◽  
pp. 851-877 ◽  
Author(s):  
James Robert Brasić
Keyword(s):  
Differential Diagnosis ◽  
Nursing Home ◽  
Behavioral Problems ◽  
Functional Neuroimaging ◽  
Phantom Limb ◽  
Visual Hallucinations ◽  
Wide Range ◽  
Visual Phenomena ◽  
Rapid Cognitive Decline ◽  
Home Placement

Hallucinations, sensory perceptions without environmental stimuli, occur as simple experiences of auditory, gustatory, olfactory, tactile, or visual phenomena as well as mixed or complex experiences of more than one simple phenomenon. The nature of the hallucination assists localization, differential diagnosis, and treatment planning. In particular, the presence of persistent visual hallucinations of persons with Parkinson's disease predicts dementia, rapid deterioration, permanent nursing home placement, and death. Hallucinations in persons with Alzheimer's disease are often associated with serious behavioral problems and predict a rapid cognitive decline. Theories of the etiology of hallucinations include (1) stimulation, e.g., neurochemical, electrical, seizure, and ephaptic, and (2) inhibition, e.g., destruction of normally inhibitory functions, resulting in disinhibition as in the Charles Bonnet and phantom limb syndromes. Functional neuroimaging procedures suggest anatomical associations for hallucinations. While hallucinations may be a symptom of medical, neurologic, and psychiatric disorders, they may also occur in a wide range of human experiences.

“Transition” to Schizophrenia or Fluctuations within the Same Disorder?

2021 ◽  
pp. 1-9
Author(s):  
Julie Nordgaard ◽  
Rasmus Handest ◽  
Mads Gram Henriksen ◽  
Anne Vollmer-Larsen ◽  
Peter Handest ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Psychotic Experiences ◽  
Level Of Functioning ◽  
Perceptual Disorders ◽  
Thought Disorders ◽  
The Subject ◽  
Schizotypal Disorder ◽  
Current Terminology ◽  
Distressing Condition

<b><i>Background:</i></b> To prevent or delay the onset of psychotic disorders or ameliorate their course, prodromal research has strived to identify and treat individuals at risk of developing psychosis. While this approach is laudable, it is, however, not entirely unproblematic from clinical and conceptual perspectives. For example, it remains unclear how we are to understand the development from a nonpsychotic, distressing condition such as schizotypal disorder to a psychotic disorder such as schizophrenia? The current terminology on the subject implies either a nonlinear jump (“conversion”) or a more linear progression (“transition”) from one disorder to another. To enrich our understanding of such diagnostic shifts, we examined the psychopathological pictures of patients who “transitioned” from schizotypal disorder to schizophrenia. <b><i>Methods:</i></b> From a larger study on psychopathology, we examined 40 patients who were diagnosed with schizotypal disorder at baseline. At 5-year follow-up, 30 patients maintained the diagnosis of schizotypal disorder, while 10 were re-diagnosed with schizophrenia. We examined detailed descriptions of the 10 patients who progressed to schizophrenia, comparing psychopathology and level of functioning. <b><i>Results:</i></b> The level of functioning decreased slightly from baseline to follow-up in 9 out of 10 patients. Eight patients had previously had micro-psychotic or psychotic experiences. All patients had self-disorders at baseline, and several patients had perceptual disorders. Nine patients had formal thought disorders at baseline. The progression is illustrated by 2 cases. <b><i>Conclusion:</i></b> In this small study, we did not find any striking changes in any of the patients, neither in terms of psychopathological manifestations nor in terms of their level of functioning. Thus, rather than witnessing a genuine “conversion” or “transition” from schizotypal disorder to schizophrenia, we observed dimensional fluctuations within the same condition.

Anterior Cingulectomy in Schizophrenia and Other Psychotic Disorders: Clinical Results

1954 ◽  
Vol 100 (418) ◽  
pp. 46-61 ◽  
Author(s):  
P. Macdonald Tow ◽  
R. W. Armstrong
Keyword(s):  
Mental Disorders ◽  
Local Anaesthesia ◽  
Psychotic Disorders ◽  
Clinical Results ◽  
Recent Interest ◽  
Mental Change ◽  
Original Procedure ◽  
The Subject ◽  
Constant Observation ◽  
Small Bundle

Recent interest in the surgical alleviation of mental disorders has centred in the trial of new and different operations. Fairly early in the development of the subject Freeman and Watts (1944) themselves reported the fairly constant observation that under local anaesthesia gross mental change did not occur until certain stab incisions had been made deep in the infero-medial quadrants. Marked mental change, with confusion, unresponsiveness and disorientation, seemed to occur on section of a small bundle of fibres located interiorly close to the midline. Most of the modifications of Moniz's original procedure have, however, been made on an essentially empirical basis.

Neuroanatomy

2012 ◽  
pp. 144-156
Author(s):  
R. C. A. Pearson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cerebral Cortex ◽  
Brain Structures ◽  
Psychiatric Disease ◽  
The Central Nervous System ◽  
The Subject ◽  
The Many ◽  
Brain And Spinal Cord

The symptoms, signs, and syndromes of psychiatry, whether organic or biological psychiatric disease or not, in the main reflect alterations in functions which reside in the cerebral cortex, including the limbic lobe, and those structures and pathways closely related to the cortex. These cortical manifestations of psychiatric disease include alterations in thought, language, perception, mood, memory, motivation, personality, behaviour, and intellect. Therefore, this brief account of brain structures and pathways that are important in psychiatry will concentrate on the cerebral cortex and related structures and pathways. Readers who require a fuller account of central nervous system anatomy are referred to the many standard texts, which give a more complete coverage of the subject. Broadly speaking, neuroanatomy can be subdivided into two parts—the topographical organization of the brain and spinal cord, and the anatomical connections forming functional pathways in the central nervous system. The former is of vital importance clinically, since pathologies rarely respect the boundaries of functional systems, and knowledge of the spatial relationships of different brain structures is increasingly useful as modern imaging methods more accurately visualize detailed brain structure in vivo. However, it is the second subdivision of the subject which makes the greater contribution to understanding the biological basis of psychiatric disease, and it is this that will be at the centre of the present account.

Psychiatry of Old Age

2014 ◽  
Author(s):  
Clare Wadlow
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Psychotic Disorders ◽  
General Medicine ◽  
Public Understanding ◽  
Psychiatric Disease ◽  
Allied Health Professionals ◽  
Unique Challenge ◽  
Health And Wellbeing ◽  
Psychiatric Theory

This chapter of practice exam questions aims to put you, albeit briefly, in the seat of an old age psychiatrist dealing with important aspects of psychiatric disease in older adults. Our population is ageing and this, in addition to wider public understanding and earlier diagnoses of dementia, is leading to an increasing burden of disease. Furthermore it is acknowledged that the incidence of affective and psychotic disorders unexpectedly peaks again as we reach old age and can be devastating if not recognized and managed effectively. The unique challenge of psychiatry of old age is the need for a sound grasp of general medicine and neurology to tackle unusual presentations of illness and possible multiple co-morbidities, in addition to a ground­ing in psychiatric theory. There remains a great need for lateral think­ing, particularly in liaison work on the medical and surgical wards where delirium is rife and can masquerade as everything psychiatric. Within the specialty, true collaboration exists as allied health professionals and psy­chiatrists work together at problem solving to improve patients’ quality of life beyond simply offering medication. An understanding of the pathology, epidemiology, diagnosis, and treat­ment of mental illness and dementia in older adults is an essential skill for any doctor at the coalface. Working with older adults is incredibly rewarding and never stops being educational to the clinician. These patients and their carers will continue to challenge and impress you throughout your career. As you manage to feel more confident with the facts, the practicalities and benefits of talking to and helping older adults become clearer. There is nothing that surpasses learning on the job, with many opportunities through attachments in psychiatry, GPs, ED, and geriatric wards. There are excellent resources available with regard to dementia, including NICE guidelines and the Alzheimer’s Society website. The aim of the following questions is to touch on a range of areas throughout the subject, taking us from first principles to practical applica­tion, through effective management, and support of older adults’ mental health and wellbeing.

scholarly journals Acute psychotic disorders induced by topiramate: report of two cases

2002 ◽  
Vol 60 (2A) ◽  
pp. 285-287 ◽  
Author(s):  
Florindo Stella ◽  
Dorgival Caetano ◽  
Fernando Cendes ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Antipsychotic Drugs ◽  
Psychotic Disorders ◽  
The Other ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Visual Hallucinations ◽  
Psychomotor Agitation ◽  
Full Remission ◽  
Epileptic Patients ◽  
Severe Anxiety

We report on two epileptic patients who developed acute psychosis after the use of topiramate (TPM). One patient exhibited severe psychomotor agitation, heteroaggressiveness, auditory and visual hallucinations as well as severe paranoid and mystic delusions. The other patient had psychomotor agitation, depersonalization, derealization, severe anxiety and deluded that he was losing his memory. Both patients had to be taken to the casualty room. After interruption of TPM in one patient and reduction of dose in the other, a full remission of the psychotic symptoms was obtained without the need of antipsychotic drugs. Clinicians should be aware of the possibility of development of acute psychotic symptoms in patients undergoing TPM treatment.

Charles Bonnet Hallucinations: A Case Series*

1992 ◽  
Vol 37 (4) ◽  
pp. 267-270 ◽  
Author(s):  
Martin G. Cole
Keyword(s):  
Substance Abuse ◽  
Emotional Response ◽  
Sensory Deprivation ◽  
Case Series ◽  
Eye Disease ◽  
Visual Hallucinations ◽  
Visual Deficits ◽  
Visual Status ◽  
Visual Phenomena ◽  
Impaired Cognition

Charles Bonnet hallucinations are complex visual hallucinations which occur during clear consciousness inpatients who do not suffer from psychosis, substance abuse, sleep disorders, focal neurological lesions or acute eye disease. They are well-defined images of patterns, scenes, animals or humans combined with normal perceptions and elicit a neutral or pleasant emotional response. Because of conflicting reports about cognitive or visual impairments among patients with these hallucinations, I describe the cognitive and visual status of 13 patients. One patient had preserved cognition and vision; three had preserved cognition and impaired vision; three had impaired cognition and preserved vision; and six had both impaired cognition and vision. It is unlikely that cognitive or visual deficits alone caused the hallucinations, but may have contributed to a state of sensory deprivation with visual phenomena.

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