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PubMed1998

Night-time hypnopompic visual hallucinations related to REM sleep disorder.

We encountered three patients who had experienced hypnopompic visual night-time hallucinations. Their clinical manifestations resembled Charles Bonnet's syndrome and the content of their experiences were understood as attempts at wish fulfillment. However, abnormal REM findings were recognized on polysomnogram at the occurrence of visual hallucination in two cases. We speculated that dysfunction of REM sleep mechanism might contribute to the night-time occurrence of such kind of visual hallucination and that their visual experiences might be reflected by dream content.

Aged↗
PubMed2004

Musical and auditory hallucinations: A spectrum.

Musical hallucinosis is a rare and poorly understood clinical phenomenon. While an association appears to exist between this phenomenon and organic brain pathology, aging and sensory impairment the precise association remains unclear. The authors present two cases of musical hallucinosis, both in elderly patients with mild-moderate cognitive impairment and mild-moderate hearing loss, who subsequently developed auditory hallucinations and in one case command hallucinations. The literature in reference to musical hallucinosis will be reviewed and a theory relating to the development of musical hallucinations will be proposed.

Aged↗
PubMed2004

Phenomenological features of auditory hallucinations and their symptomatological relevance.

Auditory hallucinations include particularly diverse phenomena that reflect various mental functions and pathologies. Their assessment may provide valuable clinical information. This article describes the development of the Matsuzawa Assessment Schedule for Auditory Hallucination (MASAH), which was designed to obtain a broadened view of the phenomena by investigating a wide range of their characteristics. The aim was to identify the basic phenomenological features of auditory hallucinations by performing a factor analytic study of the MASAH ratings of 214 patients with schizophrenia or schizoaffective disorder. Four identified factors were intractability, delusion, influence, and externality, on the basis of which we constructed composite scales that were assumed to represent the features. The correlation analysis of the scales with symptom dimensions derived from the positive and negative syndrome scale verified their clinical relevance. They were also interpretable in terms of human responses to the abnormal experience and some symptom constructs such as delusion and influence experience. It is concluded that the MASAH is an efficient means for evaluating the features, and that this study elicited new understandings of the phenomena such as their multifarious composition and contiguities with other psychotic symptoms.

Adult↗
PubMed1987

Hallucinations in children and teenagers admitted to Bethlem Royal Hospital in the nineteenth century and their possible relevance to the incidence of schizophrenia.

The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital, ("Bedlam"), in the nineteenth century were analysed with particular reference to the frequencies and types of hallucinations. There was a significant increase (P less than 0.001) in the frequencies of auditory and visual hallucination from 1830 to the end of the century. The presence of auditory hallucinations of people, when they occurred in males, significantly worsened the prognosis (P less than 0.025) compared to females. The findings are considered with special reference to the incidence and aetiology of schizophrenia in the last century.

Adolescent↗
PubMed1990

Evidence of a monoaminergic-cholinergic imbalance related to visual hallucinations in Lewy body dementia.

Senile dementia of Lewy body type is characterized clinically by a relatively acute onset of fluctuating memory loss and confusion, frequently accompanied by visual hallucinations. Neurochemical analyses of temporal cortex has revealed a distinction between hallucinating and nonhallucinating patients in both cholinergic and monaminergic transmitter activities. In contrast with the cholinergic enzyme choline acetyltransferase, which was more extensively reduced in hallucinating individuals, serotonergic S2 receptor binding and both dopamine and serotonin metabolites were significantly decreased in nonhallucinating cases. These results suggest that an imbalance between monaminergic and cholinergic transmitters is involved in hallucinogenesis in the human brain.

Acetylcholine↗
PubMed1999

Visual hallucinations, white matter lesions and disease severity in Parkinson's disease.

OBJECTIVES: To determine if visual hallucinations in patients with Parkinson's disease are associated with an increased prevalence of white matter lesions. PATIENTS AND METHODS: Fifteen patients with (group 1) and 15 patients without (group 2) a history of visual hallucinations were studied. Both groups were matched for age. Magnetic resonance imaging was performed in all patients using standard T2 weighted Fast-Spin-Echo sequences. Assessment of cerebral white matter changes was performed using a modification of established criteria, with semiquantitative evaluation of periventricular and deep white matter changes. RESULTS: There was no significant group difference with regard to the total amount of white matter changes, nor was a group difference found between the amount or extent of periventricular hyperintensities or deep white matter lesions. Group 1 was significantly (P = 0.001) more disabled as evaluated by Hoehn/Yahr stage controlling for age and duration of disease. Mean increases in Hoehn/Yahr stage were not significantly greater in group 1 compared with group 2 at a 2-year follow-up examination (0.6 vs. 0.3, P = 0.166). CONCLUSION: Our data suggest that visual hallucinations are an indicator of a more aggressive course of the disease, but are not associated with a higher prevalence of global or occipital white matter lesions.

Aged↗
PubMed1995

Clinical characteristics of auditory hallucinations.

We studied 25 clinical characteristics of auditory hallucinations by means of 3-point observer-rated scales in a sample of 60 inpatients with mainly schizophrenic or schizophreniform disorders. The interrater reliability of the scales was found to be satisfactory. High levels of conviction about the reality of the sensory stimuli, clarity of content, location of their source of origin and lack of volitional control were found to be the hallmarks of verbal hallucinations. This finding supports the hypothesis that the concept of auditory hallucinations represents many aspects of patients' hallucinatory experiences, which are relatively independent of one another.

Adolescent↗
PubMed1996

The content and characteristics of auditory hallucinations in Saudi Arabia and the UK: a cross-cultural comparison.

This study investigated the content and characteristics of auditory hallucinations reported by 75 patients in Saudi Arabia (SA) and the UK. Each patient was asked to report on the content and characteristics of their hallucinations with regard to several dimensions, including loudness, frequency, clarity and perceived validity. In general, the characteristics of the voices did not vary between the SA and UK patients, but the content differed between cultures. Much of the content of the hallucinations of SA patients was religious and superstitious in nature, whereas instructional themes and running commentary were common in the UK patients. The results suggest that cultural differences need to be taken into account when applying psychological methods to this group of patients.

Adult↗
PubMed1998

Effectiveness of cognitive therapy with coping training for persistent auditory hallucinations: a retrospective study of attenders of a psychiatric out-patient department.

Recent studies have suggested positive effects of cognitive therapy on psychotic symptoms. However, the effects of coping training are less clear, and generalization to daily functioning has not been attempted for either intervention. A total of 40 patients with therapy-refractory auditory hallucinations received standard care plus cognitive therapy with coping training. In a retrospective, descriptive study, multiple assessments of outcome were measured. The experimental therapy seems to improve both overall symptomatology and quality of life, and is acceptable to both patients and relatives. Generalization to daily functioning and continuation over time was observed. Improvements with regard to the occurrence of hallucinations, fear, disturbance of thought, social interactions and daily activities were significant. Complete disappearance of hallucinations occurred in 20% of participants, and in 40% of those who were regularly discharged from treatment. The level of satisfaction with therapy was high (78%), and the drop-out rate was low (9%). Improvement was not significantly correlated with psychiatric diagnosis (schizophrenia vs. other diagnoses), and was sustained at follow-up after 1 year.

Adaptation, Psychological↗
PubMed1999

Auditory hallucinations: phenomenology, neuropsychology and neuroimaging update.

Auditory verbal hallucinations (AVHs) are a cardinal feature of psychosis. Recent research is reviewed which has attempted to advance our knowledge of the mechanisms underlying this symptom. Phenomenological surveys have confirmed the importance of the content of such hallucinations and their meaning to the voice-hearer. Psychological and neuroimaging studies of inner speech and source monitoring have provided a neuropsychological framework for AVHs as well as some novel therapeutic strategies. There have also been successful attempts to 'capture' neural activity coincident with the experience of hallucinations using PET, SPECT and functional magnetic resonance imaging (MRI). This body of knowledge in combination with work on in-vivo receptor binding (dopamine and GABA) provides the beginnings of a cognitive and neurophysiological understanding of this complex and intriguing phenomenon.

Auditory Cortex↗
PubMed2004

Pleasurable auditory hallucinations.

OBJECTIVE: The focus in auditory hallucination (AH) research is usually on the negative impact of the experience itself. There are practically no studies on whether voices can be perceived as pleasurable. The aim of the present study was to assess the frequency of voices as a pleasurable experience in a psychotic patient population. METHOD: A total of 160 patients with AHs (89 schizophrenia and 17 other psychoses) were assessed with the psychotic symptom rating scale (PSYRATS) for AHs, including an added item on whether the experience was pleasurable. RESULTS: Twenty-eight patients (26%) reported the voices as a pleasurable experience and 10 of them did so frequently. Pleasurable hallucinations showed negative associations with amount and intensity of distress, degree of negative content and loudness. Positive associations were apparent with chronicity and perceived control over the voices. CONCLUSION: Pleasurable hallucinations can be detected in a substantial proportion of patients, and cross validated with existing instruments.

Adult↗
PubMed2006

Complex visual hallucination and mirror sign in posterior cortical atrophy.

OBJECTIVE: In posterior cortical atrophy (PCA), visual hallucinations are rare symptoms and mirror sign has not been described. METHOD: Single case report. RESULTS: We reported a 60-year-old woman with PCA who reported complex visual hallucinations, such as a man walking in her room, and mirror sign, which was the perception of a stranger staring at her when she looked into a mirror. She could not recognize images of herself in the mirror correctly, although she could recognize that a person standing next to her and the images of that person reflected in the mirror were the same person. CONCLUSION: Early complex visual hallucinations in this patient appeared to be more characteristic of dementia with Lewy body than Alzheimer's disease (AD). It is hard to explain mirror sign in this patient as being because of either prosopagnosia, Balint's syndrome or advanced AD. This patient may have other underlying cognitive dysfunction.

Agnosia↗
PubMed1976

Towards a theory of auditory hallucinations: outline of an hypothetical four-factor model.

The research findings of the writer to date on auditorily hallucinated patients are briefly summarized and an hypothetical four-factor model outlined to account for them. This general working model envisages auditory hallucinations as stemming from the interaction of psychological stress with an underlying hallucinatroy predisposition which is to a large extent genetically determined. A third factor of external stimulation is seen as exerting an inhibitory effect on the conscious experience of the hallucination. While a fourth speculative factor of a positive feedback loop is introduced to account for a number of otherwise incompatible observations. Each of the four factors in the hypothetical model is defined as precisely as is possible at present and discussed in relation to other research findings in this area and to the literature more generally. An attempt is made to spell out some of the theoretical predictions and clinical implications of the model.

Acoustic Stimulation↗
PubMed1978

Effects of naloxone on schizophrenia: reduction in hallucinations in a subpopulation of subjects.

Endogenous opiate-like peptides (endorphins) are putative neuroregulators located throughout the mammalian brainstem. There is some evidence for their role in pain, stress, and affect. We report that the opiate antagonist, naloxone, alters some schizophrenic symptoms. In a double-blind, cross-over study, naloxone produced decreases in auditory hallucinations in some schizophrenic patients. This finding supports the hypothesis that the endorphins may play a roll in modulating hallucinations in a highly selected subgroup of chronically hallucinating schizophrenic patients.

Adult↗
PubMed1983

Musical hallucinations associated with acquired deafness.

Two patients with auditory hallucinations beginning after a long history of progressive bilateral hearing loss were studied. The hallucinations included both unformed (tinnitus and irregular sounds of varying pitch and timbre) and formed (instrumental music, singing and voices) components, and were repetitive. They were affected by ambient noise levels; their content and speed were influenced by attentional and intentional factors. There was no evidence of global dementia, nor of epileptogenic or psychiatric disturbance. A combination of peripheral and associated central "disinhibition" may be responsible for the occurrence of such hallucinations.

Aged↗
PubMed1995

Prospective study of relations between cortical Lewy bodies, poor eyesight, and hallucinations in Alzheimer's disease.

The presence of hallucinations is included in some, but not all, of the sets of clinical diagnostic criteria that have been proposed for dementia associated with cortical Lewy bodies. These criteria were developed from retrospective casenote analyses. This prospective, longitudinal study suggests that, in patients with Alzheimer's disease, cortical Lewy bodies are associated with more persistent and severe hallucinations, independently of any association with severity of cognitive decline. Poor eyesight contributes to the severity but not the persistence of the hallucinations.

Aged↗
PubMed2005

Auditory hallucinations in acute stroke.

Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996-2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.

Acute Disease↗
PubMedDate not supplied

'Alice in Wonderland' syndrome and Lilliputian hallucinations in a patient with a substance-related disorder.

The present paper describes a patient who exhibited 'Alice in Wonderland' (AIW) syndrome as well as Lilliputian hallucinations. The patient regularly consumed a cough syrup that contained dihydrocodein phosphate and dl-methylephedrine hydrochloride over 3 years. At the age of 46, he developed AIW syndrome. The patient ingested a large dose of triazolam and exhibited delirium. Even after the disappearance of symptoms associated with AIW syndrome and delirium, the patient continued to experience Lilliputian hallucinations. We believe that these hallucinations were caused by some of the components of the cough syrup.

Body Image↗