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PubMed1995

The illusion of reality or the reality of illusion. Hallucinations and culture.

BACKGROUND: The aim of this review is to integrate research findings on the role of sociocultural factors in hallucinations and to relate these factors to current psychological theory and research. METHOD: The literature was surveyed by manual search, and the more reliable studies selected for the review. RESULTS: One hundred and thirteen publications were scrutinised and 30 of them were included in this review. CONCLUSIONS: Cross-cultural concepts of reality are related to the development and the threshold of hallucinations. Attitudes toward hallucinations tend to affect the emotional reaction to, and the degree of control of, these experiences. Awareness of these attitudes may help the diagnostician to distinguish between pathological and culturally sanctioned hallucinations. It is important that therapists consider the functional significance and meaning of hallucinations as well as the social context and the stimuli associated with them.

Cross-Cultural Comparison↗
PubMed2003

Hallucinations in nonpsychotic children: findings from a psychiatric emergency service.

Sixty-two cases of children with hallucinations but without psychosis were identified in a psychiatric emergency service. Auditory hallucinations were more frequent than visual ones. There were positive trends between the content of auditory hallucinations and diagnosis. Recognition of this clinical phenomenon of hallucinations in children in the absence of psychosis and awareness of underlying psychopathology and precipitating factors is necessary in evaluating hallucinations in nonpsychotic children. Children with such presentations run the risk of being misdiagnosed as having psychosis or schizophrenia and being subjected to the inherent risks of treatment with antipsychotics.

Adolescent↗
PubMed2000

Incidence of and risk factors for hallucinations and delusions in patients with probable AD.

OBJECTIVE: To examine the incidence of and risk factors for hallucinations and delusions associated with patients clinically diagnosed with probable AD. BACKGROUND: Estimates of the incidence of psychosis in AD range widely from 10% to 75%. The risk factors for psychosis of AD are not known, although multiple studies indicate that AD patients with psychosis demonstrate greater cognitive and functional impairment. METHODS: The authors conducted psychiatric evaluations of 329 patients with probable AD from the University of California at San Diego Alzheimer's Disease Research Center to determine the incidence of hallucinations and delusions. They examined data from annual clinical and neuropsychological evaluations to determine whether there were specific risk factors for the development of hallucinations and delusions. RESULTS: Using Cox survival analyses, the cumulative incidence of hallucinations and delusions was 20.1% at 1 year, 36.1% at 2, 49.5% at 3, and 51.3% at 4 years. Parkinsonian gait, bradyphrenia, exaggerated general cognitive decline, and exaggerated semantic memory decline were significant predictors. Age, education, and gender were not significant predictors. CONCLUSIONS: The authors found a relatively high incidence of hallucinations and delusions in patients diagnosed with probable AD and suggest that specific neurologic signs, cognitive abilities, and accelerated decline may be predictive markers for their occurrence.

Alzheimer Disease↗
PubMed2003

Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder.

In light of recent studies indicating a relationship between child abuse and the positive symptoms of schizophrenia, this study investigated the hypotheses that childhood sexual and physical abuse are related to hallucinations, delusions, and thought disorder in adults, and that those relationships are greater in those who have suffered abuse during adulthood as well as childhood. In 200 community mental-health-centre clients, the clinically evaluated symptomatology of the 92 clients whose files documented sexual or physical abuse at some point in their lives was compared with that of the 108 for whom no abuse was documented. In the 60 patients for whom child abuse was documented, hallucinations (including all six subtypes), but not delusions, thought disorder or negative symptoms, were significantly more common than in the non-abused group. Adult sexual assault was related to hallucinations, delusions, and thought disorder. In linear regression analysis, a combination of child abuse and adult abuse predicted hallucinations, delusions, and thought disorder. However, child abuse was a significant predictor of auditory and tactile hallucinations, even in the absence of adult abuse. Possible psychological and neurobiological pathways from abuse to symptoms are discussed, along with research and clinical implications.

Adolescent↗
PubMed1977

Somesthetic hallucinations and motility in schizophrenia: neurophysiological views and information flow model.

Clinical study of three schizophrenic men without known seizure disorders has heuristic implications, pointing to neurophysiological factors in their somesthetic hallucinations: (a) In two instances the body areas involved in such hallucinations (the abdominal cavity and the top of one foot) also happen to be represented side by side on the "map" of the receptive somesthetic areas at the postcentral gyrus. (b) In all three schizophrenic men the occurrence of their somesthetic hallucinations can be conceptualized along the lines of MacKay's (1970) information flow model for perception in general, with some specific modifications, which center around the key roles of sufficient change occurring in two specific aspects of this model. (c) Further conceptualization is suggested within Grey Walter's (1973) testable model of triple association among Conditional, Imperative and Operant Response--albeit mostly in reverse sequence with respect to somesthetic hallucinations under discussion. These schizophrenic men reveal in their past and present experiences a pattern in which the sequence of events is initiated through changes at the efferent side (restriction of voluntary motility), which trigger afferent experiences, albeit hallucinated ones. Practical implications center around the probably salutary role of voluntary motility performed purposefully and at the person's own pace.

Adult↗
PubMed1982

Visual hallucinations in blindness: the Charles Bonnet syndrome.

A 64-year-old woman developed complex visual hallucinations consisting of snakes crawling out of people's head and on her body. She had become blind 14 years before the onset of the hallucinations. Neurosurgical removal of a large suprasellar meningioma was followed by disappearance of her hallucinations. This case suggests that the complex hallucinations often encountered in blind subjects ("release hallucinations"), a phenomenon originally described by Charles Bonnet in 1769, are related to both sensory deprivation and an impairment in CNS functioning.

Blindness↗
PubMed2002

Hallucinations with therapeutic doses of clarithromycin.

OBJECTIVE: Hallucinations caused by adverse reactions to medication are not uncommon and a wide variety of drugs may be involved. We present a case of hallucinations caused by therapeutic doses of oral clarithromycin (500 mg b.i.d). CASE REPORT: A 32-year-old woman attended the Emergency Department of the hospital with severe visual hallucinations together with marked anxiety and nervousness following the second dose of clarithromycin, which was the only medication she was taking. The antibiotic was identified as the possible cause of the clinical manifestations and was stopped immediately. The patient did not require hospitalization and was discharged a few hours later with no signs of neurological disturbances. Clarithromycin was substituted by amoxycillin-clavulanic acid (500/125 mg) t.i.d. CONCLUSIONS: The temporal relationship between commencement of antibiotic therapy and the appearance of hallucinations, together with the fact that the symptoms disappeared once the antibiotic was suspended, support a causal relationship between clarithromycin and the hallucinations. Further support for a causal relationship was obtained by application of Naranjo's algorithm which gave a likelihood level for causality of PROBABLE.

Adult↗
PubMed2000

[Complex visual hallucination in the quadrantanopsic field in a patient with a medial temporal hematoma following left putaminal hemorrhage].

A 56-year-old man with a left medial temporal lobe hematoma from the left putaminal hemorrhage presented with complex visual hallucinations in the right quadrantanopsic field. In the right superior quadrantanopsic field, he saw colored and formed hallucinations of plants, bamboo thickets and a stature of bodhisattva. Most of these hallucinations were what he had actually seen before. The visual hallucinations disappeared when he gazed them with saccadic eye movements. EEG showed no epileptic discharges. MRI revealed hematoma from the lower putamen to the medial temporal lobe including amygdala on the left. 123I-IMP SPECT showed hypoperfusion in the left temporal lobe and in the left occipital and parietal lobes. We speculate that the hallucinations of the present case were produced by the dysfunctions not only of the temporooccipital and temporoparietal regions but also of the posterior inferotemporal cortex which has strong interactions with amygdala and works as the visual memory center.

Amygdala↗
PubMed2000

[An unusual case of epilepsy exhibiting gelastic seizure, simple visual hallucination, and transient swelling of the left parieto-occipital region].

We report a 74-year-old man with gelastic seizure, simple visual hallucination, and adversive seizure. The patient described his visual hallucinations as "rotating light like a firefly" and "mimicking a stream". Brain CT scan showed a transient swelling as well as low density of a left parieto-occipital region. Electroencephalographic study revealed spikes and fast waves beginning at left occipital region. Although temporal lobe and hypothalamic lesions (especially hypothalamic hamartomas) are well known as origins of gelastic seizures, we could not find any report that described a series of occurrence of gelastic seizure and simple visual hallucination. Usually, simple visual hallucination is thought to occur in occipital lesion. In our case, it is possible that gelastic seizure and simple visual hallucination are related to the epileptic discharge from occipital lesion directly or indirectly. The reversible brain swelling with low density seen in the present case might be caused by cytotoxic edema due to status epilepticus.

Aged↗
PubMed2000

Dichotic listening in college students who report auditory hallucinations.

College students were placed in 2 groups, hallucinators and nonhallucinators, on the basis of their responses to a verbal hallucinations questionnaire. Both groups were given a consonant-vowel version of a Dichotic Listening Test under 3 conditions: nonforced, forced-right, and forced-left. When hallucinators were instructed to attend to the left ear stimuli (forced-left condition), they had fewer correct responses to right ear syllables than did nonhallucinators. This resulted in a left ear advantage for hallucinators. When nonhallucinators were instructed to attend to the left ear, they maintained a right ear advantage. Results suggest that auditory hallucinations in college students are associated with differences in hemispheric functioning.

Adult↗
PubMed2001

[A case of 'hallucination of soliloquy' with hypothyroidism induced Hashimoto disease. Meaning of psychopathological research about symptomatic psychosis].

We describe the first reported case of symptomatic psychosis with the 'hallucination of soliloquy.' A 48[correction of 40]-year-old woman with Hashimoto disease exhibited of compulsive checking, mysophobia, and excessive hand washing. When these obsessive-compulsive symptoms diminished, she began to suffer from the 'hallucination of soliloquy', the automatic flow of meaningless words inside her mind. As the 'soliloquy' increased, her mood became unstable and she attempted suicide by analgesic ingestion. After this, she was admitted to the psychiatric ward of a general hospital. The administration of clomipramine (150 mg daily) decreased the 'soliloquy' symptoms, but they did not resolve. When hypothyroidism became available, thyroid hormone treatment (levothyroxine at 50 mg daily) was started. Four weeks later, her 'soliloquy' symptoms had almost resolved and after three months in a stable state, thyroid hormone treatment was stopped and her 'soliloquy' symptoms soon reappeared. After thyroid hormone treatment was resumed, her 'soliloquy' symptoms disappeared immediately. Typical auditory hallucinations and delusions of reference were not observed throughout the clinical course. We speculate that the symptoms were symptomatic psychosis induced by hypothyroidism secondary to Hashimoto disease, because the changes of her hallucinations were related to free T3 values and the symptoms disappeared soon after starting thyroid hormone treatment. The main features of this case were 'soliloquy' alternating with obsessive-compulsive symptoms, but her 'soliloquy' symptoms were thought to be autochthonous ideas rather than obsessive thoughts. Furthermore, the symptoms in this case were different from schizophrenia, since there was no disturbance of communication, and she had the sensation of both speaking and hearing her own voice. The psychopathology of this 'hallucination of soliloquy' may be related to the theory of 'vocalization of background thinking' (N. Nakayasu). Detailed observation of patients with symptomatic psychosis and a psychopathological description of their symptoms may help to contribute to the etiologic elucidation and treatment of psychosis.

Female↗
PubMed2002

[Hallucinations, delusions, and nocturnal events in 152 Parkinson's patients: a regional survey].

Parkinson's disease cannot be reduced to its motor symptoms. Psychological and behavioral disorders often accompany its development. Our study was conducted in June 1999 among 36 neurologists practicing in hospital or private clinic settings in the Poitou-Charentes area. Neurologists were requested to record hallucinations, delusions and nocturnal events observed in Parkinson's patients. A total of 152 reports were collected from 17 physicians. Fifty-three percent of the patients attended hospital clinics and 47p.100; were seen at the physician's office. Hallucinations were recorded in 23.1p.100; of the patients. The risk of hallucination symptoms was higher among patients seen at hospital clinics and who had more advanced disease. Only 7.2p.100; of the patients reported delusions, most often of a persecution type. Nocturnal events affected 49.3p.100; of the patients. The appearance of such symptoms was highly related to Hoehn and Yahr stage and was more frequent in hospital patients. Hallucinations, delusions, and nocturnal events affect patients with advanced Parkinson's disease, associated with long-term L-dopa treatment. Eighty-three percent of the patients had such symptoms and most of them used L-dopa. This long-term treatment is linked to these three symptoms. Hallucinations were increasingly reported for patients with increasing long-term medication with dopaminergic agonists. Nocturnal events, for patients on L-dopa, were associated with advanced disease, long-term treatment with L-dopa, and hospitalization. Psychic and behavioral disorders appear frequently in Parkinson's disease patients and are inter-related. Physicians should be aware of the relationship with treatment to avoid aggravation.

Aged↗
PubMedDate not supplied

[Evaluation of auditory hallucinations: the PSYRATS scale].

INTRODUCTION: Translate and adapt the PSYRATS scale for evaluation of auditory hallucinations to Spanish and study the psychometric behavior. METHOD: After being translated into Spanish, the scale was applied to a sample of 80 patients. All had a history of auditory hallucinations, 71 with Schizophrenia and 9 with schizoaffective disorder according to DSM-IV diagnostic criteria. Demographic and clinical data were collected by a semi-structured interview, tape recording the sessions for every patient. For the reliability study, 27 patients of the sample were evaluated independently by the first four auhors of this paper. For the study of concurrent validity the results of this scale were compared with those of the Krawiecka scale in 60 patients of the sample. RESULTS: In the Spanish version, the 11 items were conserved with slight modifications in two of them. The scale showed high reliability with coefficients in the 11 items higher than 0.85. The concurrent validity showed high association between the hallucination item of the Krawiecka scale and the PSYRATS. In the factorial analysis four factors that explained 62% of the variance were obtained. CONCLUSIONS: The Spanish version of the PSYRATS (for hallucinations) is, to our knowledge, the first scale adapted to Spanish for the study of auditory hallucinations, showing excellent psychometric properties.

Adolescent↗
PubMed1991

Verbal hallucinations in psychotic patients.

"Verbal hallucinations" are sentences that psychotic patients may say repeatedly throughout a conversation which are out of context or unconnected to the topic of conversation. These hallucinations are not the outcome of a remembrance of an experience or an event and do not bring about any emotional relief or catharsis, but they supply valuable information. They resemble Jacques Lacan's description of the psychotic mechanism "Forclusion." This mechanism relates to experiences that did not undergo the process of primary symbolization through language, and experiences where words were attached but were not bound to the language structure. The result being that these experiences did not enter into the unconscious discourse of the subject. This information can reappear as verbal hallucinations in the psychotic patient. In such cases, the therapist, with the assistance of the patient's family, must investigate the meaning of the verbal hallucinations through research into the patient's and family's history in the phase prior to language development. When such a connection is discovered, the therapist must then bridge the hallucinations with the events unknown to the patient but contained in his subconscious. The therapist's role in such cases resembles that of a parent with a child: To translate the subject's experience through language from the physical schema to the body image and symbolic plane and in so doing, give meaning to meaninglessness. In our paper three short clinical cases are presented.

Body Image↗
PubMed1991

[Visual hallucination associated with anterior cerebral artery occlusion].

The author experienced two cases who showed visual hallucinations after they had had CT-proven cerebral infarctions in the left fronto-medial lobe. Cerebral angiography evidenced the occlusion of the left anterior cerebral artery at the genu portion (case 1) and after branching the frontopolar artery (case 2). Case 1 was a 50 year old national rail way officer who had neither past history of a drug abuse nor that of psychoses. His initial symptom was right hemiparesis predominantly in his lower extremity. Mutism and sympathetic apraxia were also observed. About three months after the onset, he showed psychical excitement due to his curious experience of seeing dogs and snakes in the window and ceiling of his hospital room. A famous professional golf player was also seen. This hallucination lasted about three weeks and never occurred afterwards. Case 2 was a 70 year old housewife who was noticed abnormal by her family because of her mutism of sudden onset. Clumsiness of her extremities was also seen. She had nothing to do with a drug abuse and psychoses. Three days after the onset her mutism turned into talkativeness. She complained of seeing dead persons, who were hanging and coming from the ceiling of her room. Animals and familiar landscapes were also seen. This hallucination lasted about a week. In both cases hallucinations were vivid and colorful. Patients were basically critical for the phenomena although they were initially influenced and excited by them. Temporal and occipital lobes have been thought to bo responsible for the occurrence of organic hallucinations in supratentorial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

True hallucination as conversion symptom--a case report.

The concept of conversion hallucination is a relatively new one, however there have been several articles written on this phenomena, some attesting to it being a special form of hallucination while others dismissing it altogether. But currently this concept is slowly being accepted among psychiatrists and as such it is important for us to understand some of the concepts. In this case report, the patient presented with clear conversion hallucinations. The case is followed by a discussion on true and pseudo-hallucinations, previous case reports and finally a discussion of conversion hallucinations, viz. the clinical features and the conversion hypothesis.

Adult↗
PubMed1977

A study of reported hallucinations in a southeastern county.

In traditional Western psychiatric theory, seeing or hearing things that other people do not think are there could be termed a hallucination which is often considered indicative of underlying psychopathology. The psychiatric interpretation of pathological meanings of these experiences for an individual can be contrasted with an anthropologic approach which considers whether there are underlying cultural influences to account for certain distributions of reported hallucinations and their content and to ask about the social and spiritual, as well as psychologic, meanings of such experiences. This paper presents data on reported hallucinations in a random sample of the general population of a county in north central Florida. When the results of the questions on hallucinations were compared in relation to sociodemographic variables, it was found that hallucinations were more commonly reported by the young, by blacks, by members of the lower socioeconomic quintiles and by those belonging to certain church types. These data will be discussed from the complementing and contrasting psychiatric and anthropologic viewpoints.

Adolescent↗
PubMed1994

[A study of relationships among solvent inhalation, personality and expectancy; especially on affinity to hallucination, sensation seeking and neurotic tendency].

94 delinquents in two homes for resocialization were surveyed to elucidate the relationship among the status of volatile solvent inhalation, expectancy and personality. The subjects were classified into solvent-inhalation group and non-solvent-inhalation group, and the former was divided into solvent dependence group and abuse group according to DSM-III-R. Each group was given personality tests; general health questionnaire (GHQ), sensation seeking scale (SSS), the vividness of visual imagery (VVIQ), test of visual imagery control (TVIC) and Yatabe-Guilford test (YG). In addition we investigated expectancy and mental symptoms caused by inhalation in it. The results are summarized as follows; 1. Inhalation group scored higher on SSS than non-inhalation group. 2. Compared with abuse group, dependence group presented with 1) higher GHQ score meaning neurotic tendency; 2) higher TVIC score meaning imagery-control-ability; 3) a higher incidence of day-dream and hallucination, especially egosyntonic type; 4) higher expectancy of "enhancement of positive affection", "reduction of negative affection" and "hallucination seeking"; 5) lower expectancy of "association with friends". 3. Higher scored inhalers on TVIC showed visual hallucinations, especially egosyntonic type more frequently than lower ones. 4. Significant correlations were recognized between GHQ score and expectancy of "reduction of negative affection", and between lack of objectiveness score of YG subscale and "hallucination seeking" expectancy. These results suggested that 1) beginning of inhalation is associated with sensation seeking trait, 2) progression to solvent dependence is correlated with three expectancies, i.e., seeking egosyntonic hallucinations paralleling high imagery-control-ability and subjectivity, reducing negative affection paralleling neurotic tendency, and enhancing positive affection. According to the findings, indulgence to drug induced positive imagery led delinquents into splitting of personality. In their treatment we need to help them to integrate high imagery ability and sensation seeking for recovery.

Adolescent↗