WorldWideScience

Sample records for hallucinations

  1. Auditory hallucinations.

    Science.gov (United States)

    Blom, Jan Dirk

    2015-01-01

    Auditory hallucinations constitute a phenomenologically rich group of endogenously mediated percepts which are associated with psychiatric, neurologic, otologic, and other medical conditions, but which are also experienced by 10-15% of all healthy individuals in the general population. The group of phenomena is probably best known for its verbal auditory subtype, but it also includes musical hallucinations, echo of reading, exploding-head syndrome, and many other types. The subgroup of verbal auditory hallucinations has been studied extensively with the aid of neuroimaging techniques, and from those studies emerges an outline of a functional as well as a structural network of widely distributed brain areas involved in their mediation. The present chapter provides an overview of the various types of auditory hallucination described in the literature, summarizes our current knowledge of the auditory networks involved in their mediation, and draws on ideas from the philosophy of science and network science to reconceptualize the auditory hallucinatory experience, and point out directions for future research into its neurobiologic substrates. In addition, it provides an overview of known associations with various clinical conditions and of the existing evidence for pharmacologic and non-pharmacologic treatments. © 2015 Elsevier B.V. All rights reserved.

  2. The neuropsychology of hallucinations

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2011-01-01

    Full Text Available Hallucinations are a psychopathological phenomenon with neuropsychological, neuroanatomical and pathophysiological correlates in specific brain areas. They can affect any of the senses, but auditory and visual hallucinations predominate. Verbal hallucinations reveal no gross organic lesions while visual hallucinations are connected to defined brain lesions. Functional neuroimaging shows impairments in modality specific sensory systems with the hyperactivity of the surrounding cerebral cortex. Disinhibition and expansion of the inner speech was noted with impaired internal monitoring in auditory verbal hallucinations. The subcortical areas and modal-specific associative cortex and cingulate cortex are essential for the occurrence of hallucinations.

  3. Hallucinations, Delusions and Paranoia

    Science.gov (United States)

    ... hallucinations are frightening, and not all delusions are paranoid in nature. See the doctor. When helping someone ... a history of serious mental illness, such as schizophrenia, the hallucinations and/or delusions may be related ...

  4. Disjunctivism, hallucinations, and metacognition.

    Science.gov (United States)

    Jérôme, Dokic; Jean-Rémy, Martin

    2012-09-01

    Perceptual experiences have been construed either as representational mental states-Representationalism-or as direct mental relations to the external world-Disjunctivism. Both conceptions are critical reactions to the so-called 'Argument from Hallucination', according to which perceptions cannot be about the external world, since they are subjectively indiscriminable from other, hallucinatory experiences, which are about sense-data or mind-dependent entities. Representationalism agrees that perceptions and hallucinations share their most specific mental kind, but accounts for hallucinations as misrepresentations of the external world. According to Disjunctivism, the phenomenal character of perceptions is exhausted by worldly objects and features, and thus must be different from the phenomenal character of hallucinations. Disjunctivism claims that subjective indiscriminability is not the result of a common experiential ground, but is because of our inability to discriminate, from the inside, hallucinations from perceptions. At first sight, Representationalism is more congenial to the way cognitive science deals with perception. However, empirically oriented revisions of Disjunctivism could be developed and tested by giving a metacognitive account of hallucinations. Two versions of this account can be formulated, depending on whether metacognition is understood as explicit metarepresentation or as implicit monitoring of first-order informational states. The first version faces serious objections, but the second is more promising, as it embodies a more realistic view of perceptual phenomenology as having both sensory and affective aspects. Affect-based phenomenology is constituted by various metacognitive feelings, such as the feeling of being perceptually confronted with the world itself, rather than with pictures or mere representations. WIREs Cogn Sci 2012 doi: 10.1002/wcs.1190 For further resources related to this article, please visit the WIREs website. Copyright

  5. Reality of auditory verbal hallucinations.

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    Raij, Tuukka T; Valkonen-Korhonen, Minna; Holi, Matti; Therman, Sebastian; Lehtonen, Johannes; Hari, Riitta

    2009-11-01

    Distortion of the sense of reality, actualized in delusions and hallucinations, is the key feature of psychosis but the underlying neuronal correlates remain largely unknown. We studied 11 highly functioning subjects with schizophrenia or schizoaffective disorder while they rated the reality of auditory verbal hallucinations (AVH) during functional magnetic resonance imaging (fMRI). The subjective reality of AVH correlated strongly and specifically with the hallucination-related activation strength of the inferior frontal gyri (IFG), including the Broca's language region. Furthermore, how real the hallucination that subjects experienced was depended on the hallucination-related coupling between the IFG, the ventral striatum, the auditory cortex, the right posterior temporal lobe, and the cingulate cortex. Our findings suggest that the subjective reality of AVH is related to motor mechanisms of speech comprehension, with contributions from sensory and salience-detection-related brain regions as well as circuitries related to self-monitoring and the experience of agency.

  6. Misleading hallucinations in unrecognized narcolepsy.

    Science.gov (United States)

    Szucs, A; Janszky, J; Holló, A; Migléczi, G; Halász, P

    2003-10-01

    To describe psychosis-like hallucinatory states in unrecognized narcolepsy. Two patients with hypnagogic/hypnapompic hallucinations are presented. Both patients had realistic and complex - multi-modal and scenic-daytime sexual hallucinations leading, in the first case, to a legal procedure because of false accusation, and in the second, to serious workplace conflicts. Both patients were convinced of the reality of their hallucinatory experiences but later both were able to recognize their hallucinatory character. Clinical data, a multiple sleep latency test, polysomnography, and HLA typing revealed that both patients suffered from narcolepsy. We suggest that in unrecognized narcolepsy with daytime hypnagogic/hypnapompic hallucinations the diagnostic procedure may mistakenly incline towards delusional psychoses. Daytime realistic hypnagogic/hypnapompic hallucinations may also have forensic consequences and mislead legal evaluation. Useful clinical features in differentiating narcolepsy from psychoses are: the presence of other narcoleptic symptoms, features of hallucinations, and response to adequate medication.

  7. Auditory Hallucinations in Acute Stroke

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    Yair Lampl

    2005-01-01

    Full Text Available 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.

  8. Culture and hallucinations: overview and future directions.

    Science.gov (United States)

    Larøi, Frank; Luhrmann, Tanya Marie; Bell, Vaughan; Christian, William A; Deshpande, Smita; Fernyhough, Charles; Jenkins, Janis; Woods, Angela

    2014-07-01

    A number of studies have explored hallucinations as complex experiences involving interactions between psychological, biological, and environmental factors and mechanisms. Nevertheless, relatively little attention has focused on the role of culture in shaping hallucinations. This article reviews the published research, drawing on the expertise of both anthropologists and psychologists. We argue that the extant body of work suggests that culture does indeed have a significant impact on the experience, understanding, and labeling of hallucinations and that there may be important theoretical and clinical consequences of that observation. We find that culture can affect what is identified as a hallucination, that there are different patterns of hallucination among the clinical and nonclinical populations, that hallucinations are often culturally meaningful, that hallucinations occur at different rates in different settings; that culture affects the meaning and characteristics of hallucinations associated with psychosis, and that the cultural variations of psychotic hallucinations may have implications for the clinical outcome of those who struggle with psychosis. We conclude that a clinician should never assume that the mere report of what seems to be a hallucination is necessarily a symptom of pathology and that the patient's cultural background needs to be taken into account when assessing and treating hallucinations. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  9. Culture and Hallucinations: Overview and Future Directions

    Science.gov (United States)

    Larøi, Frank; Luhrmann, Tanya Marie; Bell, Vaughan; Christian, William A.; Deshpande, Smita; Fernyhough, Charles; Jenkins, Janis; Woods, Angela

    2014-01-01

    A number of studies have explored hallucinations as complex experiences involving interactions between psychological, biological, and environmental factors and mechanisms. Nevertheless, relatively little attention has focused on the role of culture in shaping hallucinations. This article reviews the published research, drawing on the expertise of both anthropologists and psychologists. We argue that the extant body of work suggests that culture does indeed have a significant impact on the experience, understanding, and labeling of hallucinations and that there may be important theoretical and clinical consequences of that observation. We find that culture can affect what is identified as a hallucination, that there are different patterns of hallucination among the clinical and nonclinical populations, that hallucinations are often culturally meaningful, that hallucinations occur at different rates in different settings; that culture affects the meaning and characteristics of hallucinations associated with psychosis, and that the cultural variations of psychotic hallucinations may have implications for the clinical outcome of those who struggle with psychosis. We conclude that a clinician should never assume that the mere report of what seems to be a hallucination is necessarily a symptom of pathology and that the patient’s cultural background needs to be taken into account when assessing and treating hallucinations. PMID:24936082

  10. Hypnagogic and hypnopompic hallucinations: pathological phenomena?

    Science.gov (United States)

    Ohayon, M M; Priest, R G; Caulet, M; Guilleminault, C

    1996-10-01

    Hypnagogic and hypnopompic hallucinations are common in narcolepsy. However, the prevalence of these phenomena in the general population is uncertain. A representative community sample of 4972 people in the UK, aged 15-100, was interviewed by telephone (79.6% of those contacted). Interviews were performed by lay interviewers using a computerised system that guided the interviewer through the interview process. Thirty-seven per cent of the sample reported experiencing hypnagogic hallucinations and 12.5% reported hypnopompic hallucinations. Both types of hallucinations were significantly more common among subjects with symptoms of insomnia, excessive daytime sleepiness or mental disorders. According to this study, the prevalence of narcolepsy in the UK is 0.04%. Hypnagogic and hypnopompic hallucinations were much more common than expected, with a prevalence that far exceeds that which can be explained by the association with narcolepsy. Hypnopompic hallucinations may be a better indicator of narcolepsy than hypnagogic hallucinations in subjects reporting excessive daytime sleepiness.

  11. Neuropsychiatry of complex visual hallucinations.

    Science.gov (United States)

    Mocellin, Ramon; Walterfang, Mark; Velakoulis, Dennis

    2006-09-01

    To describe the phenomenology and pathophysiology of complex visual hallucinations (CVH) in various organic states, in particular Charles Bonnet syndrome and peduncular hallucinosis. Three cases of CVH in the setting of pontine infarction, thalamic infarction and temporoparietal epileptiform activity are presented and the available psychiatric, neurological and biological literature on the structures of the central nervous system involved in producing hallucinatory states is reviewed. Complex visual hallucinations can arise from a variety of processes involving the retinogeniculocalcarine tract, or ascending brainstem modulatory structures. The cortical activity responsible for hallucinations results from altered or reduced input into these regions, or a loss of ascending inhibition of their afferent pathways. A significant degree of overlaps exists between the concepts of Charles Bonnet syndrome and peduncular hallucinosis. The fluidity of these eponymous syndromes reduces their validity and meaning, and may result in an inappropriate attribution of the underlying pathology. An understanding of how differing pathologies may produce CVH allows for the appropriate tailoring of treatment, depending on the site and nature of the lesion and content of perceptual disturbance.

  12. Musical Hallucinations and Schizophrenia: Case Report

    Directory of Open Access Journals (Sweden)

    Catarina Klut

    2013-11-01

    Full Text Available Musical hallucinations are a type of complex auditory hallucinations. They are a relatively rare and etiologically heterogeneous phenomenon. Their major causes are deafness, organic brain disease, epilepsy and psychiatric diseases, including schizophrenia. Based on a clinical case report the authors aim to review and discuss the etiology and psychopathology of musical hallucinations. It seems to be an under recognized phenomenon that, if systematically inquired, may enable a better understanding and characterization of the patient ́s clinical picture.

  13. Musical Hallucinations and Schizophrenia: Case Report

    OpenAIRE

    Catarina Klut; Salomé Xavier; João Graça; Graça Cardoso

    2013-01-01

    Musical hallucinations are a type of complex auditory hallucinations. They are a relatively rare and etiologically heterogeneous phenomenon. Their major causes are deafness, organic brain disease, epilepsy and psychiatric diseases, including schizophrenia. Based on a clinical case report the authors aim to review and discuss the etiology and psychopathology of musical hallucinations. It seems to be an under recognized phenomenon that, if systematically inquired, may enable a better understand...

  14. Musical hallucination associated with hearing loss.

    Science.gov (United States)

    Sanchez, Tanit Ganz; Rocha, Savya Cybelle Milhomem; Knobel, Keila Alessandra Baraldi; Kii, Márcia Akemi; Santos, Rosa Maria Rodrigues dos; Pereira, Cristiana Borges

    2011-01-01

    In spite of the fact that musical hallucination have a significant impact on patients' lives, they have received very little attention of experts. Some researchers agree on a combination of peripheral and central dysfunctions as the mechanism that causes hallucination. The most accepted physiopathology of musical hallucination associated to hearing loss (caused by cochlear lesion, cochlear nerve lesion or by interruption of mesencephalon or pontine auditory information) is the disinhibition of auditory memory circuits due to sensory deprivation. Concerning the cortical area involved in musical hallucination, there is evidence that the excitatory mechanism of the superior temporal gyrus, as in epilepsies, is responsible for musical hallucination. In musical release hallucination there is also activation of the auditory association cortex. Finally, considering the laterality, functional studies with musical perception and imagery in normal individuals showed that songs with words cause bilateral temporal activation and melodies activate only the right lobe. The effect of hearing aids on the improvement of musical hallucination as a result of the hearing loss improvement is well documented. It happens because auditory hallucination may be influenced by the external acoustical environment. Neuroleptics, antidepressants and anticonvulsants have been used in the treatment of musical hallucination. Cases of improvement with the administration of carbamazepine, meclobemide and donepezil were reported, but the results obtained were not consistent.

  15. Khat-induced hypnagogic hallucinations.

    Science.gov (United States)

    Granek, M; Shalev, A; Weingarten, A M

    1988-10-01

    Khat is a plant whose leaves are chewed for their stimulating effect. This effect is attributed to cathinone, an alkaloid identical to dextroamphetamine. Khat chewing is widespread among eastern African and Yemenite populations and is believed to be innocuous. Our experience shows, however, that a substantial number of chronic khat chewers experience persistent hypnagogic hallucinations - a symptom that has not yet been described. Three vignettes illustrates this phenomena, which often interferes with psychiatric diagnosis. Different explanatory models are discussed, among them chronic suppression of REM sleep.

  16. Musical hallucinations : Review of treatment effects

    NARCIS (Netherlands)

    Coebergh, Jan A. F.; Lauw, R. F.; Bots, R.; Sommer, I. E. C.; Blom, J. D.

    2015-01-01

    Background: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. Objective: To review the

  17. Musical hallucinations : review of treatment effects

    NARCIS (Netherlands)

    Coebergh, Jan A F; Lauw, R F; Bots, R; Sommer, I E C; Blom, J D

    2015-01-01

    BACKGROUND: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE: To review the

  18. Hallucinations

    Science.gov (United States)

    ... Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  19. Musical hallucinations: review of treatment effects

    Directory of Open Access Journals (Sweden)

    Jan eCoebergh

    2015-06-01

    Full Text Available AbstractBackground: Despite an increased scientific interest in musical hallucinations throughout the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analysed the treatment results in relation to the aetiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion and other pathology, epilepsy or intoxication.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct aetiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g. more acoustic stimulation are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being more helpful than antiepileptics (which are still better than antipsychotics. The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication is the main aetiological factor, it is important to stop or switch the

  20. Negative hallucinations, dreams and hallucinations: The framing structure and its representation in the analytic setting.

    Science.gov (United States)

    Perelberg, Rosine Jozef

    2016-12-01

    This paper explores the meaning of a patient's hallucinatory experiences in the course of a five times a week analysis. I will locate my understanding within the context of André Green's ideas on the role of the framing structure and the negative hallucination in the structuring of the mind. The understanding of the transference and countertransference was crucial in the creation of meaning and enabling the transformations that took place in the analytic process. Through a detailed analysis of a clinical example the author examines Bion's distinction between hysterical hallucinations and psychotic hallucinations and formulates her own hypothesis about the distinctions between the two. The paper suggests that whilst psychotic hallucinations express a conflict between life and death, in the hysterical hallucination it is between love and hate. The paper also contains some reflections on the dramatic nature of the analytic encounter. Copyright © 2016 Institute of Psychoanalysis.

  1. [Negative hallucination, self-onsciousness and ageing].

    Science.gov (United States)

    Hazif-Thomas, C; Stephan, F; Walter, M; Thomas, P

    2015-04-01

    Negative hallucinations are characterized by a defect in perception of an object or a person, or a denial of the existence of their perception. Negative hallucinations create blank spaces, due to both an impossible representation and an incapability of investment in reality. They have a close relationship with Cotard's syndrome, delusional theme of organ denial observed in melancholic syndromes in the elderly. Phenomenological approach. The phenomenology of negative hallucinations provides quite an amount of information on the origin of the psychotic symptoms when one is rather old. The connections between hallucinations, mood disorders and negative symptoms are often difficult to live with for the nearest and dearest. Negative hallucinations require a strict approach to identify their expression that is crucial because a wide heterogeneity exists within the pathological pictures, as in Cotard's syndrome. Although the negative hallucination has an anti traumatic function in elderly people fighting against mental pain, it still represents a deficiency in symbolization. The prevalence of this symptom is without doubt underestimated, although its presence often underlines thymic suffering that is more striking. These hallucinatory symptoms have an important impact on the patients' daily life, and they appear to be prisoners of a suffering, which cannot be revealed. We propose in this article to review the clinical symptoms of negative hallucinations in the elderly and the way to manage them. The medicinal approaches are not always effective. A greater place must be given to what is in connection with the body, aiming at a strong impact and thus to offer non-pharmacological approaches, such as somatic ones, which can be either invasive (electroconvulsive therapy) or not (transcranial magnetic stimulation). Copyright © 2014. Published by Elsevier Masson SAS.

  2. The psychopathology of hallucinations--a methodological analysis.

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    Lothane, Z

    1982-12-01

    A psychiatry based on operational and dynamic principles requires a new definition of hallucinations which is both heuristically useful and helpful for the understanding of the phenomenon of hallucinations. The time-hallowed definition of hallucinations as 'perceptions without stimulation of the sense organs' is both incorrect and a relic of late 19th century para-physiological thinking. Heuristically it leads into a blind alley. Central to the redefinition of hallucinations is the conception of the hallucinator, the author of his hallucinations, homologous to the dreamer, the author of his dreams. This idea was held firmly by early French 19th century clinicians, who were inspired by a holistic and operational conception in philosophy. Hallucinations are a multifaceted complex human mental activity and defined by means of a number of parameters held together as an indivisible whole. Hallucinations are described phenomenologically, psychologically, dynamically, psychodynamically, emotionally, logically, nosologically, and interpersonally.

  3. The prevalence and correlates of hallucinations in a general ...

    African Journals Online (AJOL)

    Multivariate analyses revealed a significant association between role impairment, service utilisation, suicidality and reported auditory or visual hallucinations. No significant association was found between urbanicity and reported psychotic symptoms. Conclusion: Our finding that psychotic symptoms (ie hallucinations) are ...

  4. Oscillatory Cortical Network Involved in Auditory Verbal Hallucinations in Schizophrenia

    NARCIS (Netherlands)

    van Lutterveld, R.; Hillebrand, A.; Diederen, K.M.J.; Daalman, K.; Kahn, R.S.; Stam, C.J.; Sommer, I.E.C.

    2012-01-01

    Background: Auditory verbal hallucinations (AVH), a prominent symptom of schizophrenia, are often highly distressing for patients. Better understanding of the pathogenesis of hallucinations could increase therapeutic options. Magnetoencephalography (MEG) provides direct measures of neuronal activity

  5. Auditory verbal hallucinations predominantly activate the right inferior frontal area

    NARCIS (Netherlands)

    Sommer, Iris E. C.; Diederen, Kelly M. J.; Blom, Jan-Dirk; Willems, Anne; Kushan, Leila; Slotema, Karin; Boks, Marco P. M.; Daalman, Kirstin; Hoek, Hans W.; Neggers, Sebastiaan F. W.; Kahn, Rene S.

    2008-01-01

    The pathophysiology of auditory verbal hallucinations (AVH) is largely unknown. Several functional imaging studies have measured cerebral activation during these hallucinations, but sample sizes were relatively small (one to eight subjects) and findings inconsistent. In this study cerebral

  6. Hypnagogic and hypnopompic hallucinations during amitriptyline treatment.

    Science.gov (United States)

    Hemmingsen, R; Rafaelsen, O J

    1980-10-01

    Four cases of hypnagogic or hypnopompic visual hallucinations in patients during amitriptyline treatment are reported. The hallucinations were clearly delineated, projected to the outer objective space and were for a short time experienced as real. The patients rapidly realized the unreality of the "sights", probably because they regained the full criticism and coherent thinking of an unpsychotic awake individual. There may be a relation between the effects of amitriptyline in brain, the changed pattern of sleep and the clinical recovery. Patients should be informed about the benign character of this type of hallucinatory phenomena so that treatment is not terminated at an undue time.

  7. [Hallucinations and borderline personality disorder: a review].

    Science.gov (United States)

    Gras, A; Amad, A; Thomas, P; Jardri, R

    2014-12-01

    Hallucinations constitute understudied symptoms in borderline personality disorders (BPD), which can be observed in about 30% of the patients, essentially in the auditory modality. Most of these experiences are transitory, triggered by intermittent stressors, but chronicity remains a major cause of concern. In order to better circumscribe hallucinations in BPD, we summarized the literature on this particular phenomenon. We conducted a review using Medline, Scopus and Google Scholar databases up to March 2013, using the following keywords combinations: "borderline personality disorder", "hallucinat*" and "psychotic symptoms". Papers were included in the review if they were published in an English or French language peer-reviewed journal; the study enrolled patients with BPD; and the diagnosis was made according to the Diagnostic and Statistical Manual (DSM) criteria. Fifteen studies published between 1985 and 2012, merging a total of 635 patients, were retained. The hallucinatory experiences observed in BPD appeared phenomenologically similar to those described in the schizophrenia spectrum in terms of vividness, duration, spatial localization, beliefs about malevolence or omnipotence. Conversely, the hallucinatory content appeared more negative and potentially more distressful. Crucially, this literature search also revealed that these symptoms have long been regarded as "pseudo-hallucinations" (or "hallucination-like symptoms"). This concept was judged of poor scientific validity, inducing stigma for BPD patients in that it casts doubt on the authenticity of these experiences while disqualifying the related distress. This situation points out that research should focus more on understanding hallucinations in BPD than questioning their existence. Interestingly, recent comorbidity studies reopened a 40-year debate on the potential links that may exist between BPD and psychosis. Initially considered as a para-psychotic disorder, BPD was effectively redefined as an

  8. Top-down modulation, emotion, and hallucination

    NARCIS (Netherlands)

    Aleman, A; Kahn, RS

    2002-01-01

    We argue that the pivotal role assigned by Northoff to the principle of top-down modulation in catatonia might successfully be applied to other symptoms of schizophrenia, for example, hallucinations. Second, we propose that Northoffs account would benefit from a more comprehensive analysis of the

  9. Auditory Hallucinations in Polyglots | Hemphill | South African ...

    African Journals Online (AJOL)

    The patients' mental performance was relatively better when the non-home language was used. In the psychosis of toxic, drug, and organic origin and in epilepsy, hallucinations may be multilingual, in contrast to schizophrenia. This is of value in differential diagnosis. A case of paranoid psychosis in which a White man had ...

  10. Lilliputian hallucinations in Schizophrenia: a case report

    African Journals Online (AJOL)

    SCIENTIFIC LETTER | http://dx.doi.org/10.4314/ajpsy.v15i5.37. Afr J Psychiatry 2012 ... Her illness was characterized by auditory hallucinations of commenting and ... Further research should focus on firstly, developing an understanding of the ...

  11. Threatening auditory hallucinations and Cotard syndrome in Parkinson disease.

    Science.gov (United States)

    Factor, Stewart A; Molho, Eric S

    2004-01-01

    Psychotic symptoms are commonly reported in patients with Parkinson disease (PD). In particular, patients experience nonthreatening visual hallucinations that can occur with insight (so called hallucinosis) or without. Auditory hallucinations are uncommon, and schizophrenialike symptoms such as pejorative and threatening auditory hallucinations and delusions that are persecutory, referential, somatic, religious, or grandiose have rarely been reported. The authors present 2 PD patients who experienced threatening auditory hallucinations, without visual hallucinations, and schizophrenialike delusions with detailed description of the clinical phenomenology including 1 patient with Cotard syndrome.

  12. Action simulation in hallucination-prone adolescents

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    Tarik eDahoun

    2013-07-01

    Full Text Available Theoretical and empirical accounts suggest that impairments in self-other discrimination processes are likely to promote the expression of hallucinations. However, our understanding of such processes during adolescence is still at an early stage. The present study thus aims 1 to delineate the neural correlates sustaining mental simulation of actions involving self-performed actions (first-person perspective; 1PP and other-performed actions (third-person perspective; 3PP during adolescence 2 to identify atypical activation patterns during 1PP/3PP mental simulation of actions in hallucination-prone adolescents 3 to examine whether differential risk for schizophrenia (clinical vs genetic is also associated with differential impairments in the 1PP/3PP mental simulation of actions during adolescence. Twenty-two typically developing controls (Control group; 6 females, twelve hallucination-prone adolescents (AH group; 7 females and thirteen adolescents with 22q11.2 Deletion Syndrome (22q11.2DS group; 4 females were included in the study. During the fMRI task, subjects were presented with a cue (self-other priming cues indicating to perform the task using either a first person perspective (you-1PP or a third person perspective (friend-3PP and then they were asked to mentally simulate actions based on the type of cue. Our results indicated that atypical patterns of cerebral activation, particularly in the key areas of self-other distinction, were found in both groups at risk for auditory hallucinations (AH and 22q11.2DS. More precisely, adolescents in the AH and 22q11.2DS groups presented decreased activations in the parieto-occipital region BA19 during 3PP. This study characterizes the neural correlates of mental imagery for actions during adolescence, and suggests that a differential risk for hallucination-proneness (clinical vs. genetic is associated to similar patterns of atypical activations in key areas sustaining self-other discrimination

  13. Electroconvulsive Therapy in Functional Hallucination: Scope and Challenges

    Directory of Open Access Journals (Sweden)

    Sulochana Joshi

    2017-01-01

    Full Text Available Functional hallucinations are hallucinations triggered by a stimulus in the same modality and cooccur with it. They are rare in occurrence; however, their rarity has no significance as psychopathology till date. Also, very little is known about the treatment of such hallucinations. Electroconvulsive therapy (ECT has been tested for several psychiatric illnesses and has a few relative contraindications; however, it has not previously been used in treating functional hallucinations. We report on a female patient with paranoid schizophrenia who experienced functional hallucinations continuously despite the use of adequate risperidone, which controlled other symptoms. She was treated with ECT which resolved the functional hallucinations. The case highlights the need to ponder on the significance of the phenomenon as well as treatment of this psychopathology by ECT. It also underscores ECT as a treatment option for this kind of hallucination.

  14. Simulating Auditory Hallucinations in a Video Game

    DEFF Research Database (Denmark)

    Weinel, Jonathan; Cunningham, Stuart

    2017-01-01

    In previous work the authors have proposed the concept of 'ASC Simulations': including audio-visual installations and experiences, as well as interactive video game systems, which simulate altered states of consciousness (ASCs) such as dreams and hallucinations. Building on the discussion...... of the authors' previous paper, where a large-scale qualitative study explored the changes to auditory perception that users of various intoxicating substances report, here the authors present three prototype audio mechanisms for simulating hallucinations in a video game. These were designed in the Unity video...... that make up the player character, and in future developments of this type of work we foresee a more advanced, standardised interface that models the senses, emotions and state of consciousness of player avatars....

  15. Religious content of hallucinations in paranoid schizophrenia.

    Science.gov (United States)

    Krzystanek, Marek; Krysta, Krzysztof; Klasik, Adam; Krupka-Matuszczyk, Irena

    2012-09-01

    Different environmental factors are thought to be responsible for 15-20% of schizophrenia pathogenesis. Religion has long been considered a major force in human life, regardless of economic, social or political affiliation. How the perception of religion has changed over time, especially in the context of mental illness, was the focal point of this long-term comparative study. A random selection of 100 case histories from the years 1932, 1952, 1972 and 1992 was selected. By reviewing the subject history and medical notes, information on the presence of religious hallucinations and/or delusions were collected and grouped. Religious topics were demonstrated in 46.8% of the test population. Whereas there was a clear diversity of religious-themed delusions, "God", "Christ", "Mary", "Satan/devil" and "hell" all figured prominently across all reviewed years. There is a progressive decrease in the number of religious topics in paranoid schizophrenia. The transfer of holiness from historical saints onto a subject was observed. Evil dominates over good in productive symptoms in paranoid schizophrenia. The phenomenon of apocalyptic subjects in paranoid hallucinations and delusions increased after the Second World War. Religious topics of hallucinations and delusions change over time and relate to objective historical events and reflect changes in religiosity in society.

  16. Auditory hallucinations and PTSD in ex-POWS

    DEFF Research Database (Denmark)

    Crompton, Laura; Lahav, Yael; Solomon, Zahava

    2017-01-01

    (PTSD) symptoms, over time. Former prisoners of war (ex-POWs) from the 1973 Yom Kippur War (n = 99) with and without PTSD and comparable veterans (n = 103) were assessed twice, in 1991 (T1) and 2003 (T2) in regard to auditory hallucinations and PTSD symptoms. Findings indicated that ex-POWs who suffered...... from PTSD reported higher levels of auditory hallucinations at T2 as well as increased hallucinations over time, compared to ex-POWs without PTSD and combatants who did not endure captivity. The relation between PTSD and auditory hallucinations was unidirectional, so that the PTSD overall score at T1...... predicted an increase in auditory hallucinations between T1 and T2, but not vice versa. Assessing the role of PTSD clusters in predicting hallucinations revealed that intrusion symptoms had a unique contribution, compared to avoidance and hyperarousal symptoms. The findings suggest that auditory...

  17. Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome

    OpenAIRE

    Pang, Linda

    2016-01-01

    ABSTRACT Charles Bonnet Syndrome is a condition where visual hallucinations occur as a result of damage along the visual pathway. Patients with Charles Bonnet Syndrome maintain partial or full insight that the hallucinations are not real, absence of psychological conditions, and absence of hallucinations affecting other sensory modalities, while maintaining intact intellectual functioning. Charles Bonnet Syndrome has been well documented in neurologic, geriatric medicine, and psychiatric lite...

  18. Using Facebook to Reach People Who Experience Auditory Hallucinations

    OpenAIRE

    Crosier, Benjamin Sage; Brian, Rachel Marie; Ben-Zeev, Dror

    2016-01-01

    Background Auditory hallucinations (eg, hearing voices) are relatively common and underreported false sensory experiences that may produce distress and impairment. A large proportion of those who experience auditory hallucinations go unidentified and untreated. Traditional engagement methods oftentimes fall short in reaching the diverse population of people who experience auditory hallucinations. Objective The objective of this proof-of-concept study was to examine the viability of leveraging...

  19. Suggestibility and signal detection performance in hallucination-prone students.

    Science.gov (United States)

    Alganami, Fatimah; Varese, Filippo; Wagstaff, Graham F; Bentall, Richard P

    2017-03-01

    Auditory hallucinations are associated with signal detection biases. We examine the extent to which suggestions influence performance on a signal detection task (SDT) in highly hallucination-prone and low hallucination-prone students. We also explore the relationship between trait suggestibility, dissociation and hallucination proneness. In two experiments, students completed on-line measures of hallucination proneness (the revised Launay-Slade Hallucination Scale; LSHS-R), trait suggestibility (Inventory of Suggestibility) and dissociation (Dissociative Experiences Scale-II). Students in the upper and lower tertiles of the LSHS-R performed an auditory SDT. Prior to the task, suggestions were made pertaining to the number of expected targets (Experiment 1, N = 60: high vs. low suggestions; Experiment 2, N = 62, no suggestion vs. high suggestion vs. no voice suggestion). Correlational and regression analyses indicated that trait suggestibility and dissociation predicted hallucination proneness. Highly hallucination-prone students showed a higher SDT bias in both studies. In Experiment 1, both bias scores were significantly affected by suggestions to the same degree. In Experiment 2, highly hallucination-prone students were more reactive to the high suggestion condition than the controls. Suggestions may affect source-monitoring judgments, and this effect may be greater in those who have a predisposition towards hallucinatory experiences.

  20. Insightful hallucination: psychopathology or paranormal phenomenon?

    Science.gov (United States)

    Gadit, Amin A Muhammad

    2011-03-15

    This report describes a 26-year-old man who was so emotionally attached to his mother that the mere thought of separating from her caused immense anxiety. The death of his mother after a brief illness resulted in prolonged bereavement. However, the patient started seeing and talking to his mother after her death, which led to huge improvement in his mood and social functioning. His wife brought him in for consultation but no obvious psychopathology was detected. This gave rise to the dilemma of whether to consider this a real psychopathology and treat it, or to disregard this reported hallucination. No active treatment is being given to this patient at the moment.

  1. Visual memory errors in Parkinson's disease patient with visual hallucinations.

    Science.gov (United States)

    Barnes, J; Boubert, L

    2011-03-01

    The occurrences of visual hallucinations seem to be more prevalent in low light and hallucinators tend to be more prone to false positive type errors in memory tasks. Here we investigated whether the richness of stimuli does indeed affect recognition differently in hallucinating and nonhallucinating participants, and if so whether this difference extends to identifying spatial context. We compared 36 Parkinson's disease (PD) patients with visual hallucinations, 32 Parkinson's patients without hallucinations, and 36 age-matched controls, on a visual memory task where color and black and white pictures were presented at different locations. Participants had to recognize the pictures among distracters along with the location of the stimulus. Findings revealed clear differences in performance between the groups. Both PD groups had impaired recognition compared to the controls, but those with hallucinations were significantly more impaired on black and white than on color stimuli. In addition, the group with hallucinations was significantly impaired compared to the other two groups on spatial memory. We suggest that not only do PD patients have poorer recognition of pictorial stimuli than controls, those who present with visual hallucinations appear to be more heavily reliant on bottom up sensory input and impaired on spatial ability.

  2. Visual hallucinations in schizophrenia: confusion between imagination and perception.

    Science.gov (United States)

    Brébion, Gildas; Ohlsen, Ruth I; Pilowsky, Lyn S; David, Anthony S

    2008-05-01

    An association between hallucinations and reality-monitoring deficit has been repeatedly observed in patients with schizophrenia. Most data concern auditory/verbal hallucinations. The aim of this study was to investigate the association between visual hallucinations and a specific type of reality-monitoring deficit, namely confusion between imagined and perceived pictures. Forty-one patients with schizophrenia and 43 healthy control participants completed a reality-monitoring task. Thirty-two items were presented either as written words or as pictures. After the presentation phase, participants had to recognize the target words and pictures among distractors, and then remember their mode of presentation. All groups of participants recognized the pictures better than the words, except the patients with visual hallucinations, who presented the opposite pattern. The participants with visual hallucinations made more misattributions to pictures than did the others, and higher ratings of visual hallucinations were correlated with increased tendency to remember words as pictures. No association with auditory hallucinations was revealed. Our data suggest that visual hallucinations are associated with confusion between visual mental images and perception.

  3. Hallucinations and related concepts – their conceptual background

    Directory of Open Access Journals (Sweden)

    Diogo eTelles-Correia

    2015-07-01

    Full Text Available Prior to the 17th century, the experiences we now name hallucinations or others alike were valued within a cultural context, they could bring meaning to the subject or the world. From mid-17th to 18th centuries, they acquire a medical quality in mental and organic illnesses. However, the term was only fully integrated in psychiatry by Esquirol in the 18th-19th centuries. By then, a controversy begins on whether hallucinations have a perceptual or intellectual origin. Esquirol favours the intellectual origin, describing them as an involuntary exercise of memory and imagination.By the twentieth century, some authors maintain that hallucinations are a form of delusion (Ey, while others describe them as a change in perception (Jaspers, Fish. A more integrated perspectives like those proposed by Alonso Fernandez and Luque, highlights the heterogeneity of hallucinations and the multiplicity of their types and causes.The terms pseudohallucination, illusion and hallucinosis are grafted into the concept of hallucination. Since its introduction the term pseudohallucination has been used with different meanings. The major characteristics that we found associated with pseudohallucinations were ‘lack of objectivity’ and ‘presence of insight’ (differing from hallucinations. Illusions are unanimously taken as distortions of real objects. Hallucinosis, first described in the context of alcohol consumption, is generally considered egodystonic, in which insight is preserved.These and other controversial aspects regarding the evolution of the term hallucination and all its derivative concepts are discussed in this paper.

  4. Hallucinations, loneliness, and social isolation in Alzheimer's disease.

    Science.gov (United States)

    El Haj, Mohamad; Jardri, Renaud; Larøi, Frank; Antoine, Pascal

    2016-01-01

    Cognitive and functional compromise, as frequently observed in Alzheimer's disease (AD), hinders communication and social interactions. One consequence of this hindrance may be a feeling of loneliness. Moreover, emptiness and boredom, as observed in social isolation and loneliness, may thus be compensated for by creating imagined stimuli. Conditions of loneliness may be viewed as potentially generating hallucinatory experiences. To assess this assumption, the present study explored the relationship between social isolation, loneliness, and hallucinations in a sample of 22 mild AD participants and 24 elderly, healthy controls. Participants were assessed using the Launay-Slade Hallucination Scale, the UCLA Loneliness Scale, and a scale exploring contact with others and social participation. More hallucinatory experiences, social isolation, and loneliness were found in the AD group than in the healthy control group. Moreover, significant correlations were observed between hallucinations and loneliness and between hallucinations and social isolation in both groups. Finally, hallucinations were predicted by social isolation. Hallucinations may constitute a compensatory mechanism that aims to fulfil communication needs in lonely, elderly participants. Hallucinations may also be regarded as experiences that allow certain participants to escape the cycle of boredom, emptiness, and affective deprivation caused by social isolation.

  5. Discharging the voices : Non-invasive brain stimulation as a treatment for hallucinations

    NARCIS (Netherlands)

    Schuite-Koops, Sanne

    2018-01-01

    Hallucinations are a common and disturbing symptom in psychotic disorders, among which auditory hallucinations are most frequently seen; 60 to 70% of patients with a schizophrenia spectrum disorder experience this type of hallucinations. These hallucinations are often in the form of negative and

  6. IMP-SPECT at patients with hallucinations

    International Nuclear Information System (INIS)

    Podreka, I.; Mamoli, B.; Lesch, O.; Suess, E.; Wimberger, D.; Mayr, N.; Havelec, L.; Mueller, C.; Steiner, M.; Deecke, L.

    1986-01-01

    IMP-SPECT was performed in 14 normal volunteers. A 'regional index=RI' of tracer distribution was calculated for 18 regions in each hemisphere RI=(cts/voxel ROI)/(mean cts/voxel of all ROI's). 30 seizure patients (E) and 12 patients with acoustic, partialy also visual hallucinations (H) were investigated. Regions were defined as hypo- or hyperperfused if the RI exceeded the value of the corresponding normal-RI +- 2 std. EEG was recorded in all (E). 93.3% of EEG-findings were abnormal, 50% showed a focus, 46.7% paroxysmal activity. SPECT detected in 93.3% of (E) hypoperfused regions, mostly located in the temporal lobe. All (H) had decreased rCBF, predominantly in the frontal cortex. ANOVA and t-test revealed significant RI-differences in the frontal lobe, both hippocampi, right and left inferior occipital cortex, and right anterior basal ganglia. (H) had lower RI's in frontal lobes, higher RI's in both hippocampal regions as well as inferior occipital regions and anterior basal ganglia Differences between (E) and (H) were found in the frontal lobe ((H)sub(→)), right superior temporal region ((H)sup(→)), left hippocampus ((H)sup(→)), both inferior occipital regions ((H)sup(→)) and right anterior basal ganglia ((H)sup(→)). The study shows that by means of IMP-SPECT hypo- and hyperperfused areas can be detected in the hemispheres of (E) and (H), corresponding to disturbed brain function. Higher hippocampal CBF in (E) and (H) may be related to the role of this limbic structure in generation of seizures and psychotic states. Hallucinations are associated with increased CBF in the right temporal and associative visual cortex. (Author)

  7. Nasal cycle dominance and hallucinations in an adult schizophrenic female.

    Science.gov (United States)

    Shannahoff-Khalsa, David; Golshan, Shahrokh

    2015-03-30

    Nasal dominance, at the onset of hallucinations, was studied as a marker of both the lateralized ultradian rhythm of the autonomic nervous system and the tightly coupled ultradian rhythm of alternating cerebral hemispheric dominance in a single case study of a schizophrenic female. Over 1086 days, 145 hallucination episodes occurred with left nostril dominance significantly greater than the right nostril dominant phase of the nasal cycle. A right nostril breathing exercise, that primarily stimulates the left hemisphere, reduces symptoms more quickly for hallucinations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A Case Report on Somatoform Disorder: Colorful Visual Hallucinations

    Directory of Open Access Journals (Sweden)

    Susan Afghah

    2013-04-01

    Full Text Available Objectives: To report a case of somatoform disorder (not otherwise specified-NOS. Methods: The patient was an eight-year-old boy who complained of anxiety and seeing visual hallucinations of colorful shapes. He was administered ant migraine and antiepileptic drugs. However, no changes were observed. Psychotherapy was started, as well as fluoxetine (20 mg per day. Initial assessments included a behavioral interview, charting of daily activities, and recording visual hallucinations with a description of the patient’s emotional and situational condition during the hallucinations. Results: The patient’s visual hallucinations disappeared completely after two months of treatment. Discussion: Somatoform disorders may respond well to a combination of behavioral therapy and antidepressant medication.

  9. Visual hallucinations caused by Charles Bonnet Syndrome: A case ...

    African Journals Online (AJOL)

    had no cognitive impairment and was fully aware of the ... eration. Ms P's main complaint was visual hallucinations. ... brother in front of her eyes. She also displayed ... her would seem to develop a full beard. .... Beta blocking agents. 4.

  10. Clinical and neurocognitive aspects of hallucinations in Alzheimer's disease.

    Science.gov (United States)

    El Haj, Mohamad; Roche, Jean; Jardri, Renaud; Kapogiannis, Dimitrios; Gallouj, Karim; Antoine, Pascal

    2017-12-01

    Due to their prevalence, hallucinations are considered as one of the most frequent psychotic symptoms in Alzheimer's disease (AD). These psychotic manifestations reduce patients' well-being, increase the burden of caregivers, contribute to early institutionalization, and are related with the course of cognitive decline in AD. Considering their consequences, we provide a comprehensive account of the current state of knowledge about the prevalence and characteristics of hallucinations in AD. We propose a comprehensive and testable theoretical model about hallucinations in AD: the ALZHA (ALZheimer and HAllucinations) model. In this model, neurological, genetic, cognitive, affective, and iatrogenic factors associated with hallucinations in AD are highlighted. According to the ALZHA model, hallucinations in AD first involve trait markers (i.e., cognitive deficits, neurological deficits, genetic predisposition and/or sensory deficits) to which state markers that may trigger these experiences are added (e.g., psychological distress and/or iatrogenic factors). Finally, we provide recommendations for assessment and management of these psychotic manifestations in AD, with the aim to benefit patients, caregivers, and health professionals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The Study of Frequency Self Care Strategies against Auditory Hallucinations

    Directory of Open Access Journals (Sweden)

    Mahin Nadem

    2012-03-01

    Full Text Available Background: In schizophrenic clients, self-care strategies against auditory hallucinations can decrease disturbances results in hallucination. This study was aimed to assess frequency of self-care strategies against auditory hallucinations in paranoid schizophrenic patients, hospitalized in Shafa Hospital.Materials and Method: This was a descriptive study on 201 patients with paranoid schizophrenia hospitalized in psychiatry unit with convenience sampling in Rasht. The gathered data consists of two parts, first unit demographic characteristic and the second part, self- report questionnaire include 38 items about self-care strategies.Results: There were statistically significant relationship between demographic variables and knowledg effect and self-care strategies against auditory hallucinaions. Sex with phisical domain p0.07, marriage status with cognitive domain (p>0.07 and life status with behavioural domain (p>0.01. 53.2% of reported type of our auditory hallucinations were command hallucinations, furtheremore the most effective self-care strategies against auditory hallucinations were from physical domain and substance abuse (82.1% was the most effective strategies in this domain.Conclusion: The client with paranoid schizophrenia used more than physical domain strategies against auditory hallucinaions and this result highlight need those to approprait nursing intervention. Instruction and leading about selection the effective self-care strategies against auditory ha

  12. Using Facebook to Reach People Who Experience Auditory Hallucinations.

    Science.gov (United States)

    Crosier, Benjamin Sage; Brian, Rachel Marie; Ben-Zeev, Dror

    2016-06-14

    Auditory hallucinations (eg, hearing voices) are relatively common and underreported false sensory experiences that may produce distress and impairment. A large proportion of those who experience auditory hallucinations go unidentified and untreated. Traditional engagement methods oftentimes fall short in reaching the diverse population of people who experience auditory hallucinations. The objective of this proof-of-concept study was to examine the viability of leveraging Web-based social media as a method of engaging people who experience auditory hallucinations and to evaluate their attitudes toward using social media platforms as a resource for Web-based support and technology-based treatment. We used Facebook advertisements to recruit individuals who experience auditory hallucinations to complete an 18-item Web-based survey focused on issues related to auditory hallucinations and technology use in American adults. We systematically tested multiple elements of the advertisement and survey layout including image selection, survey pagination, question ordering, and advertising targeting strategy. Each element was evaluated sequentially and the most cost-effective strategy was implemented in the subsequent steps, eventually deriving an optimized approach. Three open-ended question responses were analyzed using conventional inductive content analysis. Coded responses were quantified into binary codes, and frequencies were then calculated. Recruitment netted N=264 total sample over a 6-week period. Ninety-seven participants fully completed all measures at a total cost of $8.14 per participant across testing phases. Systematic adjustments to advertisement design, survey layout, and targeting strategies improved data quality and cost efficiency. People were willing to provide information on what triggered their auditory hallucinations along with strategies they use to cope, as well as provide suggestions to others who experience auditory hallucinations. Women, people

  13. Using Facebook to Reach People Who Experience Auditory Hallucinations

    Science.gov (United States)

    Brian, Rachel Marie; Ben-Zeev, Dror

    2016-01-01

    Background Auditory hallucinations (eg, hearing voices) are relatively common and underreported false sensory experiences that may produce distress and impairment. A large proportion of those who experience auditory hallucinations go unidentified and untreated. Traditional engagement methods oftentimes fall short in reaching the diverse population of people who experience auditory hallucinations. Objective The objective of this proof-of-concept study was to examine the viability of leveraging Web-based social media as a method of engaging people who experience auditory hallucinations and to evaluate their attitudes toward using social media platforms as a resource for Web-based support and technology-based treatment. Methods We used Facebook advertisements to recruit individuals who experience auditory hallucinations to complete an 18-item Web-based survey focused on issues related to auditory hallucinations and technology use in American adults. We systematically tested multiple elements of the advertisement and survey layout including image selection, survey pagination, question ordering, and advertising targeting strategy. Each element was evaluated sequentially and the most cost-effective strategy was implemented in the subsequent steps, eventually deriving an optimized approach. Three open-ended question responses were analyzed using conventional inductive content analysis. Coded responses were quantified into binary codes, and frequencies were then calculated. Results Recruitment netted N=264 total sample over a 6-week period. Ninety-seven participants fully completed all measures at a total cost of $8.14 per participant across testing phases. Systematic adjustments to advertisement design, survey layout, and targeting strategies improved data quality and cost efficiency. People were willing to provide information on what triggered their auditory hallucinations along with strategies they use to cope, as well as provide suggestions to others who experience

  14. Auditory hallucinations: A review of the ERC "VOICE" project.

    Science.gov (United States)

    Hugdahl, Kenneth

    2015-06-22

    In this invited review I provide a selective overview of recent research on brain mechanisms and cognitive processes involved in auditory hallucinations. The review is focused on research carried out in the "VOICE" ERC Advanced Grant Project, funded by the European Research Council, but I also review and discuss the literature in general. Auditory hallucinations are suggested to be perceptual phenomena, with a neuronal origin in the speech perception areas in the temporal lobe. The phenomenology of auditory hallucinations is conceptualized along three domains, or dimensions; a perceptual dimension, experienced as someone speaking to the patient; a cognitive dimension, experienced as an inability to inhibit, or ignore the voices, and an emotional dimension, experienced as the "voices" having primarily a negative, or sinister, emotional tone. I will review cognitive, imaging, and neurochemistry data related to these dimensions, primarily the first two. The reviewed data are summarized in a model that sees auditory hallucinations as initiated from temporal lobe neuronal hyper-activation that draws attentional focus inward, and which is not inhibited due to frontal lobe hypo-activation. It is further suggested that this is maintained through abnormal glutamate and possibly gamma-amino-butyric-acid transmitter mediation, which could point towards new pathways for pharmacological treatment. A final section discusses new methods of acquiring quantitative data on the phenomenology and subjective experience of auditory hallucination that goes beyond standard interview questionnaires, by suggesting an iPhone/iPod app.

  15. Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

    NARCIS (Netherlands)

    Thomas, N.; Hayward, M.; Peters, E; van der Gaag, M.; Bentall, R.P.; Jenner, J.; Strauss, C.; Sommer, I.E.; Johns, L.C.; Varese, F.; Gracia-Montes, J.M.; Waters, F.; Dodgson, G.; McCarthy-Jones, S.

    2014-01-01

    This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions,

  16. Suicidality and hospitalisation in patients with borderline personality disorder who experience auditory verbal hallucinations

    NARCIS (Netherlands)

    Slotema, C. W.; Niemantsverdriet, Ellis; Blom, J. D.; van der Gaag, M.; Hoek, H. W.; Sommer, I. E. C.

    Background: In patients with borderline personality disorder (BPD), about 22-50% experience auditory verbal hallucinations (AVH). However, the impact of these hallucinations on suicidal ideation, suicide attempts, crisis-service interventions, and hospital admissions is unknown. Methods: In a

  17. Associations between nonauditory hallucinations, dissociation, and childhood adversity in first-episode psychosis.

    Science.gov (United States)

    Longden, Eleanor; House, Allan O; Waterman, Mitch G

    2016-01-01

    Although repeated associations have been found between adversity exposure (particularly exposure to childhood sexual abuse), dissociation, and auditory hallucinations in the context of psychosis, there is little comparable research examining hallucinations in other modalities. This study aimed to determine whether cumulative adversity exposure influences the likelihood of experiencing visual, tactile, olfactory, and gustatory hallucinations among psychosis patients and whether measures of dissociation are significantly associated with nonauditory hallucinations when exposure to childhood adversity and psychological distress are adjusted for. Self-report measures and a retrospective case-control design were applied to assess nonauditory hallucinations, dissociation, psychological distress, and childhood adversity exposure in a sample of first-episode psychosis patients reporting nonauditory hallucinations (n = 36) and controls from the same clinical population without nonauditory hallucinations (n = 31). Case participants reported higher levels of dissociation, psychological distress, and exposure to childhood rape than the control group. Dissociation remained significantly associated with nonauditory hallucinations when we adjusted for childhood sexual abuse, other types of childhood adversity, and a combined measure of emotional distress. Indication of a dose-response relationship was detected, in that total number of adversities was significantly associated with reporting more than one modality of nonauditory hallucination. Observed associations between auditory hallucinations and dissociation in psychosis may extend to other hallucination modalities. It is suggested that more research attention be paid to the etiology and impact of nonauditory hallucinations in psychosis samples.

  18. Visual Hallucinations in First-Episode Psychosis: Association with Childhood Trauma.

    Science.gov (United States)

    Solesvik, Martine; Joa, Inge; Larsen, Tor Ketil; Langeveld, Johannes; Johannessen, Jan Olav; Bjørnestad, Jone; Anda, Liss Gøril; Gisselgård, Jens; Hegelstad, Wenche Ten Velden; Brønnick, Kolbjørn

    2016-01-01

    Hallucinations are a core diagnostic criterion for psychotic disorders and have been investigated with regard to its association with childhood trauma in first-episode psychosis samples. Research has largely focused on auditory hallucinations, while specific investigations of visual hallucinations in first-episode psychosis remain scarce. The aims of this study were to describe the prevalence of visual hallucinations, and to explore the association between visual hallucination and childhood trauma in a first-episode psychosis sample. Subjects were included from TIPS-2, a first episode psychosis study in south Rogaland, Norway. Based on the medical journal descriptions of the Positive and Negative Symptoms Scale (PANSS), a separate score for visual and auditory hallucinations was created (N = 204). Patients were grouped according to hallucination severity (none, mild, and psychotic hallucinations) and multinomial logistic regression was performed to identify factors associated with visual hallucination group. Visual hallucinations of a psychotic nature were reported by 26.5% of patients. The experience of childhood interpersonal trauma increased the likelihood of having psychotic visual hallucinations. Visual hallucinations are common in first-episode psychosis, and are related to childhood interpersonal trauma.

  19. Prevalence and correlates of auditory vocal hallucinations in middle childhood

    NARCIS (Netherlands)

    Bartels-Velthuis, A.A.; Jenner, J.A.; van de Willige, G.; van Os, J.; Wiersma, D.

    Background Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and immediate consequences. Aims To investigate prevalence, developmental risk factors and behavioural correlates of auditory vocal hallucinations in 7- and 8-year-olds. Method Auditory vocal

  20. Transcranial direct current stimulation as a treatment for auditory hallucinations

    NARCIS (Netherlands)

    Koops, Sanne; van den Brink, Hilde; Sommer, Iris E C

    2015-01-01

    Auditory hallucinations (AH) are a symptom of several psychiatric disorders, such as schizophrenia. In a significant minority of patients, AH are resistant to antipsychotic medication. Alternative treatment options for this medication resistant group are scarce and most of them focus on coping with

  1. Metoprolol-induced visual hallucinations: a case series

    Directory of Open Access Journals (Sweden)

    Goldner Jonathan A

    2012-02-01

    Full Text Available Abstract Introduction Metoprolol is a widely used beta-adrenergic blocker that is commonly prescribed for a variety of cardiovascular syndromes and conditions. While central nervous system adverse effects have been well-described with most beta-blockers (especially lipophilic agents such as propranolol, visual hallucinations have been only rarely described with metoprolol. Case presentations Case 1 was an 84-year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night. They would be standing in front of the bed or sitting on chairs watching her when she slept. Numerous medications were stopped before her physician realized the metoprolol was the causative agent. The hallucinations resolved only after discontinuation of this medication. Case 2 was a 62-year-old Caucasian man with an inferior wall myocardial infarction complicated by cardiac arrest, who was successfully resuscitated and discharged from the hospital on metoprolol. About 18 months after discharge, he related to his physician that he had been seeing dead people at night. He related his belief that since he 'had died and was brought back to life', he was now seeing people from the after-life. Upon discontinuation of the metoprolol the visual disturbances resolved within several days. Case 3 was a 68 year-old Caucasian woman with a history of severe hypertension and depression, who reported visual hallucinations at night for years while taking metoprolol. These included awakening during the night with people in her bedroom and seeing objects in her room turn into animals. After a new physician switched her from metoprolol to atenolol, the visual hallucinations ceased within four days. Conclusion We suspect that metoprolol-induced visual hallucinations may be under-recognized and under-reported. Patients may frequently fail to acknowledge this adverse effect believing that they

  2. On “Hearing” Voices and “Seeing” Things: Probing Hallucination Predisposition in a Portuguese Nonclinical Sample with the Launay-Slade Hallucination Scale-Revised

    Directory of Open Access Journals (Sweden)

    Paula Castiajo

    2017-07-01

    Full Text Available The experience of hallucinations is a hallmark of psychotic disorders, but they are also present in other psychiatric and medical conditions, and may be reported in nonclinical individuals. Despite the increased number of studies probing the incidence of nonclinical hallucinations, the underlying phenomenological characteristics are still poorly understood. This study aimed to examine the psychometrics proprieties of the Portuguese adaptation of the 16-item Launay-Slade Hallucinations Scale (LSHS, the phenomenological characteristics of nonclinical hallucinatory experiences in a Portuguese sample, and the relationship between clinical symptoms and hallucination predisposition. Three-hundred-and-fifty-four European Portuguese college students completed the LSHS. Of those, 16 participants with high LSHS scores and 14 with low LSHS scores were further screened for clinical symptoms. A three-factor solution for the LSHS Portuguese version proved to be the most adequate. Intrusive or vivid thoughts and sleep-related hallucinations were the most common. Although, fundamentally perceived as positive experiences, all types of hallucinations were described as uncontrollable and dominating. However, the more pleasant they were perceived, the more controllable they were assessed. In addition, hallucination predisposition was associated with increased clinical symptoms. These results corroborate the lower severity of hallucinations in the general population compared to psychotic individuals. Further, they support an association between clinical symptoms and increased vulnerability to hallucinations. Specifically, increased schizotypal tendencies and negative mood (anxiety and depression may be related to increased psychotic risk.

  3. Default mode network links to visual hallucinations: A comparison between Parkinson's disease and multiple system atrophy.

    Science.gov (United States)

    Franciotti, Raffaella; Delli Pizzi, Stefano; Perfetti, Bernardo; Tartaro, Armando; Bonanni, Laura; Thomas, Astrid; Weis, Luca; Biundo, Roberta; Antonini, Angelo; Onofrj, Marco

    2015-08-01

    Studying default mode network activity or connectivity in different parkinsonisms, with or without visual hallucinations, could highlight its roles in clinical phenotypes' expression. Multiple system atrophy is the archetype of parkinsonism without visual hallucinations, variably appearing instead in Parkinson's disease (PD). We aimed to evaluate default mode network functions in multiple system atrophy in comparison with PD. Functional magnetic resonance imaging evaluated default mode network activity and connectivity in 15 multiple system atrophy patients, 15 healthy controls, 15 early PD patients matched for disease duration, 30 severe PD patients (15 with and 15 without visual hallucinations), matched with multiple system atrophy for disease severity. Cortical thickness and neuropsychological evaluations were also performed. Multiple system atrophy had reduced default mode network activity compared with controls and PD with hallucinations, and no differences with PD (early or severe) without hallucinations. In PD with visual hallucinations, activity and connectivity was preserved compared with controls and higher than in other groups. In early PD, connectivity was lower than in controls but higher than in multiple system atrophy and severe PD without hallucinations. Cortical thickness was reduced in severe PD, with and without hallucinations, and correlated only with disease duration. Higher anxiety scores were found in patients without hallucinations. Default mode network activity and connectivity was higher in PD with visual hallucinations and reduced in multiple system atrophy and PD without visual hallucinations. Cortical thickness comparisons suggest that functional, rather than structural, changes underlie the activity and connectivity differences. © 2015 International Parkinson and Movement Disorder Society.

  4. Internal versus External Auditory Hallucinations in Schizophrenia: Symptom and Course Correlates

    Science.gov (United States)

    Docherty, Nancy M.; Dinzeo, Thomas J.; McCleery, Amanda; Bell, Emily K.; Shakeel, Mohammed K.; Moe, Aubrey

    2015-01-01

    Introduction The auditory hallucinations associated with schizophrenia are phenomenologically diverse. “External” hallucinations classically have been considered to reflect more severe psychopathology than “internal” hallucinations, but empirical support has been equivocal. Methods We examined associations of “internal” v. “external” hallucinations with (a) other characteristics of the hallucinations, (b) severity of other symptoms, and (c) course of illness variables, in a sample of 97 stable outpatients with schizophrenia or schizoaffective disorder who experienced auditory hallucinations. Results Patients with internal hallucinations did not differ from those with external hallucinations on severity of other symptoms. However, they reported their hallucinations to be more emotionally negative, distressing, and long-lasting, less controllable, and less likely to remit over time. They also were more likely to experience voices commenting, conversing, or commanding. However, they also were more likely to have insight into the self-generated nature of their voices. Patients with internal hallucinations were not older, but had a later age of illness onset. Conclusions Differences in characteristics of auditory hallucinations are associated with differences in other characteristics of the disorder, and hence may be relevant to identifying subgroups of patients that are more homogeneous with respect to their underlying disease processes. PMID:25530157

  5. Neuropsychopharmacology of auditory hallucinations: insights from pharmacological functional MRI and perspectives for future research.

    Science.gov (United States)

    Johnsen, Erik; Hugdahl, Kenneth; Fusar-Poli, Paolo; Kroken, Rune A; Kompus, Kristiina

    2013-01-01

    Experiencing auditory verbal hallucinations is a prominent symptom in schizophrenia that also occurs in subjects at enhanced risk for psychosis and in the general population. Drug treatment of auditory hallucinations is challenging, because the current understanding is limited with respect to the neural mechanisms involved, as well as how CNS drugs, such as antipsychotics, influence the subjective experience and neurophysiology of hallucinations. In this article, the authors review studies of the effect of antipsychotic medication on brain activation as measured with functional MRI in patients with auditory verbal hallucinations. First, the authors examine the neural correlates of ongoing auditory hallucinations. Then, the authors critically discuss studies addressing the antipsychotic effect on the neural correlates of complex cognitive tasks. Current evidence suggests that blood oxygen level-dependant effects of antipsychotic drugs reflect specific, regional effects but studies on the neuropharmacology of auditory hallucinations are scarce. Future directions for pharmacological neuroimaging of auditory hallucinations are discussed.

  6. Auditory Hallucinations as Translational Psychiatry: Evidence from Magnetic Resonance Imaging.

    Science.gov (United States)

    Hugdahl, Kenneth

    2017-12-01

    In this invited review article, I present a translational perspective and overview of our research on auditory hallucinations in schizophrenia at the University of Bergen, Norway, with a focus on the neuronal mechanisms underlying the phenomenology of experiencing "hearing voices". An auditory verbal hallucination (i.e. hearing a voice) is defined as a sensory experience in the absence of a corresponding external sensory source that could explain the phenomenological experience. I suggest a general frame or scheme for the study of auditory verbal hallucinations, called Levels of Explanation. Using a Levels of Explanation approach, mental phenomena can be described and explained at different levels (cultural, clinical, cognitive, brain-imaging, cellular and molecular). Another way of saying this is that, to advance knowledge in a research field, it is not only necessary to replicate findings, but also to show how evidence obtained with one method, and at one level of explanation, converges with evidence obtained with another method at another level. To achieve breakthroughs in our understanding of auditory verbal hallucinations, we have to advance vertically through the various levels, rather than the more common approach of staying at our favourite level and advancing horizontally (e.g., more advanced techniques and data acquisition analyses). The horizontal expansion will, however, not advance a deeper understanding of how an auditory verbal hallucination spontaneously starts and stops. Finally, I present data from the clinical, cognitive, brain-imaging, and cellular levels, where data from one level validate and support data at another level, called converging of evidence. Using a translational approach, the current status of auditory verbal hallucinations is that they implicate speech perception areas in the left temporal lobe, impairing perception of and attention to external sounds. Preliminary results also show that amygdala is implicated in the emotional

  7. Auditory Hallucinations as Translational Psychiatry: Evidence from Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Kenneth Hugdahl

    2017-12-01

    Full Text Available In this invited review article, I present a translational perspective and overview of our research on auditory hallucinations in schizophrenia at the University of Bergen, Norway, with a focus on the neuronal mechanisms underlying the phenomenology of experiencing "hearing voices". An auditory verbal hallucination (i.e. hearing a voice is defined as a sensory experience in the absence of a corresponding external sensory source that could explain the phenomenological experience. I suggest a general frame or scheme for the study of auditory verbal hallucinations, called Levels of Explanation. Using a Levels of Explanation approach, mental phenomena can be described and explained at different levels (cultural, clinical, cognitive, brain-imaging, cellular and molecular. Another way of saying this is that, to advance knowledge in a research field, it is not only necessary to replicate findings, but also to show how evidence obtained with one method, and at one level of explanation, converges with evidence obtained with another method at another level. To achieve breakthroughs in our understanding of auditory verbal hallucinations, we have to advance vertically through the various levels, rather than the more common approach of staying at our favourite level and advancing horizontally (e.g., more advanced techniques and data acquisition analyses. The horizontal expansion will, however, not advance a deeper understanding of how an auditory verbal hallucination spontaneously starts and stops. Finally, I present data from the clinical, cognitive, brain-imaging, and cellular levels, where data from one level validate and support data at another level, called converging of evidence. Using a translational approach, the current status of auditory verbal hallucinations is that they implicate speech perception areas in the left temporal lobe, impairing perception of and attention to external sounds. Preliminary results also show that amygdala is implicated in

  8. Impaired self-monitoring of inner speech in schizophrenia patients with verbal hallucinations and in non-clinical individuals prone to hallucinations

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    Gildas Brébion

    2016-09-01

    Full Text Available Background: Previous research has shown that various memory errors reflecting failure in the self-monitoring of speech were associated with auditory/verbal hallucinations in schizophrenia patients and with proneness to hallucinations in non-clinical individuals. Method: We administered to 57 schizophrenia patients and 60 healthy participants a verbal memory task involving free recall and recognition of lists of words with different structures (high-frequency, low-frequency, and semantically-organisable words. Extra-list intrusions in free recall were tallied, and the response bias reflecting tendency to make false recognitions of non-presented words was computed for each list. Results: In the male patient subsample, extra-list intrusions were positively associated with verbal hallucinations and inversely associated with negative symptoms. In the healthy participants the extra-list intrusions were positively associated with proneness to hallucinations. A liberal response bias in the recognition of the high-frequency words was associated with verbal hallucinations in male patients and with proneness to hallucinations in healthy men. Meanwhile, a conservative response bias for these high-frequency words was associated with negative symptoms in male patients and with social anhedonia in healthy men. Conclusions: Misattribution of inner speech to an external source, reflected by false recollection of familiar material, seems to underlie both clinical and non-clinical hallucinations. Further, both clinical and non-clinical negative symptoms may exert on verbal memory errors an effect opposite to that of hallucinations.

  9. MR and genetics in schizophrenia: Focus on auditory hallucinations

    International Nuclear Information System (INIS)

    Aguilar, Eduardo Jesus; Sanjuan, Julio; Garcia-Marti, Gracian; Lull, Juan Jose; Robles, Montserrat

    2008-01-01

    Although many structural and functional abnormalities have been related to schizophrenia, until now, no single biological marker has been of diagnostic clinical utility. One way to obtain more valid findings is to focus on the symptoms instead of the syndrome. Auditory hallucinations (AHs) are one of the most frequent and reliable symptoms of psychosis. We present a review of our main findings, using a multidisciplinary approach, on auditory hallucinations. Firstly, by applying a new auditory emotional paradigm specific for psychosis, we found an enhanced activation of limbic and frontal brain areas in response to emotional words in these patients. Secondly, in a voxel-based morphometric study, we obtained a significant decreased gray matter concentration in the insula (bilateral), superior temporal gyrus (bilateral), and amygdala (left) in patients compared to healthy subjects. This gray matter loss was directly related to the intensity of AH. Thirdly, using a new method for looking at areas of coincidence between gray matter loss and functional activation, large coinciding brain clusters were found in the left and right middle temporal and superior temporal gyri. Finally, we summarized our main findings from our studies of the molecular genetics of auditory hallucinations. Taking these data together, an integrative model to explain the neurobiological basis of this psychotic symptom is presented

  10. MR and genetics in schizophrenia: Focus on auditory hallucinations

    Energy Technology Data Exchange (ETDEWEB)

    Aguilar, Eduardo Jesus [Psychiatric Service, Clinic University Hospital, Avda. Blasco Ibanez 17, 46010 Valencia (Spain)], E-mail: eduardoj.aguilar@gmail.com; Sanjuan, Julio [Psychiatric Unit, Faculty of Medicine, Valencia University, Avda. Blasco Ibanez 17, 46010 Valencia (Spain); Garcia-Marti, Gracian [Department of Radiology, Hospital Quiron, Avda. Blasco Ibanez 14, 46010 Valencia (Spain); Lull, Juan Jose; Robles, Montserrat [ITACA Institute, Polytechnic University of Valencia, Camino de Vera s/n, 46022 Valencia (Spain)

    2008-09-15

    Although many structural and functional abnormalities have been related to schizophrenia, until now, no single biological marker has been of diagnostic clinical utility. One way to obtain more valid findings is to focus on the symptoms instead of the syndrome. Auditory hallucinations (AHs) are one of the most frequent and reliable symptoms of psychosis. We present a review of our main findings, using a multidisciplinary approach, on auditory hallucinations. Firstly, by applying a new auditory emotional paradigm specific for psychosis, we found an enhanced activation of limbic and frontal brain areas in response to emotional words in these patients. Secondly, in a voxel-based morphometric study, we obtained a significant decreased gray matter concentration in the insula (bilateral), superior temporal gyrus (bilateral), and amygdala (left) in patients compared to healthy subjects. This gray matter loss was directly related to the intensity of AH. Thirdly, using a new method for looking at areas of coincidence between gray matter loss and functional activation, large coinciding brain clusters were found in the left and right middle temporal and superior temporal gyri. Finally, we summarized our main findings from our studies of the molecular genetics of auditory hallucinations. Taking these data together, an integrative model to explain the neurobiological basis of this psychotic symptom is presented.

  11. Psychopathological and demographic characteristics of hallucinating patients with schizophrenia and schizoaffective disorder: an analysis based on AMDP data.

    Science.gov (United States)

    Baethge, Christopher; Jänner, Michaela; Gaebel, Wolfgang; Malevani, Jaroslav

    2017-06-01

    Hallucinations are at the core of the diagnosis of schizophrenia and schizoaffective disorders, and many neuroscience studies focus on hallucinations. However, there is a lack of data on prevalence, subtyping, and clinical correlates of hallucinations as well as on the comparison of hallucinating schizophrenia versus hallucinating schizoaffective patients. Analysis of all psychopathology evaluations is based on the AMDP scale in a German psychiatric university hospital between 2007 and 2013 regarding patients with schizophrenia or schizoaffective disorder (diagnosed according to ICD-10). Hallucinating versus non-hallucinating patients and age- and gender-matched hallucinating schizophrenic versus schizoaffective patients were compared with regard to key psychopathological and demographic characteristics. Relative to patients with schizoaffective disorder, patients with schizophrenia more often hallucinated at admission (36.6 vs. 16.2 %, RR: 2.3, p  other auditory > visual > somatic/tactile > olfactory/gustatory. Hallucinating patients of either disorder were more often affected with respect to delusions (83 vs. 62 % and 81 vs. 48 % among patients with schizophrenia and schizoaffective disorder, respectively [both p schizoaffective disorder did not differ from hallucinating patients with schizophrenia. This is one of the few studies providing data on hallucinations in a routine clinical care setting. Hallucinations are a sign and likely a cause of greater illness severity. Patients with schizoaffective disorder less often experience hallucinations than patients with schizophrenia, but if they do, they seem to resemble patients with schizophrenia with regard to illness severity.

  12. The Pareidolia Test: A Simple Neuropsychological Test Measuring Visual Hallucination-Like Illusions

    OpenAIRE

    Mamiya, Yasuyuki; Nishio, Yoshiyuki; Watanabe, Hiroyuki; Yokoi, Kayoko; Uchiyama, Makoto; Baba, Toru; Iizuka, Osamu; Kanno, Shigenori; Kamimura, Naoto; Kazui, Hiroaki; Hashimoto, Mamoru; Ikeda, Manabu; Takeshita, Chieko; Shimomura, Tatsuo; Mori, Etsuro

    2016-01-01

    Background Visual hallucinations are a core clinical feature of dementia with Lewy bodies (DLB), and this symptom is important in the differential diagnosis and prediction of treatment response. The pareidolia test is a tool that evokes visual hallucination-like illusions, and these illusions may be a surrogate marker of visual hallucinations in DLB. We created a simplified version of the pareidolia test and examined its validity and reliability to establish the clinical utility of this test....

  13. Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage

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    Bogusław Paradowski

    2013-01-01

    Full Text Available Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

  14. Different cerebral metabolic features in dementia with lewy bodies with/without visual hallucination

    International Nuclear Information System (INIS)

    Kim, Bom Sahn; Kim, Yu Kyeong; Yang, Young Soon; Park, Eun Kyung; Cho, Sang Soo; Kim, Sang Yun; Kim, Sang Eun

    2007-01-01

    Reduction of glucose metabolism in the occipital cortex is well known in dementia with Lewy Bodies (DLB). The aim of this study was to evaluate the different nature of FDG PET in DLB patients who had visual hallucination or not. Thirteen patients (729 yrs, m:f=6:7) with DLB participated. DLB patient were classified into two groups according to the presence of visual hallucination; seven DLB patients with visual hallucination and 6 patients without visual hallucination. No differences between patient with and without visual hallucination was found in their cognitive function measured by mini mental status exam (MMSE) and clinical dementia rating (CDR) scale. Age and gender matched 30 healthy subjects (age; 715 yrs, m: f = 13:17) served as controls for comparison purpose. Regional metabolic differences on FDG PET among the groups were tested using SPM. In DLB patients groups regardless of visual hallucination, significant regional hypometabolism were observed in the bilateral occipital cortices as well as bilateral parietotemporal and frontal association cortices when compared with healthy controls, as expected. In DLB patients with visual hallucination compared to patients without hallucination, regional hypometabolism over primary and secondary visual cortex (BA17, BA18) was more significant. Moreover, lower regional metabolism in the paracentral area (BA 6) and cerebellar vermis was also observed in DLB with visual hallucination than without hallucination. Profound hypometabolism in the visual cortex may be a feature in DLB patients with visual hallucination. Also, relative hypometabolism in the paracentral area and cerebellum could be neurobiological characteristics related with abnormal cognitive and motor process response to hallucination

  15. A questionnaire-based (UM-PDHQ study of hallucinations in Parkinson's disease

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    Nation Daniel

    2008-06-01

    Full Text Available Abstract Background Hallucinations occur in 20–40% of PD patients and have been associated with unfavorable clinical outcomes (i.e., nursing home placement, increased mortality. Hallucinations, like other non-motor features of PD, are not well recognized in routine primary/secondary clinical practice. So far, there has been no instrument for uniform characterization of hallucinations in PD. To this end, we developed the University of Miami Parkinson's disease Hallucinations Questionnaire (UM-PDHQ that allows comprehensive assessment of hallucinations in clinical or research settings. Methods The UM-PDHQ is composed of 6 quantitative and 14 qualitative items. For our study PD patients of all ages and in all stages of the disease were recruited over an 18-month period. The UPDRS, MMSE, and Beck Depression and Anxiety Inventories were used for comparisons. Results and Discussion Seventy consecutive PD patients were included in the analyses. Thirty-one (44.3% were classified as hallucinators and 39 as non-hallucinators. No significant group differences were observed in terms of demographics, disease characteristics, stage, education, depressive/anxiety scores or cognitive functioning (MMSE between hallucinators and non-hallucinators. Single mode hallucinations were reported in 20/31 (visual/14, auditory/4, olfactory/2 whereas multiple modalities were reported in 11/31 patients. The most common hallucinatory experience was a whole person followed by small animals, insects and reptiles. Conclusion Using the UM-PDHQ, we were able to define the key characteristics of hallucinations in PD in our cohort. Future directions include the validation of the quantitative part of the questionnaire than will serve as a rating scale for severity of hallucinations.

  16. Source memory errors in schizophrenia, hallucinations and negative symptoms: a synthesis of research findings.

    Science.gov (United States)

    Brébion, G; Ohlsen, R I; Bressan, R A; David, A S

    2012-12-01

    Previous research has shown associations between source memory errors and hallucinations in patients with schizophrenia. We bring together here findings from a broad memory investigation to specify better the type of source memory failure that is associated with auditory and visual hallucinations. Forty-one patients with schizophrenia and 43 healthy participants underwent a memory task involving recall and recognition of lists of words, recognition of pictures, memory for temporal and spatial context of presentation of the stimuli, and remembering whether target items were presented as words or pictures. False recognition of words and pictures was associated with hallucination scores. The extra-list intrusions in free recall were associated with verbal hallucinations whereas the intra-list intrusions were associated with a global hallucination score. Errors in discriminating the temporal context of word presentation and the spatial context of picture presentation were associated with auditory hallucinations. The tendency to remember verbal labels of items as pictures of these items was associated with visual hallucinations. Several memory errors were also inversely associated with affective flattening and anhedonia. Verbal and visual hallucinations are associated with confusion between internal verbal thoughts or internal visual images and perception. In addition, auditory hallucinations are associated with failure to process or remember the context of presentation of the events. Certain negative symptoms have an opposite effect on memory errors.

  17. Compensatory shifts in visual perception are associated with hallucinations in Lewy body disorders.

    Science.gov (United States)

    Bowman, Alan Robert; Bruce, Vicki; Colbourn, Christopher J; Collerton, Daniel

    2017-01-01

    Visual hallucinations are a common, distressing, and disabling symptom of Lewy body and other diseases. Current models suggest that interactions in internal cognitive processes generate hallucinations. However, these neglect external factors. Pareidolic illusions are an experimental analogue of hallucinations. They are easily induced in Lewy body disease, have similar content to spontaneous hallucinations, and respond to cholinesterase inhibitors in the same way. We used a primed pareidolia task with hallucinating participants with Lewy body disorders (n = 16), non-hallucinating participants with Lewy body disorders (n = 19), and healthy controls (n = 20). Participants were presented with visual "noise" that sometimes contained degraded visual objects and were required to indicate what they saw. Some perceptions were cued in advance by a visual prime. Results showed that hallucinating participants were impaired in discerning visual signals from noise, with a relaxed criterion threshold for perception compared to both other groups. After the presentation of a visual prime, the criterion was comparable to the other groups. The results suggest that participants with hallucinations compensate for perceptual deficits by relaxing perceptual criteria, at a cost of seeing things that are not there, and that visual cues regularize perception. This latter finding may provide a mechanism for understanding the interaction between environments and hallucinations.

  18. Brazilian National Anthem presenting as musical hallucination: A case report with 9-year follow-up

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    José Eduardo Martinelli

    Full Text Available ABSTRACT Musical hallucination is a type of complex auditory hallucination. Possible etiologies are deafness, psychiatric disorders such as schizophrenia, major depression, use of medication and stress, besides neurologic diseases including epilepsy, stroke and cancer. Uncommon etiologies encompass infectious diseases, metabolic disorders, and sensory deprivation. Although musical hallucinations have a major impact on patients' lives, they have been undervalued and understudied in the literature. We report a case of a 79-year-old woman with musical hallucination (hearing a sung National anthem without cognitive impairment or hearing loss. The patient had preserved insight of her complaint and responded well to neuroleptics.

  19. Association of auditory-verbal and visual hallucinations with impaired and improved recognition of colored pictures.

    Science.gov (United States)

    Brébion, Gildas; Stephan-Otto, Christian; Usall, Judith; Huerta-Ramos, Elena; Perez del Olmo, Mireia; Cuevas-Esteban, Jorge; Haro, Josep Maria; Ochoa, Susana

    2015-09-01

    A number of cognitive underpinnings of auditory hallucinations have been established in schizophrenia patients, but few have, as yet, been uncovered for visual hallucinations. In previous research, we unexpectedly observed that auditory hallucinations were associated with poor recognition of color, but not black-and-white (b/w), pictures. In this study, we attempted to replicate and explain this finding. Potential associations with visual hallucinations were explored. B/w and color pictures were presented to 50 schizophrenia patients and 45 healthy individuals under 2 conditions of visual context presentation corresponding to 2 levels of visual encoding complexity. Then, participants had to recognize the target pictures among distractors. Auditory-verbal hallucinations were inversely associated with the recognition of the color pictures presented under the most effortful encoding condition. This association was fully mediated by working-memory span. Visual hallucinations were associated with improved recognition of the color pictures presented under the less effortful condition. Patients suffering from visual hallucinations were not impaired, relative to the healthy participants, in the recognition of these pictures. Decreased working-memory span in patients with auditory-verbal hallucinations might impede the effortful encoding of stimuli. Visual hallucinations might be associated with facilitation in the visual encoding of natural scenes, or with enhanced color perception abilities. (c) 2015 APA, all rights reserved).

  20. Face Hallucination with Linear Regression Model in Semi-Orthogonal Multilinear PCA Method

    Science.gov (United States)

    Asavaskulkiet, Krissada

    2018-04-01

    In this paper, we propose a new face hallucination technique, face images reconstruction in HSV color space with a semi-orthogonal multilinear principal component analysis method. This novel hallucination technique can perform directly from tensors via tensor-to-vector projection by imposing the orthogonality constraint in only one mode. In our experiments, we use facial images from FERET database to test our hallucination approach which is demonstrated by extensive experiments with high-quality hallucinated color faces. The experimental results assure clearly demonstrated that we can generate photorealistic color face images by using the SO-MPCA subspace with a linear regression model.

  1. Verbal working memory deficits predict levels of auditory hallucination in first-episode psychosis.

    Science.gov (United States)

    Gisselgård, Jens; Anda, Liss Gøril; Brønnick, Kolbjørn; Langeveld, Johannes; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Larsen, Tor Ketil

    2014-03-01

    Auditory verbal hallucinations are a characteristic symptom in schizophrenia. Recent causal models of auditory verbal hallucinations propose that cognitive mechanisms involving verbal working memory are involved in the genesis of auditory verbal hallucinations. Thus, in the present study, we investigate the hypothesis that verbal working memory is a specific factor behind auditory verbal hallucinations. In the present study, we investigated the association between verbal working memory manipulation (Backward Digit Span and Letter-Number Sequencing) and auditory verbal hallucinations in a population study (N=52) of first episode psychosis. The degree of auditory verbal hallucination as reported in the P3-subscale of the PANSS interview was included as dependent variable using sequential multiple regression, while controlling for age, psychosis symptom severity, executive cognitive functions and simple auditory working memory span. Multiple sequential regression analyses revealed verbal working memory manipulation to be the only significant predictor of verbal hallucination severity. Consistent with cognitive data from auditory verbal hallucinations in healthy individuals, the present results suggest a specific association between auditory verbal hallucinations, and cognitive processes involving the manipulation of phonological representations during a verbal working memory task. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Predicting compliance with command hallucinations: anger, impulsivity and appraisals of voices' power and intent.

    Science.gov (United States)

    Bucci, Sandra; Birchwood, Max; Twist, Laura; Tarrier, Nicholas; Emsley, Richard; Haddock, Gillian

    2013-06-01

    Command hallucinations are experienced by 33-74% of people who experience voices, with varying levels of compliance reported. Compliance with command hallucinations can result in acts of aggression, violence, suicide and self-harm; the typical response however is non-compliance or appeasement. Two factors associated with such dangerous behaviours are anger and impulsivity, however few studies have examined their relationship with compliance to command hallucinations. The current study aimed to examine the roles of anger and impulsivity on compliance with command hallucinations in people diagnosed with a psychotic disorder. The study was a cross-sectional design and included individuals who reported auditory hallucinations in the past month. Subjects completed a variety of self-report questionnaire measures. Thirty-two people experiencing command hallucinations, from both in-patient and community settings, were included. The tendency to appraise the voice as powerful, to be impulsive, to experience anger and to regulate anger were significantly associated with compliance with command hallucinations to do harm. Two factors emerged as significant independent predictors of compliance with command hallucinations; omnipotence and impulsivity. An interaction between omnipotence and compliance with commands, via a link with impulsivity, is considered and important clinical factors in the assessment of risk when working with clients experiencing command hallucinations are recommended. The data is highly suggestive and warrants further investigation with a larger sample. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Auditory hallucinations in adults with hearing impairment: a large prevalence study.

    Science.gov (United States)

    Linszen, M M J; van Zanten, G A; Teunisse, R J; Brouwer, R M; Scheltens, P; Sommer, I E

    2018-03-20

    Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment. Hallucination presence was determined in 1007 subjects aged 18-92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands. The presence and severity of hearing impairment were calculated using mean air conduction thresholds from the most recent pure tone audiometry. Out of 829 participants with hearing impairment, 16.2% (n = 134) had experienced auditory hallucinations in the past 4 weeks; significantly more than the non-impaired group [5.8%; n = 10/173; p impairment, with rates up to 24% in the most profoundly impaired group (p impairment in the best ear. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%). Our findings reveal that auditory hallucinations are common among patients with hearing impairment, and increase with impairment severity. Although more research on potential confounding factors is necessary, clinicians should be aware of this phenomenon, by inquiring after hallucinations in hearing-impaired patients and, conversely, assessing hearing impairment in patients with auditory hallucinations, since it may be a treatable factor.

  4. Do auditory verbal hallucinations have always aclinical significance?

    Directory of Open Access Journals (Sweden)

    Jolanta Rabe-Jabłońska

    2013-06-01

    Full Text Available This article presents the prevalence of auditory verbal hallucinations (AVHs across the life span in various clinical and nonclinical groups in childhood, adolescence, and adult populations. Data on the occurrence of this phenomenon in the general population vary and usually are in the range of 5–28%. The prevalence of non-clinical AVHs is similar in childhood, ado‑ lescence and adulthood. It seems possible that the mechanisms which cause AVHs in non-clinical populations are different from those which are behind AVHs presentations in psychotic illness. In this paper the characteristics of differentiating clini‑ cal forms of hallucinations from the non-clinical ones are discussed. These are: the location of sensations, their content, inhibition control disorders, metacognitive disorders, emotional dysregulation, stress level, and their influence on functioning dis‑ orders. Considered as  etiological factors are abnormal activities of  some areas of  the brain and abnormal pruning. The triggering factors of both types of perception disorders are traumatic events and psychoactive substances use. Long-term studies have shown that the factors which lead to the transformation of non-clinical hallucinations into their clinical forms are: genetic predisposition, schizotypy, at-risk mental state, and stress. The future research needs to focus on the comparison of underlying factors and mechanisms that lead to the onset of AVHs in both patients and non-clinical populations.

  5. Self-recognition Deficits in Schizophrenia Patients With Auditory Hallucinations : A Meta-analysis of the Literature

    NARCIS (Netherlands)

    Waters, Flavie; Woodward, Todd; Allen, Paul; Aleman, Andre; Sommers, Iris

    Theories about auditory hallucinations in schizophrenia suggest that these experiences occur because patients fail to recognize thoughts and mental events as self-generated. Different theoretical models have been proposed about the cognitive mechanisms underlying auditory hallucinations. Regardless

  6. Cost-effectiveness of the HIT programme in patients with schizophrenia and persistent auditory hallucinations

    NARCIS (Netherlands)

    Stant, AD; TenVergert, EM; Groen, H; Jenner, JA; Nienhuis, FJ; van de Willige, G; Wiersma, D

    Objective: To examine the cost-effectiveness of Hallucination focused Integrative Treatment (HIT) in patients with schizophrenia and a history of persistent auditory hallucinations. Method: Costs, in and outside the health care sector, and outcomes were registered prospectively during a period of 18

  7. What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences?

    NARCIS (Netherlands)

    Waters, Flavie; Blom, Jan Dirk; Thien Thanh Dang-Vu,; Cheyne, Allan J.; Alderson-Day, Ben; Woodruff, Peter; Collerton, Daniel

    By definition, hallucinations occur only in the full waking state. Yet similarities to sleep-related experiences such as hypnagogic and hypnopompic hallucinations, dreams and parasomnias, have been noted since antiquity. These observations have prompted researchers to suggest a common aetiology for

  8. What Is the Link Between Hallucinations, Dreams, and Hypnagogic–Hypnopompic Experiences?

    Science.gov (United States)

    Waters, Flavie; Blom, Jan Dirk; Dang-Vu, Thien Thanh; Cheyne, Allan J.; Alderson-Day, Ben; Woodruff, Peter; Collerton, Daniel

    2016-01-01

    By definition, hallucinations occur only in the full waking state. Yet similarities to sleep-related experiences such as hypnagogic and hypnopompic hallucinations, dreams and parasomnias, have been noted since antiquity. These observations have prompted researchers to suggest a common aetiology for these phenomena based on the neurobiology of rapid eye movement (REM) sleep. With our recent understanding of hallucinations in different population groups and at the neurobiological, cognitive and interpersonal levels, it is now possible to draw comparisons between the 2 sets of experiences as never before. In the current article, we make detailed comparisons between sleep-related experiences and hallucinations in Parkinson’s disease, schizophrenia and eye disease, at the levels of phenomenology (content, sensory modalities involved, perceptual attributes) and of brain function (brain activations, resting-state networks, neurotransmitter action). Findings show that sleep-related experiences share considerable overlap with hallucinations at the level of subjective descriptions and underlying brain mechanisms. Key differences remain however: (1) Sleep-related perceptions are immersive and largely cut off from reality, whereas hallucinations are discrete and overlaid on veridical perceptions; and (2) Sleep-related perceptions involve only a subset of neural networks implicated in hallucinations, reflecting perceptual signals processed in a functionally and cognitively closed-loop circuit. In summary, both phenomena are non-veridical perceptions that share some phenomenological and neural similarities, but insufficient evidence exists to fully support the notion that the majority of hallucinations depend on REM processes or REM intrusions into waking consciousness. PMID:27358492

  9. Elevated Voriconazole Level Associated With Hallucinations and Suicidal Ideation: A Case Report.

    Science.gov (United States)

    Jansen, Jeffrey W; Sen, Sumon K; Moenster, Ryan P

    2017-01-01

    Voriconazole, a broad-spectrum antifungal, has been associated with visual and auditory hallucinations. We report the case of patient being treated with voriconazole for pulmonary aspergillosis who developed visual hallucinations and new suicidal ideation with plan. Voriconazole troughs were supratherapeutic (9.0 mcg/mL) and the patient was positive for the CYP2C19*1/*2 allele.

  10. [Formed visual hallucination after excision of the right temporo parietal cystic meningioma--a case report].

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    Yoshimura, Masaki; Uchiyama, Yoshinori; Kaneko, Akira; Hayashi, Noriko; Yamanaka, Kazuhiro; Iwai, Yoshiyasu

    2010-08-01

    We report the case of a 64-year-old woman with cystic meningioma; this patients was otherwise healthy and experienced formed visual hallucinations after excision of the tumor. She experienced diplopia associated with metamorphopsia, which had persisted for 5 years only when she laid down and turned on her left side. After the excision of the convexity meningioma located in the right temporoparietal lobe, she experienced several types of formed visual hallucinations such as closet-like pictures, flowers sketched on stones, falling maple-like leaves, and moving or wriggling dwarves. She was alert and her visual field was normal; further, she did not experience delirium or seizures. She experienced these hallucinations only when she closed her eyes; these hallucinations persisted for 3 days after the operation. The patient illustrated her observations with beautiful sketches, and the mechanism of visual hallucinations was studied.

  11. Online Methods of Managing Auditory Hallucinations: A New Trend to Understand Psychopathology.

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    Sharma, Manoj Kumar; Mahindru, Poornima

    2017-01-01

    Treatment seekers use various coping methods to reduce the distress associated with auditory hallucinations. With the increase use of technology, the technology means are also in use to manage the auditory hallucination. The current report documents the implications of technology means for the management of auditory hallucinations. The user was assessed using clinical interview, internet addiction test, problematic online gaming questionnaire, and screening questions for technology addiction. It showed the use of technology to manage the auditory hallucinations. Psychotherapy work revealed a reduction in their use of technology means at follow-up. It implies to evolve the therapeutic use of technology means and development of alternative therapeutic means to manage the auditory hallucinations.

  12. [Complex visual hallucinations following occipital infarct and perception of optical illusions].

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    Renou, P; Deltour, S; Samson, Y

    2008-05-01

    The physiopathology of visual hallucinations in the hemianopic field secondary to occipital infarct is uncertain. We report the case of a patient with a history of occipital infarct who presented nonstereotyped complex hallucinations in the quadranopic field resulting from a second controlateral occipital infarct. Based on an experience with motion optical illusions, we suggested that the association of these two occipital lesions, involving the V5 motion area on the one side and the V1 area on the other side, could have produced the complex hallucinations due to a release phenomenon. The patient experienced simultaneously a double visual consciousness, with both hallucinations and real visual perceptions. The study of perceptual illusions in patients with visual hallucinations could illustrate the innovative theory of visual consciousness as being not unified but constituted of multiple microconsciousnesses.

  13. Visual Hallucinations Due to Rivastigmine Transdermal Patch Application in Alzheimer's Disease; The First Case Report

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    Yıldız Değirmenci

    2016-12-01

    Full Text Available Rivastigmine is a well-known dual acting acetylcholinesterase and butyrylcholinesterase inhibitor, which is effective on behavioral and psychiatric symptoms including hallucinations, as well as cognitive symptoms of dementia. The most common adverse effects of rivastigmine related to cholinergic stimulation in brain and peripheral tissues are gastrointestinal, cardiorespiratory, extrapyramidal, genitourinary, musculoskeletal symptoms, sleep disturbances, and skin irritations with the transdermal patch form in particular. Despite to the previous reports revealing the improving effects of the drug on hallucinations, we presented a-80 year old women with Alzheimer's disease suffering from visual hallucinations whose complaints began with rivastigmine treatment. Since the patient had recent memory disturbance without any behavioral and/or psychiatric symptoms before rivastigmine administration, and visual hallucinations disappeared with the discontinuation of the drug, visual hallucinations were attributed to rivastigmine.

  14. Transcranial direct current stimulation as a treatment for auditory hallucinations.

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    Sanne eKoops

    2015-03-01

    Full Text Available Auditory hallucinations (AH are a symptom of several psychiatric disorders, such as schizophrenia. In a significant minority of patients, AH are resistant to antipsychotic medication. Alternative treatment options for this medication-resistant group are scarce and most of them focus on coping with the hallucinations. Finding an alternative treatment that can diminish AH is of great importance.Transcranial direct current stimulation (tDCS is a safe and non-invasive technique that is able to directly influence cortical excitability through the application of very low electric currents. A 1-2 mA direct current is applied between two surface electrodes, one serving as the anode and the other as the cathode. Cortical excitability is increased in the vicinity of the anode and reduced near the cathode. The technique, which has only a few transient side effects and is cheap and portable, is increasingly explored as a treatment for neurological and psychiatric symptoms. It has shown efficacy on symptoms of depression, bipolar disorder, schizophrenia, Alzheimer’s disease, Parkinson’s disease, epilepsy and stroke. However, the application of tDCS as a treatment for AH is relatively new. This article provides an overview of the current knowledge in this field and provides guidelines for future research.

  15. Auditory verbal hallucinations and cognitive functioning in healthy individuals.

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    Daalman, Kirstin; van Zandvoort, Martine; Bootsman, Florian; Boks, Marco; Kahn, René; Sommer, Iris

    2011-11-01

    Auditory verbal hallucinations (AVH) are a characteristic symptom in schizophrenia, and also occur in the general, non-clinical population. In schizophrenia patients, several specific cognitive deficits, such as in speech processing, working memory, source memory, attention, inhibition, episodic memory and self-monitoring have been associated with auditory verbal hallucinations. Such associations are interesting, as they may identify specific cognitive traits that constitute a predisposition for AVH. However, it is difficult to disentangle a specific relation with AVH in patients with schizophrenia, as so many other factors can affect the performance on cognitive tests. Examining the cognitive profile of healthy individuals experiencing AVH may reveal a more direct association between AVH and aberrant cognitive functioning in a specific domain. For the current study, performance in executive functioning, memory (both short- and long-term), processing speed, spatial ability, lexical access, abstract reasoning, language and intelligence performance was compared between 101 healthy individuals with AVH and 101 healthy controls, matched for gender, age, handedness and education. Although performance of both groups was within the normal range, not clinically impaired, significant differences between the groups were found in the verbal domain as well as in executive functioning. Performance on all other cognitive domains was similar in both groups. The predisposition to experience AVH is associated with lower performance in executive functioning and aberrant language performance. This association might be related to difficulties in the inhibition of irrelevant verbal information. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Oscillatory cortical network involved in auditory verbal hallucinations in schizophrenia.

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    Remko van Lutterveld

    Full Text Available Auditory verbal hallucinations (AVH, a prominent symptom of schizophrenia, are often highly distressing for patients. Better understanding of the pathogenesis of hallucinations could increase therapeutic options. Magnetoencephalography (MEG provides direct measures of neuronal activity and has an excellent temporal resolution, offering a unique opportunity to study AVH pathophysiology.Twelve patients (10 paranoid schizophrenia, 2 psychosis not otherwise specified indicated the presence of AVH by button-press while lying in a MEG scanner. As a control condition, patients performed a self-paced button-press task. AVH-state and non-AVH state were contrasted in a region-of-interest (ROI approach. In addition, the two seconds before AVH onset were contrasted with the two seconds after AVH onset to elucidate a possible triggering mechanism.AVH correlated with a decrease in beta-band power in the left temporal cortex. A decrease in alpha-band power was observed in the right inferior frontal gyrus. AVH onset was related to a decrease in theta-band power in the right hippocampus.These results suggest that AVH are triggered by a short aberration in the theta band in a memory-related structure, followed by activity in language areas accompanying the experience of AVH itself.

  17. The proximity between hallucination and delusion dimensions: An observational, analytic, cross-sectional, multicentre study

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    Diogo Telles-correia

    2016-11-01

    Full Text Available 5.In the current psychiatric classifications, hallucinations (mainly auditory hallucinations are one of the fundamental criteria for establishing a schizophrenia diagnosis or any of the related psychotic disorder’s diagnoses.6.Throughout the history of Psychiatry the conceptual proximity between delusions and hallucinations in the psychiatric patient was maintained until the end of the XIX century,with several supporters during the XX century. Their frontier was not yet definitely defined in terms of Descriptive Psychopathology, and much less so in terms of biochemical and anatomical models.7.In this article we aimed to analyse the dimensions of both hallucinations and delusions in a sample of patients with schizophrenia and schizoaffective disorder. We also intend to find the determinants of the main dimensions of hallucinations.8.One hundred patients with schizophrenia or schizoaffective disorder from both the outpatient and inpatient units of the Psychiatry Department of Hospital of Santa Maria and the Centro Hospitalar Psiquiátrico de Lisboa were assessed by means of the Psychotic Symptom Rating Scales (PSYRATS. 9.In this study we found an empirical based model, where the main dimensions of hallucinations are determined by the central dimensions of delusions. 10.Keywords: Psyrats, Hallucinations, Psychopathology, Psychosis, delusions

  18. Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders: A meta-analysis.

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    Zhang, Yingli; Liang, Wei; Yang, Shichang; Dai, Ping; Shen, Lijuan; Wang, Changhong

    2013-10-05

    This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive transcranial magnetic stimulation", and "hallucination". Selected studies were randomized controlled trials assessing therapeutic efficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repetitive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P = 0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for

  19. From Hallucination to Fiction: The Invention of Meaning in Psychosis.

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    Lippi, Silvia; Lehaire, Célia; Petit, Laetitia

    2016-12-01

    Taking their inspiration from a case history, the authors explore the effects of a writing workshop led by a professional writer for patients in a psychiatric hospital. This workshop allowed different modes of transference to unfold: transference to the analyst-therapist, transference to the writer who led the workshop, and transference to the other members of the group. The writing activity created conditions in which there could be a movement from hallucination to delusion-a delusion expressed in fiction through the act of writing. Psychotic patients "invent" a writing that remains unfinished and that relates to the experiences of persecution. Writing thus makes it possible for them to tolerate language, through its transformation into writing.

  20. Diminished auditory sensory gating during active auditory verbal hallucinations.

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    Thoma, Robert J; Meier, Andrew; Houck, Jon; Clark, Vincent P; Lewine, Jeffrey D; Turner, Jessica; Calhoun, Vince; Stephen, Julia

    2017-10-01

    Auditory sensory gating, assessed in a paired-click paradigm, indicates the extent to which incoming stimuli are filtered, or "gated", in auditory cortex. Gating is typically computed as the ratio of the peak amplitude of the event related potential (ERP) to a second click (S2) divided by the peak amplitude of the ERP to a first click (S1). Higher gating ratios are purportedly indicative of incomplete suppression of S2 and considered to represent sensory processing dysfunction. In schizophrenia, hallucination severity is positively correlated with gating ratios, and it was hypothesized that a failure of sensory control processes early in auditory sensation (gating) may represent a larger system failure within the auditory data stream; resulting in auditory verbal hallucinations (AVH). EEG data were collected while patients (N=12) with treatment-resistant AVH pressed a button to indicate the beginning (AVH-on) and end (AVH-off) of each AVH during a paired click protocol. For each participant, separate gating ratios were computed for the P50, N100, and P200 components for each of the AVH-off and AVH-on states. AVH trait severity was assessed using the Psychotic Symptoms Rating Scales AVH Total score (PSYRATS). The results of a mixed model ANOVA revealed an overall effect for AVH state, such that gating ratios were significantly higher during the AVH-on state than during AVH-off for all three components. PSYRATS score was significantly and negatively correlated with N100 gating ratio only in the AVH-off state. These findings link onset of AVH with a failure of an empirically-defined auditory inhibition system, auditory sensory gating, and pave the way for a sensory gating model of AVH. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Minds on replay: musical hallucinations and their relationship to neurological disease.

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    Golden, Erin C; Josephs, Keith A

    2015-12-01

    The phenomenon of musical hallucinations, in which individuals perceive music in the absence of an external auditory stimulus, has been described sparingly in the literature through small case reports and series. Musical hallucinations have been linked to multiple associated conditions, including psychiatric and neurologic disease, brain lesions, drug effect, and hearing impairment. This study aimed to review the demographics of subjects with musical hallucinations and to determine the prevalence of neurological disorders, particularly neurodegenerative disease. Through the Mayo medical record, 393 subjects with musical hallucinations were identified and divided into five categories based on comorbid conditions that have been associated with musical hallucinations: neurological, psychiatric, structural, drug effect and not otherwise classifiable. Variables, including hearing impairment and the presence of visual and other auditory hallucinations, were evaluated independently in all five groups. The mean age at onset of the hallucinations was 56 years, ranging from 18 to 98 years, and 65.4% of the subjects were female. Neurological disease and focal brain lesions were found in 25% and 9% of the total subjects, respectively. Sixty-five subjects were identified with a neurodegenerative disorder, with the Lewy body disorders being the most common. Visual hallucinations were more common in the group with neurological disease compared to the psychiatric, structural, and not otherwise classifiable groups (P < 0.001), whereas auditory hallucinations were more common in the psychiatric group compared to all other groups (P < 0.001). Structural lesions associated with musical hallucinations involved both hemispheres with a preference towards the left, and all but two included the temporal lobe. Hearing impairment was common, particularly in the not otherwise classifiable category where 67.2% had documented hearing impairment, more than in any other group (P < 0.001). Those

  2. Eye-related visual hallucinations: Consider ′Charles Bonnet syndrome′

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    Nilgun Cinar

    2011-01-01

    Full Text Available The Charles Bonnet Syndrome (CBS is typically characterized by visual hallucinations in elderly people without cognitive defects. This article presents the case of an 80-year-old male patient with a one-year history of visual hallucinations, secondary to glaucoma, in both eyes. Neither a dopamine agonist nor cholinesterase inhibitor therapy improved his symptoms. In this case, the hallucinations were gradually improved after administration of a GABAergic drug, pregabalin, for diabetic polyneuropathy. Placebo-controlled clinical trials would be needed to support this effect of pregabalin, as suggested by this association.

  3. Visual hallucinations and pontine demyelination in a child: possible REM dissociation?

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    Vita, Maria Gabriella; Batocchi, Anna Paola; Dittoni, Serena; Losurdo, Anna; Cianfoni, Alessandro; Stefanini, Maria Chiara; Vollono, Catello; Della Marca, Giacomo; Mariotti, Paolo

    2008-12-15

    An 11 year-old-boy acutely developed complex visual and acoustic hallucinations. Hallucinations, consisting of visions of a threatening, evil character of the Harry Potter saga, persisted for 3 days. Neurological and psychiatric examinations were normal. Ictal EEG was negative. MRI documented 3 small areas of hyperintense signal in the brainstem, along the paramedian and lateral portions of pontine tegmentum, one of which showed post-contrast enhancement. These lesions were likely of inflammatory origin, and treatment with immunoglobulins was started. Polysomnography was normal, multiple sleep latency test showed a mean sleep latency of 8 minutes, with one sleep-onset REM period. The pontine tegmentum is responsible for REM sleep regulation, and contains definite "REM-on" and "REM-off" regions. The anatomical distribution of the lesions permits us to hypothesize that hallucinations in this boy were consequent to a transient impairment of REM sleep inhibitory mechanisms, with the appearance of dream-like hallucinations during wake.

  4. Hallucinations in Healthy Older Adults: An Overview of the Literature and Perspectives for Future Research

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    Johanna C. Badcock

    2017-07-01

    Full Text Available KEY POINTS➢ Studies suggest a substantial minority of healthy older adults have hallucinatory experiences, in line with existing evidence on hallucinations in other age groups, though it is still unclear if hallucination prevalence increases or declines with age in older cohorts.➢ Stigma attached to both hallucinations and ageing leads to considerable under-reporting of these experiences in healthy older adults and may negatively bias how professionals, family members, and the public respond.➢ Why and when hallucinations in healthy older adults remit, persist, or progress to other clinical disorders remains poorly understood.➢ Current evidence points to a range of factors associated with hallucinations in older adults including decline in sensory or cognitive functioning, poor sleep, and psychosocial stressors (e.g., social isolation, loneliness, and bereavement, highlighting the need for accurate assessment and tailored interventions.Hallucinations, though common in youth and younger adults, are not the preserve of these age groups. Accumulating evidence shows that hallucinatory experiences are also present at surprisingly high rates in healthy older adults in the general community. Furthermore, stigma and misunderstanding of hallucinations, together with ageism, may lead to under-reporting of these experiences by older adults, and misdiagnosis or mismanagement by health and mental health practitioners. Consequently, improved public and professional knowledge is needed about the nature and significance of hallucinations with advancing age. The purpose of this review is to provide a comprehensive overview, and critical analysis, of research on the prevalence, psychosocial, and neurobiological factors associated with hallucinations in people aged 60 years and over. To the best of our knowledge, this is the first review of its kind in the literature. The evidence supports a dynamic conceptualization of hallucinations, in which the

  5. Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study.

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    Rosenberg, Oded; Roth, Yiftach; Kotler, Moshe; Zangen, Abraham; Dannon, Pinhas

    2011-02-09

    Schizophrenia is a chronic and disabling disease that presents with delusions and hallucinations. Auditory hallucinations are usually expressed as voices speaking to or about the patient. Previous studies have examined the effect of repetitive transcranial magnetic stimulation (TMS) over the temporoparietal cortex on auditory hallucinations in schizophrenic patients. Our aim was to explore the potential effect of deep TMS, using the H coil over the same brain region on auditory hallucinations. Eight schizophrenic patients with refractory auditory hallucinations were recruited, mainly from Beer Ya'akov Mental Health Institution (Tel Aviv university, Israel) ambulatory clinics, as well as from other hospitals outpatient populations. Low-frequency deep TMS was applied for 10 min (600 pulses per session) to the left temporoparietal cortex for either 10 or 20 sessions. Deep TMS was applied using Brainsway's H1 coil apparatus. Patients were evaluated using the Auditory Hallucinations Rating Scale (AHRS) as well as the Scale for the Assessment of Positive Symptoms scores (SAPS), Clinical Global Impressions (CGI) scale, and the Scale for Assessment of Negative Symptoms (SANS). This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2%) and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%). In this study, we have demonstrated the potential of deep TMS treatment over the temporoparietal cortex as an add-on treatment for chronic auditory hallucinations in schizophrenic patients. Larger samples in a double-blind sham-controlled design are now being preformed to evaluate the effectiveness of deep TMS treatment for auditory hallucinations. This trial is registered with clinicaltrials.gov (identifier: NCT00564096).

  6. Deep transcranial magnetic stimulation for the treatment of auditory hallucinations: a preliminary open-label study

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    Zangen Abraham

    2011-02-01

    Full Text Available Abstract Background Schizophrenia is a chronic and disabling disease that presents with delusions and hallucinations. Auditory hallucinations are usually expressed as voices speaking to or about the patient. Previous studies have examined the effect of repetitive transcranial magnetic stimulation (TMS over the temporoparietal cortex on auditory hallucinations in schizophrenic patients. Our aim was to explore the potential effect of deep TMS, using the H coil over the same brain region on auditory hallucinations. Patients and methods Eight schizophrenic patients with refractory auditory hallucinations were recruited, mainly from Beer Ya'akov Mental Health Institution (Tel Aviv university, Israel ambulatory clinics, as well as from other hospitals outpatient populations. Low-frequency deep TMS was applied for 10 min (600 pulses per session to the left temporoparietal cortex for either 10 or 20 sessions. Deep TMS was applied using Brainsway's H1 coil apparatus. Patients were evaluated using the Auditory Hallucinations Rating Scale (AHRS as well as the Scale for the Assessment of Positive Symptoms scores (SAPS, Clinical Global Impressions (CGI scale, and the Scale for Assessment of Negative Symptoms (SANS. Results This preliminary study demonstrated a significant improvement in AHRS score (an average reduction of 31.7% ± 32.2% and to a lesser extent improvement in SAPS results (an average reduction of 16.5% ± 20.3%. Conclusions In this study, we have demonstrated the potential of deep TMS treatment over the temporoparietal cortex as an add-on treatment for chronic auditory hallucinations in schizophrenic patients. Larger samples in a double-blind sham-controlled design are now being preformed to evaluate the effectiveness of deep TMS treatment for auditory hallucinations. Trial registration This trial is registered with clinicaltrials.gov (identifier: NCT00564096.

  7. What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences?

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    Waters, Flavie; Blom, Jan Dirk; Dang-Vu, Thien Thanh; Cheyne, Allan J; Alderson-Day, Ben; Woodruff, Peter; Collerton, Daniel

    2016-09-01

    By definition, hallucinations occur only in the full waking state. Yet similarities to sleep-related experiences such as hypnagogic and hypnopompic hallucinations, dreams and parasomnias, have been noted since antiquity. These observations have prompted researchers to suggest a common aetiology for these phenomena based on the neurobiology of rapid eye movement (REM) sleep. With our recent understanding of hallucinations in different population groups and at the neurobiological, cognitive and interpersonal levels, it is now possible to draw comparisons between the 2 sets of experiences as never before. In the current article, we make detailed comparisons between sleep-related experiences and hallucinations in Parkinson's disease, schizophrenia and eye disease, at the levels of phenomenology (content, sensory modalities involved, perceptual attributes) and of brain function (brain activations, resting-state networks, neurotransmitter action). Findings show that sleep-related experiences share considerable overlap with hallucinations at the level of subjective descriptions and underlying brain mechanisms. Key differences remain however: (1) Sleep-related perceptions are immersive and largely cut off from reality, whereas hallucinations are discrete and overlaid on veridical perceptions; and (2) Sleep-related perceptions involve only a subset of neural networks implicated in hallucinations, reflecting perceptual signals processed in a functionally and cognitively closed-loop circuit. In summary, both phenomena are non-veridical perceptions that share some phenomenological and neural similarities, but insufficient evidence exists to fully support the notion that the majority of hallucinations depend on REM processes or REM intrusions into waking consciousness. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. The Pareidolia Test: A Simple Neuropsychological Test Measuring Visual Hallucination-Like Illusions.

    Science.gov (United States)

    Mamiya, Yasuyuki; Nishio, Yoshiyuki; Watanabe, Hiroyuki; Yokoi, Kayoko; Uchiyama, Makoto; Baba, Toru; Iizuka, Osamu; Kanno, Shigenori; Kamimura, Naoto; Kazui, Hiroaki; Hashimoto, Mamoru; Ikeda, Manabu; Takeshita, Chieko; Shimomura, Tatsuo; Mori, Etsuro

    2016-01-01

    Visual hallucinations are a core clinical feature of dementia with Lewy bodies (DLB), and this symptom is important in the differential diagnosis and prediction of treatment response. The pareidolia test is a tool that evokes visual hallucination-like illusions, and these illusions may be a surrogate marker of visual hallucinations in DLB. We created a simplified version of the pareidolia test and examined its validity and reliability to establish the clinical utility of this test. The pareidolia test was administered to 52 patients with DLB, 52 patients with Alzheimer's disease (AD) and 20 healthy controls (HCs). We assessed the test-retest/inter-rater reliability using the intra-class correlation coefficient (ICC) and the concurrent validity using the Neuropsychiatric Inventory (NPI) hallucinations score as a reference. A receiver operating characteristic (ROC) analysis was used to evaluate the sensitivity and specificity of the pareidolia test to differentiate DLB from AD and HCs. The pareidolia test required approximately 15 minutes to administer, exhibited good test-retest/inter-rater reliability (ICC of 0.82), and moderately correlated with the NPI hallucinations score (rs = 0.42). Using an optimal cut-off score set according to the ROC analysis, and the pareidolia test differentiated DLB from AD with a sensitivity of 81% and a specificity of 92%. Our study suggests that the simplified version of the pareidolia test is a valid and reliable surrogate marker of visual hallucinations in DLB.

  9. Hallucinators find meaning in noises: pareidolic illusions in dementia with Lewy bodies.

    Science.gov (United States)

    Yokoi, Kayoko; Nishio, Yoshiyuki; Uchiyama, Makoto; Shimomura, Tatsuo; Iizuka, Osamu; Mori, Etsuro

    2014-04-01

    By definition, visual illusions and hallucinations differ in whether the perceived objects exist in reality. A recent study challenged this dichotomy, in which pareidolias, a type of complex visual illusion involving ambiguous forms being perceived as meaningful objects, are very common and phenomenologically similar to visual hallucinations in dementia with Lewy bodies (DLB). We hypothesise that a common psychological mechanism exists between pareidolias and visual hallucinations in DLB that confers meaning upon meaningless visual information. Furthermore, we believe that these two types of visual misperceptions have a common underlying neural mechanism, namely, cholinergic insufficiency. The current study investigated pareidolic illusions using meaningless visual noise stimuli (the noise pareidolia test) in 34 patients with DLB, 34 patients with Alzheimer׳s disease and 28 healthy controls. Fifteen patients with DLB were administered the noise pareidolia test twice, before and after donepezil treatment. Three major findings were discovered: (1) DLB patients saw meaningful illusory images (pareidolias) in meaningless visual stimuli, (2) the number of pareidolic responses correlated with the severity of visual hallucinations, and (3) cholinergic enhancement reduced both the number of pareidolias and the severity of visual hallucinations in patients with DLB. These findings suggest that a common underlying psychological and neural mechanism exists between pareidolias and visual hallucinations in DLB. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. The Pareidolia Test: A Simple Neuropsychological Test Measuring Visual Hallucination-Like Illusions.

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    Yasuyuki Mamiya

    Full Text Available Visual hallucinations are a core clinical feature of dementia with Lewy bodies (DLB, and this symptom is important in the differential diagnosis and prediction of treatment response. The pareidolia test is a tool that evokes visual hallucination-like illusions, and these illusions may be a surrogate marker of visual hallucinations in DLB. We created a simplified version of the pareidolia test and examined its validity and reliability to establish the clinical utility of this test.The pareidolia test was administered to 52 patients with DLB, 52 patients with Alzheimer's disease (AD and 20 healthy controls (HCs. We assessed the test-retest/inter-rater reliability using the intra-class correlation coefficient (ICC and the concurrent validity using the Neuropsychiatric Inventory (NPI hallucinations score as a reference. A receiver operating characteristic (ROC analysis was used to evaluate the sensitivity and specificity of the pareidolia test to differentiate DLB from AD and HCs.The pareidolia test required approximately 15 minutes to administer, exhibited good test-retest/inter-rater reliability (ICC of 0.82, and moderately correlated with the NPI hallucinations score (rs = 0.42. Using an optimal cut-off score set according to the ROC analysis, and the pareidolia test differentiated DLB from AD with a sensitivity of 81% and a specificity of 92%.Our study suggests that the simplified version of the pareidolia test is a valid and reliable surrogate marker of visual hallucinations in DLB.

  11. Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions.

    Science.gov (United States)

    Kjelby, E; Sinkeviciute, I; Gjestad, R; Kroken, R A; Løberg, E-M; Jørgensen, H A; Hugdahl, K; Johnsen, E

    2015-10-01

    Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders. One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation. Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans. The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk. ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Preclinical Polymodal Hallucinations for 13 Years before Dementia with Lewy Bodies

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    Carlo Abbate

    2014-01-01

    Full Text Available Objective. We describe a case of dementia with Lewy bodies (DLB that presented long-lasting preclinical complex polymodal hallucinations. Background. Few studies have deeply investigated the characteristics of hallucinations in DLB, especially in the preclinical phase. Moreover, the clinical phenotype of mild cognitive impairment-(MCI- DLB is poorly understood. Methods. The patient was followed for 4 years and a selective phenomenological and cognitive study was performed at the predementia stage. Results. The phenomenological study showed the presence of hypnagogic and hypnopompic hallucinations that allowed us to make a differential diagnosis between DLB and Charles Bonnet syndrome (CBS. The neuropsychological evaluation showed a multiple domain without amnesia MCI subtype with prefrontal dysexecutive, visuoperceptual, and visuospatial impairments and simultanagnosia, which has not previously been reported in MCI-DLB. Conclusions. This study extends the prognostic value of hallucinations for DLB to the preclinical phases. It supports and refines the MCI-DLB concept and identifies simultanagnosia as a possible early cognitive marker. Finally, it confirms an association between hallucinations and visuoperceptual impairments at an intermediate stage of the disease course and strongly supports the hypothesis that hallucinations in the earliest stages of DLB may reflect a narcolepsy-like REM-sleep disorder.

  13. A functional magnetic resonance imaging investigation of visual hallucinations in the human striate cortex.

    Science.gov (United States)

    Abid, Hina; Ahmad, Fayyaz; Lee, Soo Y; Park, Hyun W; Im, Dongmi; Ahmad, Iftikhar; Chaudhary, Safee U

    2016-11-29

    Human beings frequently experience fear, phobia, migraine and hallucinations, however, the cerebral mechanisms underpinning these conditions remain poorly understood. Towards this goal, in this work, we aim to correlate the human ocular perceptions with visual hallucinations, and map them to their cerebral origins. An fMRI study was performed to examine the visual cortical areas including the striate, parastriate and peristriate cortex in the occipital lobe of the human brain. 24 healthy subjects were enrolled and four visual patterns including hallucination circle (HCC), hallucination fan (HCF), retinotopy circle (RTC) and retinotopy cross (RTX) were used towards registering their impact in the aforementioned visual related areas. One-way analysis of variance was used to evaluate the significance of difference between induced activations. Multinomial regression and and K-means were used to cluster activation patterns in visual areas of the brain. Significant activations were observed in the visual cortex as a result of stimulus presentation. The responses induced by visual stimuli were resolved to Brodmann areas 17, 18 and 19. Activation data clustered into independent and mutually exclusive clusters with HCC registering higher activations as compared to HCF, RTC and RTX. We conclude that small circular objects, in rotation, tend to leave greater hallucinating impressions in the visual region. The similarity between observed activation patterns and those reported in conditions such as epilepsy and visual hallucinations can help elucidate the cortical mechanisms underlying these conditions. Trial Registration 1121_GWJUNG.

  14. Preclinical Polymodal Hallucinations for 13 Years before Dementia with Lewy Bodies

    Science.gov (United States)

    Abbate, Carlo; Trimarchi, Pietro Davide; Inglese, Silvia; Viti, Niccolò; Cantatore, Alessandra; De Agostini, Lisa; Pirri, Federico; Marino, Lorenza; Bagarolo, Renzo

    2014-01-01

    Objective. We describe a case of dementia with Lewy bodies (DLB) that presented long-lasting preclinical complex polymodal hallucinations. Background. Few studies have deeply investigated the characteristics of hallucinations in DLB, especially in the preclinical phase. Moreover, the clinical phenotype of mild cognitive impairment-(MCI-) DLB is poorly understood. Methods. The patient was followed for 4 years and a selective phenomenological and cognitive study was performed at the predementia stage. Results. The phenomenological study showed the presence of hypnagogic and hypnopompic hallucinations that allowed us to make a differential diagnosis between DLB and Charles Bonnet syndrome (CBS). The neuropsychological evaluation showed a multiple domain without amnesia MCI subtype with prefrontal dysexecutive, visuoperceptual, and visuospatial impairments and simultanagnosia, which has not previously been reported in MCI-DLB. Conclusions. This study extends the prognostic value of hallucinations for DLB to the preclinical phases. It supports and refines the MCI-DLB concept and identifies simultanagnosia as a possible early cognitive marker. Finally, it confirms an association between hallucinations and visuoperceptual impairments at an intermediate stage of the disease course and strongly supports the hypothesis that hallucinations in the earliest stages of DLB may reflect a narcolepsy-like REM-sleep disorder. PMID:24868122

  15. Auditory Hallucinations and the Brain’s Resting-State Networks: Findings and Methodological Observations

    Science.gov (United States)

    Alderson-Day, Ben; Diederen, Kelly; Fernyhough, Charles; Ford, Judith M.; Horga, Guillermo; Margulies, Daniel S.; McCarthy-Jones, Simon; Northoff, Georg; Shine, James M.; Turner, Jessica; van de Ven, Vincent; van Lutterveld, Remko; Waters, Flavie; Jardri, Renaud

    2016-01-01

    In recent years, there has been increasing interest in the potential for alterations to the brain’s resting-state networks (RSNs) to explain various kinds of psychopathology. RSNs provide an intriguing new explanatory framework for hallucinations, which can occur in different modalities and population groups, but which remain poorly understood. This collaboration from the International Consortium on Hallucination Research (ICHR) reports on the evidence linking resting-state alterations to auditory hallucinations (AH) and provides a critical appraisal of the methodological approaches used in this area. In the report, we describe findings from resting connectivity fMRI in AH (in schizophrenia and nonclinical individuals) and compare them with findings from neurophysiological research, structural MRI, and research on visual hallucinations (VH). In AH, various studies show resting connectivity differences in left-hemisphere auditory and language regions, as well as atypical interaction of the default mode network and RSNs linked to cognitive control and salience. As the latter are also evident in studies of VH, this points to a domain-general mechanism for hallucinations alongside modality-specific changes to RSNs in different sensory regions. However, we also observed high methodological heterogeneity in the current literature, affecting the ability to make clear comparisons between studies. To address this, we provide some methodological recommendations and options for future research on the resting state and hallucinations. PMID:27280452

  16. Depictions of auditory verbal hallucinations in news media.

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    Vilhauer, Ruvanee P

    2015-02-01

    The characterization of auditory verbal hallucinations (AVH) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), diverges from recent research literature, which demonstrates the occurrence of AVH in individuals who are psychologically healthy. This discrepancy raises the question of how the public perceives AVH. Public perceptions are important because they could potentially affect how individuals with AVH interpret these experiences and how people view voice hearers. Because media portrayals can provide a window into how phenomena are viewed by the public, an archival study of newspaper articles was carried out to examine depictions of AVH. A sample of 181 newspaper articles originating in the United States was analyzed using a content analysis approach. The majority of articles examined contained no suggestion that AVH are possible in psychologically healthy individuals. Most articles suggested that AVH were a symptom of mental illness, and many suggested that AVH were associated with criminal behavior, violence and suicidality. The news media examined tended to present a misleading and largely pathologizing view of AVH. More research is needed to shed light on how, and to what extent, public perceptions may influence those who experience AVH. © The Author(s) 2014.

  17. Visual hallucinations associated with varenicline: a case report

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    Raidoo B Mahendri

    2009-05-01

    Full Text Available Abstract Introduction Varenicline is widely used for smoking cessation. It has shown efficacy over placebo and bupropion in manufacturer-sponsored trials. Those with mental illness were excluded from these trials. There are case reports of exacerbation of mental illness and development of psychiatric symptoms with varenicline use. Case presentation A 61-year-old male Caucasian being treated for post-traumatic stress disorder, depression not otherwise specified and alcohol dependence, was prescribed varenicline while he was in a post-traumatic stress disorder/alcohol dual diagnosis treatment program. He developed visual hallucinations, which became worse with titration of the medication. These symptoms resolved upon discontinuation of varenicline. Conclusion Patients with mental illness have a higher incidence of nicotine dependence, and attempts should be made for smoking cessation. Varenicline has not been widely tested in this population. There are reports of exacerbation of mental illness, and probable causation of psychiatric symptoms in the mentally ill. Providers should be aware of this possibility and advise their patients appropriately.

  18. Twenty year multi-follow-up of different types of hallucinations in schizophrenia, schizoaffective disorder, bipolar disorder, and depression.

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    Goghari, Vina M; Harrow, Martin

    2016-10-01

    Hallucinations are a salient feature of both psychotic and mood disorders. Currently there is a call for more research on the phenomenology of different forms of hallucinations, in a broader array of disorders, to further both theoretical knowledge and clinical utility. We investigated auditory, visual, and olfactory hallucinations at index hospitalization and auditory and visual hallucinations prospectively for 20years in 150 young patients, namely 51 schizophrenia, 25 schizoaffective, 28 bipolar, and 79 unipolar depression. For the index hospitalization, the data showed schizophrenia and schizoaffective patients had a greater rate of auditory and visual hallucinations than bipolar and depression patients. However, over the longitudinal trajectory of their illness, a greater percentage of schizophrenia patients had auditory and visual hallucinations than schizoaffective patients, as well as bipolar and depression patients. Also, in contrast to the initial period, schizoaffective patients did not differentiate themselves over the follow-up period from bipolar patients. Bipolar and depression patients did not significantly differ at index hospitalization or at follow-up. We found visual hallucinations differentiated the groups to a greater degree over the 20year course than did auditory hallucinations. These findings suggest the longitudinal course is more important for differentiating schizophrenia and schizoaffective disorder, whereas the initial years may be more useful to differentiate schizoaffective disorder from bipolar disorder. Furthermore, we found that the early presence of auditory hallucinations was associated with a reduced likelihood for a future period of recovery. No olfactory hallucinations were present at the index hospitalization in any patients. Over the course of 20years, a minority of schizophrenia patients presented with olfactory hallucinations, and very few schizoaffective and bipolar patients presented with olfactory hallucinations. This

  19. Recovering from Hallucinations: A Qualitative Study of Coping with Voices Hearing of People with Schizophrenia in Hong Kong

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    Petrus Ng

    2012-01-01

    Full Text Available Auditory hallucination is a positive symptom of schizophrenia and has significant impacts on the lives of individuals. People with auditory hallucination require considerable assistance from mental health professionals. Apart from medications, they may apply different lay methods to cope with their voice hearing. Results from qualitative interviews showed that people with schizophrenia in the Chinese sociocultural context of Hong Kong were coping with auditory hallucination in different ways, including (a changing social contacts, (b manipulating the voices, and (c changing perception and meaning towards the voices. Implications for recovery from psychiatric illness of individuals with auditory hallucinations are discussed.

  20. Insomnia and hallucinations in the general population: Findings from the 2000 and 2007 British Psychiatric Morbidity Surveys.

    Science.gov (United States)

    Sheaves, Bryony; Bebbington, Paul E; Goodwin, Guy M; Harrison, Paul J; Espie, Colin A; Foster, Russell G; Freeman, Daniel

    2016-07-30

    Insomnia is common in people experiencing psychosis. It has been identified as a contributory cause of paranoia, but any causal relationship with hallucinations has yet to be established. We tested the hypotheses that insomnia i) has a cross-sectional association with hallucinations ii) predicts new inceptions of hallucinations and iii) that these associations remain after controlling for depression, anxiety, and paranoia. Data from the second (2000, N=8580) and third (2007, N=7403) British Psychiatric Morbidity Surveys were used to assess cross-sectional associations between insomnia and hallucinations. The 2000 dataset included an 18 month follow up of a subsample (N=2406) used to test whether insomnia predicted new inceptions of hallucinations. Insomnia was associated with hallucinations in both cross-sectional datasets. Mild sleep problems were associated with 2-3 times greater odds of reporting hallucinations, whilst chronic insomnia was associated with four times greater odds. Insomnia was also associated with increased odds of hallucinations occurring de novo over the next 18 months. These associations remained significant, although with smaller odds ratios, after controlling for depression, anxiety and paranoia. This is the first longitudinal evidence that insomnia is associated with the development of hallucinatory experiences. Effective treatment of insomnia may lessen the occurrence of hallucinations. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. Prevalent hallucinations during medical internships: phantom vibration and ringing syndromes.

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    Yu-Hsuan Lin

    Full Text Available BACKGROUND: Phantom vibration syndrome is a type of hallucination reported among mobile phone users in the general population. Another similar perception, phantom ringing syndrome, has not been previously described in the medical literature. METHODS: A prospective longitudinal study of 74 medical interns (46 males, 28 females; mean age, 24.8±1.2 years was conducted using repeated investigations of the prevalence and associated factors of phantom vibration and ringing. The accompanying symptoms of anxiety and depression were evaluated with the Beck Anxiety and Depression Inventories before the internship began, and again at the third, sixth, and twelfth internship months, and two weeks after the internship ended. RESULTS: The baseline prevalence of phantom vibration was 78.1%, which increased to 95.9% and 93.2% in the third and sixth internship months. The prevalence returned to 80.8% at the twelfth month and decreased to 50.0% 2 weeks after the internship ended. The baseline prevalence of phantom ringing was 27.4%, which increased to 84.9%, 87.7%, and 86.3% in the third, sixth, and twelfth internship months, respectively. This returned to 54.2% two weeks after the internship ended. The anxiety and depression scores also increased during the internship, and returned to baseline two weeks after the internship. There was no significant correlation between phantom vibration/ringing and symptoms of anxiety or depression. The incidence of both phantom vibration and ringing syndromes significantly increased during the internship, and subsequent recovery. CONCLUSION: This study suggests that phantom vibration and ringing might be entities that are independent of anxiety or depression during evaluation of stress-associated experiences during medical internships.

  2. Structural covariance in the hallucinating brain: a voxel-based morphometry study

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    Modinos, Gemma; Vercammen, Ans; Mechelli, Andrea; Knegtering, Henderikus; McGuire, Philip K.; Aleman, André

    2009-01-01

    Background Neuroimaging studies have indicated that a number of cortical regions express altered patterns of structural covariance in schizophrenia. The relation between these alterations and specific psychotic symptoms is yet to be investigated. We used voxel-based morphometry to examine regional grey matter volumes and structural covariance associated with severity of auditory verbal hallucinations. Methods We applied optimized voxel-based morphometry to volumetric magnetic resonance imaging data from 26 patients with medication-resistant auditory verbal hallucinations (AVHs); statistical inferences were made at p < 0.05 after correction for multiple comparisons. Results Grey matter volume in the left inferior frontal gyrus was positively correlated with severity of AVHs. Hallucination severity influenced the pattern of structural covariance between this region and the left superior/middle temporal gyri, the right inferior frontal gyrus and hippocampus, and the insula bilaterally. Limitations The results are based on self-reported severity of auditory hallucinations. Complementing with a clinician-based instrument could have made the findings more compelling. Future studies would benefit from including a measure to control for other symptoms that may covary with AVHs and for the effects of antipsychotic medication. Conclusion The results revealed that overall severity of AVHs modulated cortical intercorrelations between frontotemporal regions involved in language production and verbal monitoring, supporting the critical role of this network in the pathophysiology of hallucinations. PMID:19949723

  3. Auditory top-down control and affective theory of mind in schizophrenia with and without hallucinations.

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    Rominger, Christian; Bleier, Angelika; Fitz, Werner; Marksteiner, Josef; Fink, Andreas; Papousek, Ilona; Weiss, Elisabeth M

    2016-07-01

    Social cognitive impairments may represent a core feature of schizophrenia and above all are a strong predictor of positive psychotic symptoms. Previous studies could show that reduced inhibitory top-down control contributes to deficits in theory of mind abilities and is involved in the genesis of hallucinations. The current study aimed to investigate the relationship between auditory inhibition, affective theory of mind and the experience of hallucinations in patients with schizophrenia. In the present study, 20 in-patients with schizophrenia and 20 healthy controls completed a social cognition task (the Reading the Mind in the Eyes Test) and an inhibitory top-down Dichotic Listening Test. Schizophrenia patients with greater severity of hallucinations showed impaired affective theory of mind as well as impaired inhibitory top-down control. More dysfunctional top-down inhibition was associated with poorer affective theory of mind performance, and seemed to mediate the association between impairment to affective theory of mind and severity of hallucinations. The findings support the idea of impaired theory of mind as a trait marker of schizophrenia. In addition, dysfunctional top-down inhibition may give rise to hallucinations and may further impair affective theory of mind skills in schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Increased amygdala and parahippocampal gyrus activation in schizophrenic patients with auditory hallucinations : An fMRI study using independent component analysis

    NARCIS (Netherlands)

    Jose Escarti, Maria; de la Iglesia-Vaya, Maria; Marti-Bonmati, Luis; Robles, Montserrat; Carbonell, Jose; Jose Lull, Juan; Garcia-Marti, Gracian; Vicente Manjon, Jose; Jesus Aguilar, Eduardo; Aleman, Andre; Sanjuan, Julio

    Objective: Hallucinations in patients with schizophrenia have strong emotional connotations. Functional neuroimaging techniques have been widely used to study brain activity in patients with schizophrenia with hallucinations or emotional impairments. However, few of these Studies have investigated

  5. Use of media technology to enhance the learning of student nurses in regards to auditory hallucinations.

    Science.gov (United States)

    Mawson, Kerry

    2014-04-01

    The aim of this study was to determine if simulation aided by media technology contributes towards an increase in knowledge, empathy, and a change in attitudes in regards to auditory hallucinations for nursing students. A convenience sample of 60 second-year undergraduate nursing students from an Australian university was invited to be part of the study. A pre-post-test design was used, with data analysed using a paired samples t-test to identify pre- and post-changes on nursing students' scores on knowledge of auditory hallucinations. Nine of the 11 questions reported statistically-significant results. The remaining two questions highlighted knowledge embedded within the curriculum, with therapeutic communication being the core work of mental health nursing. The implications for practice are that simulation aided by media technology increases the knowledge of students in regards to auditory hallucinations. © 2013 Australian College of Mental Health Nurses Inc.

  6. Case study: a young male with auditory hallucinations in paranoid schizophrenia.

    Science.gov (United States)

    Kotowski, Abigail

    2012-02-01

    The purpose of this case study is to demonstrate use of the nursing process and the standardized nursing languages of NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a young male with paranoid schizophrenia to deal with auditory hallucinations. Data were obtained from the experience and expertise of the author and published literature. This case study demonstrates nurses' clinical decision making in providing care for an adolescent with mental illness. This case study provides the pertinent nursing diagnosis, patient outcomes, and nursing interventions for a young male with auditory hallucinations in paranoid schizophrenia. The use of NANDA-I, NOC, and NIC can provide the necessary framework for enhancing and improving the management of care with patients who experience auditory hallucinations in paranoid schizophrenia. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

  7. Improvement of auditory hallucinations and reduction of primary auditory area's activation following TMS

    International Nuclear Information System (INIS)

    Giesel, Frederik L.; Mehndiratta, Amit; Hempel, Albrecht; Hempel, Eckhard; Kress, Kai R.; Essig, Marco; Schröder, Johannes

    2012-01-01

    Background: In the present case study, improvement of auditory hallucinations following transcranial magnetic stimulation (TMS) therapy was investigated with respect to activation changes of the auditory cortices. Methods: Using functional magnetic resonance imaging (fMRI), activation of the auditory cortices was assessed prior to and after a 4-week TMS series of the left superior temporal gyrus in a schizophrenic patient with medication-resistant auditory hallucinations. Results: Hallucinations decreased slightly after the third and profoundly after the fourth week of TMS. Activation in the primary auditory area decreased, whereas activation in the operculum and insula remained stable. Conclusions: Combination of TMS and repetitive fMRI is promising to elucidate the physiological changes induced by TMS.

  8. Acetylcholinesterase Inhibitors (AChEI's for the treatment of visual hallucinations in schizophrenia: A review of the literature

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    Patel Sachin S

    2010-09-01

    Full Text Available Abstract Background Visual hallucinations occur in various neurological diseases, but are most prominent in Lewy body dementia, Parkinson's disease and schizophrenia. The lifetime prevalence of visual hallucinations in patients with schizophrenia is much more common than conventionally thought and ranges from 24% to 72%. Cortical acetylcholine (ACh depletion has been associated with visual hallucinations; the level of depletion being related directly to the severity of the symptoms. Current understanding of neurobiological visual processing and research in diseases with reduced cholinergic function, suggests that AChEI's may prove beneficial in treating visual hallucinations. This offers the potential for targeted drug therapy of clinically symptomatic visual hallucinations in patients with schizophrenia using acetylcholinesterase inhibition. Methods A systematic review was carried out investigating the evidence for the effects of AChEI's in treating visual hallucinations in Schizophrenia. Results No evidence was found relating to the specific role of AChEI's in treating visual hallucinations in this patient group. Discussion Given the use of AChEI's in targeted, symptom specific treatment in other neuropsychiatric disorders, it is surprising to find no related literature in schizophrenia patients. The use of AChEI's in schizophrenia has investigated effects on cognition primarily with non cognitive effects measured more broadly. Conclusions We would suggest that more focused research into the effects of AChEI's on positive symptoms of schizophrenia, specifically visual hallucinations, is needed.

  9. Persistent Interictal Musical Hallucination in a Patient With Mesial Temporal Sclerosis-Related Epilepsy: First Case Report and Etiopathological Hypothesis.

    Science.gov (United States)

    Borelli, Paolo; Vedovello, Marcella; Braga, Massimiliano; Pederzoli, Massimo; Beretta, Sandro

    2016-12-01

    Musical hallucination is a disorder of complex sound processing of instrumental music, songs, choirs, chants, etc. The underlying pathologies include moderate to severe acquired hearing loss (the auditory equivalent of Charles Bonnet syndrome), psychiatric illnesses (depression, schizophrenia), drug intoxication (benzodiazepines, salicylate, pentoxifylline, propranolol), traumatic lesions along the acoustic pathways, and epilepsy. The hallucinations are most likely to begin late in life; 70% of patients are women. Musical hallucination has no known specific therapy. Treating the underlying cause is the most effective approach; neuroleptic and antidepressant medications have only rarely succeeded.Musical hallucination in epilepsy typically presents as simple partial seizures originating in the lateral temporal cortex. To our knowledge, no formal report of musical hallucination in the interictal state has been published before. In contrast, other interictal psychotic features are a relatively common complication, especially in patients with long-standing drug-resistant epilepsy.We describe a 62-year-old woman with a long history of mesial temporal lobe epilepsy whose musical hallucination was solely interictal. We speculate on the possible link between temporal epilepsy and her hallucination. We hypothesize that, as a result of her epileptic activity-induced damage, an imbalance developed between the excitatory and inhibitory projections connecting the mesial temporal cortex to the other auditory structures. These structures may have generated hyperactivity in the lateral temporal cortex through a "release" mechanism that eventually resulted in musical hallucination.

  10. [Influencing factors of visual hallucinations in patients with Parkinson's disease and its relationship with sleep disorders].

    Science.gov (United States)

    Wu, D D; Li, S H; Jin, L Y; Jin, Y; Cui, Y Y; Zhao, H; Liu, H J; Ma, X X; Su, W; Chen, H B

    2016-04-05

    To investigate the prevalence and influencing factors of visual hallucinations in patients with Parkinson's disease(PD), and to analyze the relationship between visual hallucinations and sleep disorders. We recruited 187 patients with PD(H-Y Ⅰ-Ⅲ) from outpatient department in Beijing Hospital. The patients were investigated for general information and the use of medicine. The patients were divided into visual hallucination(VH) group and non-hallucination(non-VH) group. A comparison study was conducted between two groups. We investigated the sleep disorders of PD patients according to Non Motor Symptom Quest(NMSquest) and Parkinson's disease sleep scale(PDSS). Logistic stepwise multiple regression procedures were used to determine the best predictive model of visual hallucinations in patients with PD. (1) 42 cases(22.5%) of PD patients were accompanied by visual hallucinations; (2) the VH group and non-VH group had no difference in age, sex, duration of illness, the scores of Minimum Mental State Examination(MMSE) and levodopa equivalent doses (LED). The scores of Unified Parkinson's Disease Rating Scale(UPDRS) Ⅰ, the Hamilton Rating Scale for Anxiety(HAMA) and the Hamilton Rating Scale for Depression(HAMD) in VH group were significantly higher than those in non-VH group[3.5(2, 5) vs 2 (1, 3); 10(6.75, 15) vs 8(5, 11); 11(7.75, 17) vs 9(5, 13); Psleep behavior disorder(RBD) in VH group were significantly higher than those in non-VH group(61.9% vs 40.7%, 71.4% vs 47.6%, P0.05). The score of PDSS in VH group was significantly lower than that in non-VH group[111(92.75, 128.25) vs 123(109, 135), Psleep disorder are independently associated with VH in PD.

  11. Braille alexia during visual hallucination in a blind man with selective calcarine atrophy.

    Science.gov (United States)

    Maeda, Kengo; Yasuda, Hitoshi; Haneda, Masakazu; Kashiwagi, Atsunori

    2003-04-01

    The case of a 56-year-old man who has been blind for 25 years due to retinal degeneration is herein described. The patient complained of elementary visual hallucination, during which it was difficult for him to read Braille. Brain magnetic resonance imaging showed marked atrophy of the bilateral striate cortex. Visual hallucination as a release phenomenon of the primary visual cortex has never been reported to cause alexia for Braille. The present case supports the results of recent functional imaging studies of the recruitment of striate and prestriate cortex for Braille reading.

  12. "Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures.

    Science.gov (United States)

    Lilly, Brandon; Maynard, Erika; Melvin, Kelly; Holroyd, Suzanne

    2018-01-01

    Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

  13. The Neurophysiology of Auditory Hallucinations – A Historic and Contemporary Review

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    Remko evan Lutterveld

    2011-05-01

    Full Text Available Electroencephalography (EEG and magnetoencephalography (MEG are two techniques that distinguish themselves from other neuroimaging methodologies through their ability to directly measure brain-related activity and their high temporal resolution. A large body of research has applied these techniques to study auditory hallucinations. Across a variety of approaches, the left superior temporal cortex is consistently reported to be involved in this symptom. Moreover, there is increasing evidence that a failure in corollary discharge, i.e. a neural signal originating in frontal speech areas that indicates to sensory areas that forthcoming thought is self-generated, may underlie the experience of auditory hallucinations

  14. Hearing voices: does it give your patient a headache? A case of auditory hallucinations as acoustic aura in migraine

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    Van der Feltz-Cornelis CM

    2012-03-01

    Full Text Available Christina M van der Feltz-Cornelis1–3, Henk Biemans1, Jan Timmer11Clinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands; 2Faculty of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands; 3Trimbos Instituut, Utrecht, The NetherlandsObjective: Auditory hallucinations are generally considered to be a psychotic symptom. However, they do occur without other psychotic symptoms in a substantive number of cases in the general population and can cause a lot of individual distress because of the supposed association with schizophrenia. We describe a case of nonpsychotic auditory hallucinations occurring in the context of migraine.Method: Case report and literature review.Results: A 40-year-old man presented with imperative auditory hallucinations that caused depressive and anxiety symptoms. He reported migraine with visual aura as well which started at the same time as the auditory hallucinations. The auditory hallucinations occurred in the context of nocturnal migraine attacks, preceding them as aura. No psychotic disorder was present. After treatment of the migraine with propranolol 40 mg twice daily, explanation of the etiology of the hallucinations, and mirtazapine 45 mg daily, the migraine subsided and no further hallucinations occurred. The patient recovered.Discussion: Visual auras have been described in migraine and occur quite often. Auditory hallucinations as aura in migraine have been described in children without psychosis, but this is the first case describing auditory hallucinations without psychosis as aura in migraine in an adult. For description of this kind of hallucination, DSM-IV lacks an appropriate category.Conclusion: Psychiatrists should consider migraine with acoustic aura as a possible etiological factor in patients without further psychotic symptoms presenting with auditory hallucinations, and they should ask for headache symptoms when they take the history. Prognosis may be

  15. Visual Hallucinations in a Patient with Horner's Syndrome Secondary to Internal Carotid Dissection

    DEFF Research Database (Denmark)

    Singh, Amardeep; Mortzos, Panteleimon; Sørensen, Torben Lykke

    2014-01-01

    A 67-year-old female presented with post-ganglionic Horner's syndrome. In addition to the classical symptoms of Horner's syndrome, the patient reported experiencing frightening complex visual and auditory hallucinations on two different occasions. Magnetic resonance angiography of the cerebrum...

  16. The auditory dorsal stream plays a crucial role in projecting hallucinated voices into external space

    NARCIS (Netherlands)

    Looijestijn, Jasper; Diederen, Kelly M. J.; Goekoop, Rutger; Sommer, Iris E. C.; Daalman, Kirstin; Kahn, Rene S.; Hoek, Hans W.; Blom, Jan Dirk

    Introduction: Verbal auditory hallucinations (VAHs) are experienced as spoken voices which seem to originate in the extracorporeal environment or inside the head. Animal and human research has identified a 'where' pathway for sound processing comprising the planum temporale, the middle frontal gyrus

  17. Cognitive biases and auditory verbal hallucinations in healthy and clinical individuals

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    Daalman, K.; Sommer, I. E. C.; Derks, E. M.; Peters, E. R.

    2013-01-01

    Background. Several cognitive biases are related to psychotic symptoms, including auditory verbal hallucinations (AVH). It remains unclear whether these biases differ in voice-hearers with and without a 'need-for-care'. Method. A total of 72 healthy controls, 72 healthy voice-hearers and 72 clinical

  18. An EMG Study of the Lip Muscles during Covert Auditory Verbal Hallucinations in Schizophrenia

    Science.gov (United States)

    Rapin, Lucile; Dohen, Marion; Polosan, Mircea; Perrier, Pascal; Loevenbruck, Hélène

    2013-01-01

    Purpose: "Auditory verbal hallucinations" (AVHs) are speech perceptions in the absence of external stimulation. According to an influential theoretical account of AVHs in schizophrenia, a deficit in inner-speech monitoring may cause the patients' verbal thoughts to be perceived as external voices. The account is based on a…

  19. Suicide Risk, Stress Sensitivity, and Self-Esteem among Young Adults Reporting Auditory Hallucinations.

    Science.gov (United States)

    DeVylder, Jordan E; Hilimire, Matthew R

    2015-08-01

    Individuals with subthreshold psychotic experiences are at increased risk for suicidal thoughts and behavior, similar to those with schizophrenia and other psychotic disorders. This may be explained by shared risk factors such as heightened stress sensitivity or low self-esteem. Understanding the nature of this relationship could inform suicide prevention in social work practice. In this study, authors examined the relationship between self-reported auditory hallucinations and suicidal thoughts, plans, and attempts, in a nonclinical sample of young adults, controlling for scores on the Psychological Stress Index and Rosenberg Self-Esteem Scale. Auditory hallucinations were associated with approximately double the odds of suicidal ideation and plans and four times the odds for suicide attempts. This relationship was not explained by stress sensitivity or self-esteem, which were independently related to hallucinations and suicidality, respectively. Subthreshold auditory hallucinations may be a useful indicator of suicide risk. This association may represent a clinically significant relationship that may be addressed through social work interventions intended to alleviate stress sensitivity or improve self-esteem.

  20. Interaction of language, auditory and memory brain networks in auditory verbal hallucinations

    NARCIS (Netherlands)

    Curcic-Blake, Branislava; Ford, Judith M.; Hubl, Daniela; Orlov, Natasza D.; Sommer, Iris E.; Waters, Flavie; Allen, Paul; Jardri, Renaud; Woodruff, Peter W.; David, Olivier; Mulert, Christoph; Woodward, Todd S.; Aleman, Andre

    Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of

  1. Is Seeing Believing? The Process of Change During Cognitive-behavioural Therapy for Distressing Visual Hallucinations.

    Science.gov (United States)

    Wilson, Rea; Collerton, Daniel; Freeston, Mark; Christodoulides, Thomas; Dudley, Robert

    2016-07-01

    People with psychosis often report distressing visual hallucinations (VH). In contrast to auditory hallucinations, there is little empirical evidence on effective interventions. The effectiveness of a novel-focused cognitive-behavioural therapy (CBT) intervention for VH was explored using a multiple baseline single case design with four participants. Change to individual appraisals, emotional and behavioural responses to VH were measured with daily diaries kept throughout the baseline and intervention phase lasting up to 16 sessions. Maintenance of change was tracked during a follow-up period of one month. Changes in appraisals, distress and response in accordance with the theory was evident in two out of four of the cases. However, change occurred within the baseline phase that limited the conclusions that change could be attributed to CBT alone. There was some evidence of clinically significant change and reliable change for two out of four of the cases at follow-up on one of the standardized psychiatric assessments. The research reported here has theoretical and clinical implications for refinement of the model and interventions for distressing VH. Copyright © 2015 John Wiley & Sons, Ltd. Distressing visual hallucinations (VH) are a relatively common symptom of psychosis. Visual hallucinations seem to be associated with greater impairment and disability. We have no specific treatment for VH. The appraisal of the visual experience and the behavioural response is important in maintaining the distress. Cognitive-behavioural therapy for VH at present has limited value. Copyright © 2015 John Wiley & Sons, Ltd.

  2. 18FDG-PET and electroencephalographic findings in a patient suffering from musical hallucinations

    International Nuclear Information System (INIS)

    Erkwoh, R.; Ebel, H.; Kachel, F.; Reiche, W.; Ringelstein, E.B.; Buell, U.; Sass, H.

    1993-01-01

    The majority of reports on the phenomenon of musical hallucinations suggests that this abnormality is a complication of a progressive peripheral hearing deficit. The present case report and a review of the international literature would, however, indicate that this syndrome may be the result of a dysfunction of the temporal cortex. (orig.) [de

  3. Subjective Loudness and Reality of Auditory Verbal Hallucinations and Activation of the Inner Speech Processing Network

    NARCIS (Netherlands)

    Vercammen, Ans; Knegtering, Henderikus; Bruggeman, Richard; Aleman, Andre

    Background: One of the most influential cognitive models of auditory verbal hallucinations (AVH) suggests that a failure to adequately monitor the production of one's own inner speech leads to verbal thought being misidentified as an alien voice. However, it is unclear whether this theory can

  4. Left auditory cortex gamma synchronization and auditory hallucination symptoms in schizophrenia

    Directory of Open Access Journals (Sweden)

    Shenton Martha E

    2009-07-01

    Full Text Available Abstract Background Oscillatory electroencephalogram (EEG abnormalities may reflect neural circuit dysfunction in neuropsychiatric disorders. Previously we have found positive correlations between the phase synchronization of beta and gamma oscillations and hallucination symptoms in schizophrenia patients. These findings suggest that the propensity for hallucinations is associated with an increased tendency for neural circuits in sensory cortex to enter states of oscillatory synchrony. Here we tested this hypothesis by examining whether the 40 Hz auditory steady-state response (ASSR generated in the left primary auditory cortex is positively correlated with auditory hallucination symptoms in schizophrenia. We also examined whether the 40 Hz ASSR deficit in schizophrenia was associated with cross-frequency interactions. Sixteen healthy control subjects (HC and 18 chronic schizophrenia patients (SZ listened to 40 Hz binaural click trains. The EEG was recorded from 60 electrodes and average-referenced offline. A 5-dipole model was fit from the HC grand average ASSR, with 2 pairs of superior temporal dipoles and a deep midline dipole. Time-frequency decomposition was performed on the scalp EEG and source data. Results Phase locking factor (PLF and evoked power were reduced in SZ at fronto-central electrodes, replicating prior findings. PLF was reduced in SZ for non-homologous right and left hemisphere sources. Left hemisphere source PLF in SZ was positively correlated with auditory hallucination symptoms, and was modulated by delta phase. Furthermore, the correlations between source evoked power and PLF found in HC was reduced in SZ for the LH sources. Conclusion These findings suggest that differential neural circuit abnormalities may be present in the left and right auditory cortices in schizophrenia. In addition, they provide further support for the hypothesis that hallucinations are related to cortical hyperexcitability, which is manifested by

  5. [Nursing Experience of Using Mirror Visual Feedback for a Schizophrenia Patient With Visual Hallucinations].

    Science.gov (United States)

    Lan, Shu-Ling; Chen, Yu-Chi; Chang, Hsiu-Ju

    2018-06-01

    The aim of this paper was to describe the nursing application of mirror visual feedback in a patient suffering from long-term visual hallucinations. The intervention period was from May 15th to October 19th, 2015. Using the five facets of psychiatric nursing assessment, several health problems were observed, including disturbed sensory perceptions (prominent visual hallucinations) and poor self-care (e.g. limited abilities to self-bathe and put on clothing). Furthermore, "caregiver role strain" due to the related intense care burden was noted. After building up a therapeutic interpersonal relationship, the technique of brain plasticity and mirror visual feedback were performed using multiple nursing care methods in order to help the patient suppress her visual hallucinations by enhancing a different visual stimulus. We also taught her how to cope with visual hallucinations in a proper manner. The frequency and content of visual hallucinations were recorded to evaluate the effects of management. The therapeutic plan was formulated together with the patient in order to boost her self-confidence, and a behavior contract was implemented in order to improve her personal hygiene. In addition, psychoeducation on disease-related topics was provided to the patient's family, and they were encouraged to attend relevant therapeutic activities. As a result, her family became less passive and negative and more engaged in and positive about her future. The crisis of "caregiver role strain" was successfully resolved. The current experience is hoped to serve as a model for enhancing communication and cooperation between family and staff in similar medical settings.

  6. Theta Burst Transcranial Magnetic Stimulation for Auditory Verbal Hallucinations : Negative Findings From a Double-Blind-Randomized Trial

    NARCIS (Netherlands)

    Koops, Sanne; van Dellen, Edwin; Schutte, Maya J L; Nieuwdorp, Wendy; Neggers, Sebastiaan F W; Sommer, Iris E C

    BACKGROUND: Auditory verbal hallucinations (AVH) in schizophrenia are resistant to antipsychotic medication in approximately 25% of patients. Treatment with repetitive transcranial magnetic stimulation (rTMS) for refractory AVH has shown varying results. A stimulation protocol using continuous theta

  7. Synesthetic hallucinations induced by psychedelic drugs in a congenitally blind man.

    Science.gov (United States)

    Dell'Erba, Sara; Brown, David J; Proulx, Michael J

    2018-04-01

    This case report offers rare insights into crossmodal responses to psychedelic drug use in a congenitally blind (CB) individual as a form of synthetic synesthesia. BP's personal experience provides us with a unique report on the psychological and sensory alterations induced by hallucinogenic drugs, including an account of the absence of visual hallucinations, and a compelling look at the relationship between LSD induced synesthesia and crossmodal correspondences. The hallucinatory experiences reported by BP are of particular interest in light of the observation that rates of psychosis within the CB population are extremely low. The phenomenology of the induced hallucinations suggests that experiences acquired through other means, might not give rise to "visual" experiences in the phenomenological sense, but instead gives rise to novel experiences in the other functioning senses. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Hallucinations and delusions: the price we pay for our creative brains

    DEFF Research Database (Denmark)

    Frith, Christopher

    2008-01-01

    there is no difference in principle between perceptions and beliefs: both depend upon a process of updating models of the world on the basis of new evidence with Bayes’ theorem providing the underlying computational mechanism. Many hallucinations and delusions can be explained as the consequence of faulty evidence being...... used to generate models of the world. The mechanism by which we use evidence to discover about the physical world of objects can also be used to discover about the mental world of ideas in the minds of others. However, when modelling other people’s minds the process becomes more complex, since......, in a true interaction, each person in the dialogue is trying to model the mind of the other. For success in such interactions it is not sufficient to model what is in the other’s mind. We must also model what the other thinks is in our mind (closing the loop). The hallucinations and delusions associated...

  9. Heterogeneous iris image hallucination using sparse representation on a learned heterogeneous patch dictionary

    Science.gov (United States)

    Li, Yung-Hui; Zheng, Bo-Ren; Ji, Dai-Yan; Tien, Chung-Hao; Liu, Po-Tsun

    2014-09-01

    Cross sensor iris matching may seriously degrade the recognition performance because of the sensor mis-match problem of iris images between the enrollment and test stage. In this paper, we propose two novel patch-based heterogeneous dictionary learning method to attack this problem. The first method applies the latest sparse representation theory while the second method tries to learn the correspondence relationship through PCA in heterogeneous patch space. Both methods learn the basic atoms in iris textures across different image sensors and build connections between them. After such connections are built, at test stage, it is possible to hallucinate (synthesize) iris images across different sensors. By matching training images with hallucinated images, the recognition rate can be successfully enhanced. The experimental results showed the satisfied results both visually and in terms of recognition rate. Experimenting with an iris database consisting of 3015 images, we show that the EER is decreased 39.4% relatively by the proposed method.

  10. Inner Speech and Clarity of Self-Concept in Thought Disorder and Auditory-Verbal Hallucinations.

    Science.gov (United States)

    de Sousa, Paulo; Sellwood, William; Spray, Amy; Fernyhough, Charles; Bentall, Richard P

    2016-12-01

    Eighty patients and thirty controls were interviewed using one interview that promoted personal disclosure and another about everyday topics. Speech was scored using the Thought, Language and Communication scale (TLC). All participants completed the Self-Concept Clarity Scale (SCCS) and the Varieties of Inner Speech Questionnaire (VISQ). Patients scored lower than comparisons on the SCCS. Low scores were associated the disorganized dimension of TD. Patients also scored significantly higher on condensed and other people in inner speech, but not on dialogical or evaluative inner speech. The poverty of speech dimension of TD was associated with less dialogical inner speech, other people in inner speech, and less evaluative inner speech. Hallucinations were significantly associated with more other people in inner speech and evaluative inner speech. Clarity of self-concept and qualities of inner speech are differentially associated with dimensions of TD. The findings also support inner speech models of hallucinations.

  11. Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

    Directory of Open Access Journals (Sweden)

    Zylfije Hundozi

    2016-12-01

    Full Text Available Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS thrombosis (SSST developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

  12. Inner Speech and Clarity of Self-Concept in Thought Disorder and Auditory-Verbal Hallucinations

    Science.gov (United States)

    de Sousa, Paulo; Sellwood, William; Spray, Amy; Fernyhough, Charles; Bentall, Richard P.

    2016-01-01

    Abstract Eighty patients and thirty controls were interviewed using one interview that promoted personal disclosure and another about everyday topics. Speech was scored using the Thought, Language and Communication scale (TLC). All participants completed the Self-Concept Clarity Scale (SCCS) and the Varieties of Inner Speech Questionnaire (VISQ). Patients scored lower than comparisons on the SCCS. Low scores were associated the disorganized dimension of TD. Patients also scored significantly higher on condensed and other people in inner speech, but not on dialogical or evaluative inner speech. The poverty of speech dimension of TD was associated with less dialogical inner speech, other people in inner speech, and less evaluative inner speech. Hallucinations were significantly associated with more other people in inner speech and evaluative inner speech. Clarity of self-concept and qualities of inner speech are differentially associated with dimensions of TD. The findings also support inner speech models of hallucinations. PMID:27898489

  13. Some observations on hallucination: clinical application of some developments of Melanie Klein's work.

    Science.gov (United States)

    Taylor, D

    1983-01-01

    The analysis of a psychotic patient is used to illustrate the importance of certain developments of Melanie Klein's work. The case presentation focuses upon the formal qualities of the patient's communications, many of which were amalgamations of profoundly incompatible elements, particularly a subtle destructiveness which parasitized seemingly impartial reports about her state of mind. These communications embodied important object relationships. The patient used her communications to conjure up psychic disintegration. As a result of her involvement in 'chuntering' her preoccupations would become increasingly violent, cruel and sexualized. The patient's equivocal communications generate confusion. This is central to the patient's experience of self-destruction as persecution. A number of ideas are advanced concerning the origins of the patient's hallucinations. These include her relish at the introduction of sensory distortions. Questions are raised about the nature of certain types of hallucination, the origins and intractability of concrete thinking, about verbalization and about the typology of psychotic patients.

  14. Interaction of language, auditory and memory brain networks in auditory verbal hallucinations.

    Science.gov (United States)

    Ćurčić-Blake, Branislava; Ford, Judith M; Hubl, Daniela; Orlov, Natasza D; Sommer, Iris E; Waters, Flavie; Allen, Paul; Jardri, Renaud; Woodruff, Peter W; David, Olivier; Mulert, Christoph; Woodward, Todd S; Aleman, André

    2017-01-01

    Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Visual Hallucinations in a Patient with Horner's Syndrome Secondary to Internal Carotid Dissection

    OpenAIRE

    Amardeep Singh; Panteleimon Mortzos; Torben Lykke Sørensen

    2014-01-01

    A 67-year-old female presented with post-ganglionic Horner's syndrome. In addition to the classical symptoms of Horner's syndrome, the patient reported experiencing frightening complex visual and auditory hallucinations on two different occasions. Magnetic resonance angiography of the cerebrum, neck and upper thorax revealed internal carotid dissection. The symptoms and hallucinatory experiences resolved soon after antiplatelet therapy was commenced. We propose peduncular hallucinosis as the ...

  16. Visual Hallucinations in PD and Lewy Body Dementias: Old and New Hypotheses

    Directory of Open Access Journals (Sweden)

    M. Onofrj

    2013-01-01

    Full Text Available Visual Hallucinations (VH are a common non-motor symptom of Parkinson’s Disease (PD and the Lewy body dementias (LBD of Parkinson's disease with dementia (PDD and Dementia with Lewy Bodies (DLB. The origin of VH in PD and LBD is debated: earlier studies considered a number of different possible mechanisms underlying VH including visual disorders, Rapid Eye Movement (REM Sleep Intrusions, dysfunctions of top down or bottom up visual pathways, and neurotransmitter imbalance.

  17. Exploring the visual hallucinations of migraine aura: the tacit contribution of illustration.

    Science.gov (United States)

    Schott, G D

    2007-06-01

    The visual aura of migraine is a subjective phenomenon, and what the migraineur experiences is necessarily inaccessible to others. Fortunately, however, the sufferer can occasionally reveal what is being seen by means of graphic representation, enabling an otherwise closed 'window' to be opened on the transiently dysfunctioning brain. This article explores the unique contribution that illustration has made to understanding mechanisms subserving the visual aura. The most revealing illustrations are those made by the very few scientists who have recorded and analysed the scotomas, and in particular the expanding fortification spectra, experienced during their migraine attacks. It is solely through illustrations such as these that the uniform nature of many of these hallucinations has been demonstrated. As a result, it follows that there is likely to be a similarly uniform repertoire of processes that generate the hallucinations in the occipital cortex. The precise form of the zigzags that comprise the fortification spectrum, their shimmering appearance, and in particular the speed of the peripheral spread, all of which are entirely dependent on graphic display for their elucidation, enable conclusions to be reached about a number of the underlying pathophysiological mechanisms, including the involvement of spreading cortical depression, that likely occur. Illustration has been pivotal too in revealing uncommon and sometimes curious, if not bizarre, visual hallucinations, the forms of which suggest that extrastriate and temporal lobe involvement contributes to migraine aura in some instances. Illustration can also be valuable in differential diagnosis, depicting other forms of visual hallucination which result from a variety of non-migrainous causes. Illustration, particularly when made during the attack, provides an unusual, little used but powerful tool which uniquely allows the sufferer's subjective visual experiences to inform objective analysis. In turn, this

  18. Treatment with venlafaxine in six cases of children with narcolepsy and with cataplexy and hypnagogic hallucinations.

    Science.gov (United States)

    Møller, Lene Ruge; Østergaard, John R

    2009-04-01

    Narcolepsy with cataplexy is a chronic neuropsychiatric disorder associated with inappropriate control of rapid eye movement (REM) sleep. The main symptoms are excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and disturbed nocturnal sleep. Cataplexy is marked by episodes of muscular weakness and may cause the patient to collapse to the ground. So far, pharmacotherapy of cataplexy and hypnagogic hallucinations has been predominantly based on tricyclic antidepressants. Recently, new drugs that block the reuptake of norepineprine and serotonin (e.g., venlafaxine) have been suggested as first-line treatment. These drugs have become our choice in treating children with cataplexy and nightmares as a symptom in narcolepsy. We describe clinical case reports of venlafaxine treatment in 6 children aged 7-12 years old when diagnosed with narcolepsy-cataplexy. In 2 cases with up to 50 daily cataplectic attacks, an initial effect of 37.5 mg of venlafaxine was initially observed. However, during the first year, the dose had to be increased to 112.5 mg daily to avoid cataplexy. A third patient with partial cataplexy was treated with 75 mg of venlafaxine daily. In 2 cases, hypnagogic hallucinations, described by the patients as nightmares, were the most troubling symptom and were successfully treated with only 37.5 mg of venlafaxine daily. Side effects included an increase of disturbed nocturnal sleep when venlafaxine was taken after 2:00 p.m. No major aggressive or suicidal thoughts and no raised blood pressure were recorded. Venlafaxine has proven to be an effective treatment of cataplexy and hypnagogic hallucinations in 6 children with narcolepsy. No severe side effects were observed.

  19. Abnormal synchrony and effective connectivity in patients with schizophrenia and auditory hallucinations

    Science.gov (United States)

    de la Iglesia-Vaya, Maria; Escartí, Maria José; Molina-Mateo, Jose; Martí-Bonmatí, Luis; Gadea, Marien; Castellanos, Francisco Xavier; Aguilar García-Iturrospe, Eduardo J.; Robles, Montserrat; Biswal, Bharat B.; Sanjuan, Julio

    2014-01-01

    Auditory hallucinations (AH) are the most frequent positive symptoms in patients with schizophrenia. Hallucinations have been related to emotional processing disturbances, altered functional connectivity and effective connectivity deficits. Previously, we observed that, compared to healthy controls, the limbic network responses of patients with auditory hallucinations differed when the subjects were listening to emotionally charged words. We aimed to compare the synchrony patterns and effective connectivity of task-related networks between schizophrenia patients with and without AH and healthy controls. Schizophrenia patients with AH (n = 27) and without AH (n = 14) were compared with healthy participants (n = 31). We examined functional connectivity by analyzing correlations and cross-correlations among previously detected independent component analysis time courses. Granger causality was used to infer the information flow direction in the brain regions. The results demonstrate that the patterns of cortico-cortical functional synchrony differentiated the patients with AH from the patients without AH and from the healthy participants. Additionally, Granger-causal relationships between the networks clearly differentiated the groups. In the patients with AH, the principal causal source was an occipital–cerebellar component, versus a temporal component in the patients without AH and the healthy controls. These data indicate that an anomalous process of neural connectivity exists when patients with AH process emotional auditory stimuli. Additionally, a central role is suggested for the cerebellum in processing emotional stimuli in patients with persistent AH. PMID:25379429

  20. The influence of hallucination proneness and social threat on time perception.

    Science.gov (United States)

    Coy, Abbie L; Hutton, Samuel B

    2013-01-01

    Individuals with schizophrenia frequently report disturbances in time perception, but the precise nature of such deficits and their relation to specific symptoms of the disorder is unclear. We sought to determine the relationship between hallucination proneness and time perception in healthy individuals, and whether this relationship is moderated by hypervigilance to threat-related stimuli. 206 participants completed the Revised Launay-Slade Hallucination Scale (LSHS-R) and a time reproduction task in which, on each trial, participants viewed a face (happy, angry, neutral, or fearful) for between 1 and 5 s and then reproduced the time period with a spacebar press. High LSHS-R scores were associated with longer time estimates, but only during exposure to angry faces. A factor analysis of LSHS-R scores identified a factor comprising items related to reality monitoring, and this factor was most associated with the longer time estimates. During exposure to potential threat in the environment, duration estimates increase with hallucination proneness. The experience of feeling exposed to threat for longer may serve to maintain a state of hypervigilance which has been shown previously to be associated with positive symptoms of schizophrenia.

  1. Cognitive insight and objective quality of life in people with schizophrenia and auditory hallucinations.

    Science.gov (United States)

    Rathee, Ruchika; Luhrmann, Tanya M; Bhatia, Triptish; Deshpande, Smita N

    2018-01-01

    Poor cognitive insight in schizophrenia has been linked to delusions, hallucinations, and negative symptoms as well as to depressive/anxiety symptoms. Its impact on quality of life has been less studied, especially in schizophrenia subjects with ongoing auditory hallucinations. The Beck Cognitive Insight Scale (BCIS) and the Quality of Life Scale (QLS) were administered to subjects who met DSM IV criteria for schizophrenia after due translation and validation. All subjects reported ongoing auditory hallucinations at recruitment. Mean composite cognitive insight scores from participants (N = 60) (2.97 ± 2.649) were in the lower range as compared to published literature. Cognitive insight scores as well as self-reflectiveness subscale scores, but not self-certainty scores, correlated significantly with the QLS scores p insight, especially self-reflectiveness, may be linked to better quality of life. Self-reflectiveness could be a useful construct to address in psychotherapy to improve rehabilitation. Copyright © 2017. Published by Elsevier B.V.

  2. Does dissociation mediate the relationship between childhood trauma and hallucinations, delusions in first episode psychosis?

    Science.gov (United States)

    Sun, Pamela; Alvarez-Jimenez, Mario; Simpson, Katrina; Lawrence, Katherine; Peach, Natalie; Bendall, Sarah

    2018-04-11

    Childhood trauma has been linked to the presence of delusions and hallucinations in psychosis, although the mechanisms underlying this relationship require elucidation. Dissociation, characterized by disruptions to the integrative functioning of several core mental domains, has emerged as a potential mechanism. There is a paucity of research using a clinician-rated measure of dissociation to test the indirect effect of dissociation on the relationship between childhood trauma and psychotic symptoms. This study aimed to investigate whether dissociation mediated both the relationships between childhood trauma and hallucinations, and childhood trauma and delusions utilizing a clinician-administered measure of dissociation, namely the Structured Clinical Interview for DSM-IV Dissociative Disorders - Revised (SCID-D-R). Sixty-six first-episode psychosis (FEP) participants completed a research interview and questionnaires. Information about experiences of childhood trauma, psychosis, dissociation, general psychopathology and demographics were collected. When using the SCID-D-R, childhood trauma positively correlated with dissociation. Further, dissociation mediated the relationship between childhood trauma and delusions. Contrary to previous findings, we found no relationship between dissociation and hallucinations and no mediating effect of dissociation on the association between childhood trauma and hallucinations. The results of the SCID-D-R differed significantly from those of the Dissociative Experiences Scale-II (DES-II) which were consistent with previous research. Our findings are the first to use a clinician-rated measure to test the mediating effect of dissociation on the relationship between childhood trauma and positive symptoms (i.e., hallucinations and delusions). Given the discrepancies in results between the SCID-D-R and DES-II, how dissociation is measured in future research is an important consideration. The results add to a body of work that

  3. Exploratory study of once-daily transcranial direct current stimulation (tDCS) as a treatment for auditory hallucinations in schizophrenia.

    Science.gov (United States)

    Fröhlich, F; Burrello, T N; Mellin, J M; Cordle, A L; Lustenberger, C M; Gilmore, J H; Jarskog, L F

    2016-03-01

    Auditory hallucinations are resistant to pharmacotherapy in about 25% of adults with schizophrenia. Treatment with noninvasive brain stimulation would provide a welcomed additional tool for the clinical management of auditory hallucinations. A recent study found a significant reduction in auditory hallucinations in people with schizophrenia after five days of twice-daily transcranial direct current stimulation (tDCS) that simultaneously targeted left dorsolateral prefrontal cortex and left temporo-parietal cortex. We hypothesized that once-daily tDCS with stimulation electrodes over left frontal and temporo-parietal areas reduces auditory hallucinations in patients with schizophrenia. We performed a randomized, double-blind, sham-controlled study that evaluated five days of daily tDCS of the same cortical targets in 26 outpatients with schizophrenia and schizoaffective disorder with auditory hallucinations. We found a significant reduction in auditory hallucinations measured by the Auditory Hallucination Rating Scale (F2,50=12.22, PtDCS for treatment of auditory hallucinations and the pronounced response in the sham-treated group in this study contrasts with the previous finding and demonstrates the need for further optimization and evaluation of noninvasive brain stimulation strategies. In particular, higher cumulative doses and higher treatment frequencies of tDCS together with strategies to reduce placebo responses should be investigated. Additionally, consideration of more targeted stimulation to engage specific deficits in temporal organization of brain activity in patients with auditory hallucinations may be warranted. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. The self or the voice? Relative contributions of self-esteem and voice appraisal in persistent auditory hallucinations.

    Science.gov (United States)

    Fannon, Dominic; Hayward, Peter; Thompson, Neil; Green, Nicola; Surguladze, Simon; Wykes, Til

    2009-07-01

    Persistent auditory hallucinations are common, disabling and difficult to treat. Cognitive behavioural therapy is recommended in their treatment though there is limited empirical evidence of the role of cognitive factors in the formation and persistence of voices. Low self-esteem is thought to play a causal and maintaining role in a range of clinical disorders, particularly depression, which is prevalent and disabling in schizophrenia. It was hypothesized that low self-esteem is prominent in, and contributes to, depression in voice hearers. Beliefs about persistent auditory hallucinations were investigated in 82 patients using the Beliefs About Voices Questionnaire--revised in a cross-sectional design. Self-esteem and depression were assessed using standardized measures. Depression and low self-esteem were prominent as were beliefs about the omnipotence and malevolence of auditory hallucinations. Beliefs about the uncontrollability and dominance of auditory hallucinations and low self-esteem were significantly correlated with depression. Low self-esteem did not mediate the effect of beliefs about auditory hallucinations--both acted independently to contribute to depression in this sample of patients with schizophrenia and persistent auditory hallucinations. Low self-esteem is of fundamental importance to the understanding of affective disturbance in voice hearers. Therapeutic interventions need to address both the appraisal of self and hallucinations in schizophrenia. Measures which ameliorate low self-esteem can be expected to improve depressed mood in this patient group. Further elucidation of the mechanisms involved can strengthen existing models of positive psychotic symptoms and provide targets for more effective treatments.

  5. Right prefrontal rTMS treatment for refractory auditory command hallucinations - a neuroSPECT assisted case study.

    Science.gov (United States)

    Schreiber, Shaul; Dannon, Pinhas N; Goshen, Elinor; Amiaz, Revital; Zwas, Tzila S; Grunhaus, Leon

    2002-11-30

    Auditory command hallucinations probably arise from the patient's failure to monitor his/her own 'inner speech', which is connected to activation of speech perception areas of the left cerebral cortex and to various degrees of dysfunction of cortical circuits involved in schizophrenia as supported by functional brain imaging. We hypothesized that rapid transcranial magnetic stimulation (rTMS), by increasing cortical activation of the right prefrontal brain region, would bring about a reduction of the hallucinations. We report our first schizophrenic patient affected with refractory command hallucinations treated with 10 Hz rTMS. Treatment was performed over the right dorsolateral prefrontal cortex, with 1200 magnetic stimulations administered daily for 20 days at 90% motor threshold. Regional cerebral blood flow changes were monitored with neuroSPECT. Clinical evaluation and scores on the Positive and Negative Symptoms Scale and the Brief Psychiatric Rating Scale demonstrated a global improvement in the patient's condition, with no change in the intensity and frequency of the hallucinations. NeuroSPECT performed at intervals during and after treatment indicated a general improvement in cerebral perfusion. We conclude that right prefrontal rTMS may induce a general clinical improvement of schizophrenic brain function, without directly influencing the mechanism involved in auditory command hallucinations.

  6. Deep transcranial magnetic stimulation add-on for the treatment of auditory hallucinations: a double-blind study.

    Science.gov (United States)

    Rosenberg, Oded; Gersner, Roman; Klein, Limor Dinur; Kotler, Moshe; Zangen, Abraham; Dannon, Pinhas

    2012-05-06

    About 25% of schizophrenia patients with auditory hallucinations are refractory to pharmacotherapy and electroconvulsive therapy. We conducted a deep transcranial magnetic stimulation (TMS) pilot study in order to evaluate the potential clinical benefit of repeated left temporoparietal cortex stimulation in these patients. The results were encouraging, but a sham-controlled study was needed to rule out a placebo effect. A total of 18 schizophrenic patients with refractory auditory hallucinations were recruited, from Beer Yaakov MHC and other hospitals outpatient populations. Patients received 10 daily treatment sessions with low-frequency (1 Hz for 10 min) deep TMS applied over the left temporoparietal cortex, using the H1 coil at the intensity of 110% of the motor threshold. Procedure was either real or sham according to patient randomization. Patients were evaluated via the Auditory Hallucinations Rating Scale, Scale for the Assessment of Positive Symptoms-Negative Symptoms, Clinical Global Impressions, and Quality of Life Questionnaire. In all, 10 patients completed the treatment (10 TMS sessions). Auditory hallucination scores of both groups improved; however, there was no statistical difference in any of the scales between the active and the sham treated groups. Low-frequency deep TMS to the left temporoparietal cortex using the protocol mentioned above has no statistically significant effect on auditory hallucinations or the other clinical scales measured in schizophrenic patients. Clinicaltrials.gov identifier: NCT00564096.

  7. Deep transcranial magnetic stimulation add-on for the treatment of auditory hallucinations: a double-blind study

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    Rosenberg Oded

    2012-05-01

    Full Text Available Abstract Background About 25% of schizophrenia patients with auditory hallucinations are refractory to pharmacotherapy and electroconvulsive therapy. We conducted a deep transcranial magnetic stimulation (TMS pilot study in order to evaluate the potential clinical benefit of repeated left temporoparietal cortex stimulation in these patients. The results were encouraging, but a sham-controlled study was needed to rule out a placebo effect. Methods A total of 18 schizophrenic patients with refractory auditory hallucinations were recruited, from Beer Yaakov MHC and other hospitals outpatient populations. Patients received 10 daily treatment sessions with low-frequency (1 Hz for 10 min deep TMS applied over the left temporoparietal cortex, using the H1 coil at the intensity of 110% of the motor threshold. Procedure was either real or sham according to patient randomization. Patients were evaluated via the Auditory Hallucinations Rating Scale, Scale for the Assessment of Positive Symptoms-Negative Symptoms, Clinical Global Impressions, and Quality of Life Questionnaire. Results In all, 10 patients completed the treatment (10 TMS sessions. Auditory hallucination scores of both groups improved; however, there was no statistical difference in any of the scales between the active and the sham treated groups. Conclusions Low-frequency deep TMS to the left temporoparietal cortex using the protocol mentioned above has no statistically significant effect on auditory hallucinations or the other clinical scales measured in schizophrenic patients. Trial Registration Clinicaltrials.gov identifier: NCT00564096.

  8. A Qualitative Analysis of Student Pharmacists’ Response after an Auditory Hallucination Simulation

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    Genevieve L Ness

    2017-08-01

    Full Text Available Objectives: The goal of this research was to evaluate pharmacy students’ experiences and reactions when exposed to an auditory hallucination simulator. Methods: A convenient sample of 16 pharmacy students enrolled in the Advanced Psychiatry Elective at a private, faith-based university in the southeastern United States was selected. Students participated in an activity in which they listened to an auditory hallucination simulator from their personal laptop computers and completed a variety of tasks. Following the conclusion of the simulator, students composed a reflection guided by a five-question prompt. Qualitative analysis of the reflections was then completed to identify and categorize overarching themes. Results: The overarching themes identified included: 1 students mentioned strategies they used to overcome the distraction; 2 students discussed how the voices affected their ability to complete the activities; 3 students discussed the mental/physical toll they experienced; 4 students identified methods to assist patients with schizophrenia; 5 students mentioned an increase in their empathy for patients; 6 students reported their reactions to the voices; 7 students recognized how schizophrenia could affect the lives of these patients; and 8 students expressed how their initial expectations and reactions to the voices changed throughout the course of the simulation. Overall, the use of this simulator as a teaching aid was well received by students. Summary: In conclusion, pharmacy students were impacted by the hallucination simulator and expressed an increased awareness of the challenges faced by these patients on a daily basis. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert

  9. Chronic auditory hallucinations in schizophrenic patients: MR analysis of the coincidence between functional and morphologic abnormalities.

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    Martí-Bonmatí, Luis; Lull, Juan José; García-Martí, Gracián; Aguilar, Eduardo J; Moratal-Pérez, David; Poyatos, Cecilio; Robles, Montserrat; Sanjuán, Julio

    2007-08-01

    To prospectively evaluate if functional magnetic resonance (MR) imaging abnormalities associated with auditory emotional stimuli coexist with focal brain reductions in schizophrenic patients with chronic auditory hallucinations. Institutional review board approval was obtained and all participants gave written informed consent. Twenty-one right-handed male patients with schizophrenia and persistent hallucinations (started to hear hallucinations at a mean age of 23 years +/- 10, with 15 years +/- 8 of mean illness duration) and 10 healthy paired participants (same ethnic group [white], age, and education level [secondary school]) were studied. Functional echo-planar T2*-weighted (after both emotional and neutral auditory stimulation) and morphometric three-dimensional gradient-recalled echo T1-weighted MR images were analyzed using Statistical Parametric Mapping (SPM2) software. Brain activation images were extracted by subtracting those with emotional from nonemotional words. Anatomic differences were explored by optimized voxel-based morphometry. The functional and morphometric MR images were overlaid to depict voxels statistically reported by both techniques. A coincidence map was generated by multiplying the emotional subtracted functional MR and volume decrement morphometric maps. Statistical analysis used the general linear model, Student t tests, random effects analyses, and analysis of covariance with a correction for multiple comparisons following the false discovery rate method. Large coinciding brain clusters (P < .005) were found in the left and right middle temporal and superior temporal gyri. Smaller coinciding clusters were found in the left posterior and right anterior cingular gyri, left inferior frontal gyrus, and middle occipital gyrus. The middle and superior temporal and the cingular gyri are closely related to the abnormal neural network involved in the auditory emotional dysfunction seen in schizophrenic patients.

  10. Cerebral Responses to Vocal Attractiveness and Auditory Hallucinations in Schizophrenia: A Functional MRI Study

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    Michihiko eKoeda

    2013-05-01

    Full Text Available Impaired self-monitoring and abnormalities of cognitive bias have been implicated as cognitive mechanisms of hallucination; regions fundamental to these processes including inferior frontal gyrus (IFG and superior temporal gyrus (STG are abnormally activated in individuals that hallucinate. A recent study showed activation in IFG-STG to be modulated by auditory attractiveness, but no study has investigated whether these IFG-STG activations are impaired in schizophrenia. We aimed to clarify the cerebral function underlying the perception of auditory attractiveness in schizophrenia patients. Cerebral activation was examined in 18 schizophrenia patients and 18 controls when performing Favourability Judgment Task (FJT and Gender Differentiation Task (GDT for pairs of greetings using event-related functional MRI. A full-factorial analysis revealed that the main effect of task was associated with activation of left IFG and STG. The main effect of Group revealed less activation of left STG in schizophrenia compared with controls, whereas significantly greater activation in schizophrenia than in controls was revealed at the left middle frontal gyrus (MFG, right temporo-parietal junction (TPJ, right occipital lobe, and right amygdala (p<0.05, FDR-corrected. A significant positive correlation was observed at the right TPJ and right MFG between cerebral activation under FJT minus GDT contrast and the score of hallucinatory behaviour on the Positive and Negative Symptom Scale. Findings of hypo-activation in the left STG could designate brain dysfunction in accessing vocal attractiveness in schizophrenia, whereas hyper-activation in the right TPJ and MFG may reflect the process of mentalizing other person’s behaviour by auditory hallucination by abnormality of cognitive bias.

  11. Possible role of biochemiluminescent photons for lysergic acid diethylamide (LSD)-induced phosphenes and visual hallucinations.

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    Kapócs, Gábor; Scholkmann, Felix; Salari, Vahid; Császár, Noémi; Szőke, Henrik; Bókkon, István

    2017-01-01

    Today, there is an increased interest in research on lysergic acid diethylamide (LSD) because it may offer new opportunities in psychotherapy under controlled settings. The more we know about how a drug works in the brain, the more opportunities there will be to exploit it in medicine. Here, based on our previously published papers and investigations, we suggest that LSD-induced visual hallucinations/phosphenes may be due to the transient enhancement of bioluminescent photons in the early retinotopic visual system in blind as well as healthy people.

  12. Treatment of Alice in Wonderland Syndrome and Verbal Auditory Hallucinations Using Repetitive Transcranial Magnetic Stimulation : A Case Report with fMRI Findings

    NARCIS (Netherlands)

    Blom, Jan Dirk; Looijestijn, Jasper; Goekoop, Rutger; Diederen, Kelly M. J.; Rijkaart, Anne-Marije; Slotema, Christina W.; Sommer, Iris E. C.

    2011-01-01

    Background: Alice in Wonderland syndrome (AIWS) is a rare cluster of CNS symptoms characterized by visual distortions (i.e. metamorphopsias), body image distortions, time distortions, and deja experiences. Verbal auditory hallucinations (VAHs) are the most prevalent type of hallucination in adults

  13. Neurofeedback-Based Enhancement of Single-Trial Auditory Evoked Potentials: Treatment of Auditory Verbal Hallucinations in Schizophrenia.

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    Rieger, Kathryn; Rarra, Marie-Helene; Diaz Hernandez, Laura; Hubl, Daniela; Koenig, Thomas

    2018-03-01

    Auditory verbal hallucinations depend on a broad neurobiological network ranging from the auditory system to language as well as memory-related processes. As part of this, the auditory N100 event-related potential (ERP) component is attenuated in patients with schizophrenia, with stronger attenuation occurring during auditory verbal hallucinations. Changes in the N100 component assumingly reflect disturbed responsiveness of the auditory system toward external stimuli in schizophrenia. With this premise, we investigated the therapeutic utility of neurofeedback training to modulate the auditory-evoked N100 component in patients with schizophrenia and associated auditory verbal hallucinations. Ten patients completed electroencephalography neurofeedback training for modulation of N100 (treatment condition) or another unrelated component, P200 (control condition). On a behavioral level, only the control group showed a tendency for symptom improvement in the Positive and Negative Syndrome Scale total score in a pre-/postcomparison ( t (4) = 2.71, P = .054); however, no significant differences were found in specific hallucination related symptoms ( t (7) = -0.53, P = .62). There was no significant overall effect of neurofeedback training on ERP components in our paradigm; however, we were able to identify different learning patterns, and found a correlation between learning and improvement in auditory verbal hallucination symptoms across training sessions ( r = 0.664, n = 9, P = .05). This effect results, with cautious interpretation due to the small sample size, primarily from the treatment group ( r = 0.97, n = 4, P = .03). In particular, a within-session learning parameter showed utility for predicting symptom improvement with neurofeedback training. In conclusion, patients with schizophrenia and associated auditory verbal hallucinations who exhibit a learning pattern more characterized by within-session aptitude may benefit from electroencephalography neurofeedback

  14. “Capgras” Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures

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    Brandon Lilly

    2018-01-01

    Full Text Available Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

  15. Feasibility and Clinical Utility of High-definition Transcranial Direct Current Stimulation in the Treatment of Persistent Hallucinations in Schizophrenia.

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    Bose, A; Shivakumar, V; Chhabra, H; Parlikar, R; Sreeraj, V S; Dinakaran, D; Narayanaswamy, J C; Venkatasubramanian, G

    2017-12-01

    Persistent auditory verbal hallucination is a clinically significant problem in schizophrenia. Recent studies suggest a promising role for add-on transcranial direct current stimulation (tDCS) in treatment. An optimised version of tDCS, namely high-definition tDCS (HD-tDCS), uses smaller electrodes arranged in a 4x1 ring configuration and may offer more focal and predictable neuromodulation than conventional tDCS. This case report illustrates the feasibility and clinical utility of add-on HD-tDCS over the left temporoparietal junction in a 4x1 ring configuration to treat persistent auditory verbal hallucination in schizophrenia.

  16. From local pixel structure to global image super-resolution: a new face hallucination framework.

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    Hu, Yu; Lam, Kin-Man; Qiu, Guoping; Shen, Tingzhi

    2011-02-01

    We have developed a new face hallucination framework termed from local pixel structure to global image super-resolution (LPS-GIS). Based on the assumption that two similar face images should have similar local pixel structures, the new framework first uses the input low-resolution (LR) face image to search a face database for similar example high-resolution (HR) faces in order to learn the local pixel structures for the target HR face. It then uses the input LR face and the learned pixel structures as priors to estimate the target HR face. We present a three-step implementation procedure for the framework. Step 1 searches the database for K example faces that are the most similar to the input, and then warps the K example images to the input using optical flow. Step 2 uses the warped HR version of the K example faces to learn the local pixel structures for the target HR face. An effective method for learning local pixel structures from an individual face, and an adaptive procedure for fusing the local pixel structures of different example faces to reduce the influence of warping errors, have been developed. Step 3 estimates the target HR face by solving a constrained optimization problem by means of an iterative procedure. Experimental results show that our new method can provide good performances for face hallucination, both in terms of reconstruction error and visual quality; and that it is competitive with existing state-of-the-art methods.

  17. Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

    Science.gov (United States)

    Thomas, Neil; Hayward, Mark; Peters, Emmanuelle; van der Gaag, Mark; Bentall, Richard P.; Jenner, Jack; Strauss, Clara; Sommer, Iris E.; Johns, Louise C.; Varese, Filippo; García-Montes, José Manuel; Waters, Flavie; Dodgson, Guy; McCarthy-Jones, Simon

    2014-01-01

    This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions, through formulation-driven interventions using methods from cognitive therapy, to a number of contemporary developments. Recent developments include the application of acceptance- and mindfulness-based approaches, and consolidation of methods for working with connections between voices and views of self, others, relationships and personal history. In this article, we discuss the development of therapies for voices and review the empirical findings. This review shows that psychological therapies are broadly effective for people with positive symptoms, but that more research is required to understand the specific application of therapies to voices. Six key research directions are identified: (1) moving beyond the focus on overall efficacy to understand specific therapeutic processes targeting voices, (2) better targeting psychological processes associated with voices such as trauma, cognitive mechanisms, and personal recovery, (3) more focused measurement of the intended outcomes of therapy, (4) understanding individual differences among voice hearers, (5) extending beyond a focus on voices and schizophrenia into other populations and sensory modalities, and (6) shaping interventions for service implementation. PMID:24936081

  18. Hallucinations and REM sleep behaviour disorder in Parkinson's disease: dream imagery intrusions and other hypotheses.

    Science.gov (United States)

    Manni, Raffaele; Terzaghi, Michele; Ratti, Pietro-Luca; Repetto, Alessandra; Zangaglia, Roberta; Pacchetti, Claudio

    2011-12-01

    REM sleep behaviour disorder (RBD) is a REM sleep-related parasomnia which may be considered a "dissociated state of wakefulness and sleep", given that conflicting elements of REM sleep (dreaming) and of wakefulness (sustained muscle tone and movements) coexist during the episodes, leading to motor and behavioural manifestations reminiscent of an enacted dream. RBD has been reported in association with α-synucleinopathies: around a third of patients with Parkinson's disease (PD) have full-blown RBD. Recent data indicate that PD patients with RBD are more prone to hallucinations than PD patients without this parasomnia. However it is still not clear why RBD in PD is associated with an increased prevalence of VHs. Data exist which suggest that visual hallucinations in PD may be the result of untimely intrusions of REM visual imagery into wakefulness. RBD, which is characterised by a REM sleep dissociation pattern, might be a condition that particularly favours such intrusions. However, other hypotheses may be advanced. In fact, deficits in attentional, executive, visuoperceptual and visuospatial abilities have been documented in RBD and found to occur far more frequently in PD with RBD than in PD without RBD. Neuropsychological deficits involving visual perception and attentional processes are thought to play an important role in the pathophysiology of VHs. On this basis, RBD in PD could be viewed as a contributory risk factor for VHs. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Hypnagogic and hypnopompic hallucinations during sleep paralysis: neurological and cultural construction of the night-mare.

    Science.gov (United States)

    Cheyne, J A; Rueffer, S D; Newby-Clark, I R

    1999-09-01

    Hypnagogic and hypnopompic experiences (HHEs) accompanying sleep paralysis (SP) are often cited as sources of accounts of supernatural nocturnal assaults and paranormal experiences. Descriptions of such experiences are remarkably consistent across time and cultures and consistent also with known mechanisms of REM states. A three-factor structural model of HHEs based on their relations both to cultural narratives and REM neurophysiology is developed and tested with several large samples. One factor, labeled Intruder, consisting of sensed presence, fear, and auditory and visual hallucinations, is conjectured to originate in a hypervigilant state initiated in the midbrain. Another factor, Incubus, comprising pressure on the chest, breathing difficulties, and pain, is attributed to effects of hyperpolarization of motoneurons on perceptions of respiration. These two factors have in common an implied alien "other" consistent with occult narratives identified in numerous contemporary and historical cultures. A third factor, labeled Unusual Bodily Experiences, consisting of floating/flying sensations, out-of-body experiences, and feelings of bliss, is related to physically impossible experiences generated by conflicts of endogenous and exogenous activation related to body position, orientation, and movement. Implications of this last factor for understanding of orientational primacy in self-consciousness are considered. Central features of the model developed here are consistent with recent work on hallucinations associated with hypnosis and schizophrenia. Copyright 1999 Academic Press.

  20. The Multidimensional Spectrum of Imagination: Images, Dreams, Hallucinations, and Active, Imaginative Perception

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    Nigel J.T. Thomas

    2014-04-01

    Full Text Available A theory of the structure and cognitive function of the human imagination that attempts to do justice to traditional intuitions about its psychological centrality is developed, largely through a detailed critique of the theory propounded by Colin McGinn. Like McGinn, I eschew the highly deflationary views of imagination, common amongst analytical philosophers, that treat it either as a conceptually incoherent notion, or as psychologically trivial. However, McGinn fails to develop his alternative account satisfactorily because (following Reid, Wittgenstein and Sartre he draws an excessively sharp, qualitative distinction between imagination and perception, and because of his flawed, empirically ungrounded conception of hallucination. His arguments in defense of these views are rebutted in detail, and the traditional, passive, Cartesian view of visual perception, upon which several of them implicitly rely, is criticized in the light of findings from recent cognitive science and neuroscience. It is also argued that the apparent intuitiveness of the passive view of visual perception is a result of mere historical contingency. An understanding of perception (informed by modern visual science as an inherently active process enables us to unify our accounts of perception, mental imagery, dreaming, hallucination, creativity, and other aspects of imagination within a single coherent theoretical framework.

  1. Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

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    Thiago Cardoso Vale

    2014-05-01

    Full Text Available Objective: To present an eight-case serie of patients with Charles Bonnet syndrome (CBS. Method: All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. Results: Five patients were male (62.5% and the mean age was 52.3+16.0 years. Two patients suffered from severe myopia and glaucoma, three had retinitis pigmentosa, one had anterior ischemic optic neuropathy, one had age-related macular degeneration and one had toxoplasmic retinochoroiditis. Mean visual acuity in the right eye was 1,12 logMAR and in the left eye 0.57 logMAR. A mean delay of 41.7 months occurred until diagnosis. All hallucinations were complexes and mostly ocurred on a weekly-basis (62.5% and lasted for seconds (87.5%. Conclusions: Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases.

  2. The Effects of Apomorphine on Visual Perception in Patients With Parkinson Disease and Visual Hallucinations : A Pilot Study

    NARCIS (Netherlands)

    Geerligs, Linda; Meppelink, Anne Marthe; Brouwer, Wiebo H.; van Laar, Teus

    2009-01-01

    Visual hallucinations (VHs) often occur in patients with advanced Parkinson disease (PD). Overstimulation of dopamine receptors has been considered as one of the causes for VHs in PD. However, several clinical studies suggested that apomorphine infusion did not worsen existing VHs in PD, but could

  3. The prevalence of visual hallucinations in non-affective psychosis, and the role of perception and attention

    NARCIS (Netherlands)

    Ommen, van Marouska; van Beilen, M; Cornelissen, F W; Smid, H.G.O.M.; Knegtering, H; Aleman, A; van Laar, T

    Background. Little is known about visual hallucinations (VH) in psychosis. We investigated the prevalence and the role of bottom-up and top-down processing in VH. The prevailing view is that VH are probably related to altered top-down processing, rather than to distorted bottom-up processing.

  4. Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations : are they still healthy?

    NARCIS (Netherlands)

    Daalman, K; Diederen, K M J; Hoekema, L; van Lutterveld, R; Sommer, I E C

    BACKGROUND: Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these

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

    Science.gov (United States)

    Morita, N; Satoh, S; Oda, S; Tomita, H; Shoji, M; Seno, E; Abe, K; Konishi, T

    1994-10-01

    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

  6. Hallucination chez Flaubert : poétique de la perception

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    Tomoko Hashimoto

    2009-01-01

    Full Text Available Notre étude vise à montrer dans le cadre d’une poétique du discours réaliste la manière dont l’« hallucination » fonctionne, se construit et trouve sa signification chez Flaubert. Par quels procédés fait-il surgir des mots le caractère éphémère des images et l’intensité de leur perception ?Notre étude se développera en une forme de triptyque, où le contexte, l’avant-texte et le texte seront examinés. Mais, ces trois points constituant ensemble l’œuvre de Flaubert, nous ne les séparerons pas à...

  7. [Distinguishing the voice of self from others: the self-monitoring hypothesis of auditory hallucination].

    Science.gov (United States)

    Asai, Tomohisa; Tanno, Yoshihiko

    2010-08-01

    Auditory hallucinations (AH), a psychopathological phenomenon where a person hears non-existent voices, commonly occur in schizophrenia. Recent cognitive and neuroscience studies suggest that AH may be the misattribution of one's own inner speech. Self-monitoring through neural feedback mechanisms allows individuals to distinguish between their own and others' actions, including speech. AH maybe the results of an individual's inability to discriminate between their own speech and that of others. The present paper tries to integrate the three theories (behavioral, brain, and model approaches) proposed to explain the self-monitoring hypothesis of AH. In addition, we investigate the lateralization of self-other representation in the brain, as suggested by recent studies, and discuss future research directions.

  8. Dissecting auditory verbal hallucinations into two components: audibility (Gedankenlautwerden) and alienation (thought insertion).

    Science.gov (United States)

    Sommer, Iris E; Selten, Jean-Paul; Diederen, Kelly M; Blom, Jan Dirk

    2010-01-01

    This study proposes a theoretical framework which dissects auditory verbal hallucinations (AVH) into 2 essential components: audibility and alienation. Audibility, the perceptual aspect of AVH, may result from a disinhibition of the auditory cortex in response to self-generated speech. In isolation, this aspect leads to audible thoughts: Gedankenlautwerden. The second component is alienation, which is the failure to recognize the content of AVH as self-generated. This failure may be related to the fact that cerebral activity associated with AVH is predominantly present in the speech production area of the right hemisphere. Since normal inner speech is derived from the left speech area, an aberrant source may lead to confusion about the origin of the language fragments. When alienation is not accompanied by audibility, it will result in the experience of thought insertion. The 2 hypothesized components are illustrated using case vignettes. Copyright 2010 S. Karger AG, Basel.

  9. [A Clinical Case of Grief Hallucination through the Mourning Work Normal Grief and Spiritual Care].

    Science.gov (United States)

    Kurotori, Isaku; Kato, Satoshi

    2015-01-01

    Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context.

  10. Léon Marillier and the veridical hallucination in late-nineteenth- and early-twentieth-century French psychology and psychopathology.

    Science.gov (United States)

    Le Maléfan, Pascal; Sommer, Andreas

    2015-12-01

    Recent research on the professionalization of psychology at the end of the nineteenth century shows how objects of knowledge which appear illegitimate to us today shaped the institutionalization of disciplines. The veridical or telepathic hallucination was one of these objects, constituting a field both of division and exchange between nascent psychology and disciplines known as 'psychic sciences' in France, and 'psychical research' in the Anglo-American context. In France, Leon Marillier (1862-1901) was the main protagonist in discussions concerning the concept of the veridical hallucination, which gave rise to criticisms by mental specialists and psychopathologists. After all, not only were these hallucinations supposed to occur in healthy subjects, but they also failed to correspond to the Esquirolian definition of hallucinations through being corroborated by their representation of external, objective events. © The Author(s) 2015.

  11. 'The devil lay upon her and held her down' Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664

    NARCIS (Netherlands)

    E.J.O. Kompanje (Erwin)

    2008-01-01

    textabstractHypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic

  12. Voxel-based gray and white matter morphometry correlates of hallucinations in schizophrenia : The superior temporal gyrus does not stand alone

    NARCIS (Netherlands)

    van Tol, Marie-Jose; van der Meer, Lisette; Bruggeman, Richard; Modinos, Gemma; Knegtering, Henderikus; Aleman, André

    2014-01-01

    Introduction: Auditory verbal hallucinations (AVH) in schizophrenia (SZ) have been proposed to result from abnormal local, interregional and interhemispheric integration of brain signals in regions involved in language production and perception. This abnormal functional integration may find its base

  13. 'The devil lay upon her and held her down' Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664

    OpenAIRE

    Kompanje, Erwin

    2008-01-01

    textabstractHypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664, the Dutch physician I...

  14. Use of transcranial direct current stimulation for the treatment of auditory hallucinations of schizophrenia – a systematic review

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    Pondé PH

    2017-02-01

    Full Text Available Pedro H Pondé,1 Eduardo P de Sena,2 Joan A Camprodon,3 Arão Nogueira de Araújo,2 Mário F Neto,4 Melany DiBiasi,5 Abrahão Fontes Baptista,6,7 Lidia MVR Moura,8 Camila Cosmo2,3,6,9,10 1Dynamics of Neuromusculoskeletal System Laboratory, Bahiana School of Medicine and Public Health, 2Postgraduate Program in Interactive Process of Organs and Systems, Federal University of Bahia, Salvador, Bahia, Brazil; 3Laboratory for Neuropsychiatry and Neuromodulation and Transcranial Magnetic Stimulation Clinical Service, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 4Scientific Training Center Department, School of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil; 5Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA; 6Functional Electrostimulation Laboratory, Biomorphology Department, 7Postgraduate Program on Medicine and Human Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil; 8Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 9Center for Technological Innovation in Rehabilitation, Federal University of Bahia, 10Bahia State Health Department (SESAB, Salvador, Bahia, Brazil Introduction: Auditory hallucinations are defined as experiences of auditory perceptions in the absence of a provoking external stimulus. They are the most prevalent symptoms of schizophrenia with high capacity for chronicity and refractoriness during the course of disease. The transcranial direct current stimulation (tDCS – a safe, portable, and inexpensive neuromodulation technique – has emerged as a promising treatment for the management of auditory hallucinations. Objective: The aim of this study is to analyze the level of evidence in the literature available for the use of tDCS as a treatment for auditory hallucinations in schizophrenia. Methods: A systematic review was performed

  15. A lightning strike to the head causing a visual cortex defect with simple and complex visual hallucinations

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    Kleiter, Ingo; Luerding, Ralf; Diendorfer, Gerhard; Rek, Helga; Bogdahn, Ulrich; Schalke, Berthold

    2009-01-01

    The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. At 4 months after the accident, she developed a psychological reaction consisting of nightmares, with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning strike were retrospectively retraced PMID:21734915

  16. A differentiating empirical linguistic analysis of dreamer activity in reports of EEG-controlled REM-dreams and hypnagogic hallucinations.

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    Speth, Jana; Frenzel, Clemens; Voss, Ursula

    2013-09-01

    We present Activity Analysis as a new method for the quantification of subjective reports of altered states of consciousness with regard to the indicated level of simulated motor activity. Empirical linguistic activity analysis was conducted with dream reports conceived immediately after EEG-controlled periods of hypnagogic hallucinations and REM-sleep in the sleep laboratory. Reports of REM-dreams exhibited a significantly higher level of simulated physical dreamer activity, while hypnagogic hallucinations appear to be experienced mostly from the point of passive observer. This study lays the groundwork for clinical research on the level of simulated activity in pathologically altered states of subjective experience, for example in the REM-dreams of clinically depressed patients, or in intrusions and dreams of patients diagnosed with PTSD. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Functional studies of the human auditory cortex, auditory memory and musical hallucinations

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    Goycoolea, Marcos; Mena, Ismael; Neubauer, Sonia

    2004-01-01

    Objectives. 1. To determine which areas of the cerebral cortex are activated stimulating the left ear with pure tones, and what type of stimulation occurs (eg. excitatory or inhibitory) in these different areas. 2. To use this information as an initial step to develop a normal functional data base for future studies. 3. To try to determine if there is a biological substrate to the process of recalling previous auditory perceptions and if possible, suggest a locus for auditory memory. Method. Brain perfusion single photon emission computerized tomography (SPECT) evaluation was conducted: 1-2) Using auditory stimulation with pure tones in 4 volunteers with normal hearing. 3) In a patient with bilateral profound hearing loss who had auditory perception of previous musical experiences; while injected with Tc99m HMPAO while she was having the sensation of hearing a well known melody. Results. Both in the patient with auditory hallucinations and the normal controls -stimulated with pure tones- there was a statistically significant increase in perfusion in Brodmann's area 39, more intense on the right side (right to left p < 0.05). With a lesser intensity there was activation in the adjacent area 40 and there was intense activation also in the executive frontal cortex areas 6, 8, 9, and 10 of Brodmann. There was also activation of area 7 of Brodmann; an audio-visual association area; more marked on the right side in the patient and the normal stimulated controls. In the subcortical structures there was also marked activation in the patient with hallucinations in both lentiform nuclei, thalamus and caudate nuclei also more intense in the right hemisphere, 5, 4.7 and 4.2 S.D. above the mean respectively and 5, 3.3, and 3 S.D. above the normal mean in the left hemisphere respectively. Similar findings were observed in normal controls. Conclusions. After auditory stimulation with pure tones in the left ear of normal female volunteers, there is bilateral activation of area 39

  18. The development of in vivo tracer methods to obtain new information about human disease: a study of the hallucinating brain

    International Nuclear Information System (INIS)

    Jones, T.; Silbersweig, D.A.; Stern, E.; Schnorr, L.; Seaward, J.; Clark, J.C.; Lammertsma, A.A.; Grootoonk, S.

    1996-01-01

    An outline is provided of the development of methodological strategies to address the question of focal cerebral activation during hallucinations in schizophrenic patients. In so doing, the innovation and diligence required to tailor in vivo tracer procedures to specific clinical research issues are highlighted. Attention is drawn to the complexity of methodological advances and the way in which they are based upon close scientific and technical collaboration between clinical scientists, and non-clinical scientists and research support staff. (orig.). With 1 fig

  19. The 5-HT2A/1A agonist psilocybin disrupts modal object completion associated with visual hallucinations.

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    Kometer, Michael; Cahn, B Rael; Andel, David; Carter, Olivia L; Vollenweider, Franz X

    2011-03-01

    Recent findings suggest that the serotonergic system and particularly the 5-HT2A/1A receptors are implicated in visual processing and possibly the pathophysiology of visual disturbances including hallucinations in schizophrenia and Parkinson's disease. To investigate the role of 5-HT2A/1A receptors in visual processing the effect of the hallucinogenic 5-HT2A/1A agonist psilocybin (125 and 250 μg/kg vs. placebo) on the spatiotemporal dynamics of modal object completion was assessed in normal volunteers (n = 17) using visual evoked potential recordings in conjunction with topographic-mapping and source analysis. These effects were then considered in relation to the subjective intensity of psilocybin-induced visual hallucinations quantified by psychometric measurement. Psilocybin dose-dependently decreased the N170 and, in contrast, slightly enhanced the P1 component selectively over occipital electrode sites. The decrease of the N170 was most apparent during the processing of incomplete object figures. Moreover, during the time period of the N170, the overall reduction of the activation in the right extrastriate and posterior parietal areas correlated positively with the intensity of visual hallucinations. These results suggest a central role of the 5-HT2A/1A-receptors in the modulation of visual processing. Specifically, a reduced N170 component was identified as potentially reflecting a key process of 5-HT2A/1A receptor-mediated visual hallucinations and aberrant modal object completion potential. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Changes of Retina Are Not Involved in the Genesis of Visual Hallucinations in Parkinson’s Disease

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    Aleš Kopal

    2015-01-01

    Full Text Available Parkinson’s disease (PD is characterized by motor and nonmotor symptoms. Nonmotor symptoms include primarily visual hallucinations (VH. The aim of our study was to establish whether patients with PD and visual hallucinations (PDH+ have structural changes of retina detected by an optical coherence tomography (OCT in comparison with PD patients without visual hallucinations (PDH−. We examined 52 PD patients (18 with VH, 34 without VH and 15 age and sex matched healthy controls. Retinal nerve fiber layer (RNFL thickness and macular thickness and volume were assessed by OCT. Functional impairment of retina was assessed using 2.5% contrast sensitivity test. For OCT outcomes we analyzed 15 PDH+ and 15 PDH− subjects matched for age, gender, and PD duration. For contrast sensitivity we analyzed 8 pairs of patients matched for age, gender, and visual acuity. There was no significant difference in RNFL thickness and macular thickness and macular volume between 15 PDH+ and 15 PDH− subjects, and also between a group of 44 PD patients (both PDH+ and PDH− and 15 age and gender matched healthy controls. No significant difference was found for 2.5% contrast sensitivity test values between PDH+ and PDH− subjects. Therefore we conclude that functional and structural changes in retina play no role in genesis of VH in PD.

  1. A synthesis of evidence on inhibitory control and auditory hallucinations based on the Research Domain Criteria (RDoC framework.

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    Johanna C. Badcock

    2014-03-01

    Full Text Available The National Institute of Mental Health initiative called the Research Domain Criteria (RDoC project aims to provide a new approach to understanding mental illness grounded in the fundamental domains of human behaviour and psychological functioning. To this end the RDoC framework encourages researchers and clinicians to think outside the [diagnostic]box, by studying symptoms, behaviours or biomarkers that cut across traditional mental illness categories. In this article we examine and discuss how the RDoC framework can improve our understanding of psychopathology by zeroing in on hallucinations- now widely recognized as a symptom that occurs in a range of clinical and non-clinical groups. We focus on a single domain of functioning - namely cognitive [inhibitory] control - and assimilate key findings structured around the basic RDoC units of analysis, which span the range from observable behaviour to molecular genetics. Our synthesis and critique of the literature provides a deeper understanding of the mechanisms involved in the emergence of auditory hallucinations, linked to the individual dynamics of inhibitory development before and after puberty; favours separate developmental trajectories for clinical and nonclinical hallucinations; yields new insights into co-occurring emotional and behavioural problems; and suggests some novel avenues for treatment.

  2. Increased thalamic resting-state connectivity as a core driver of LSD-induced hallucinations.

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    Müller, F; Lenz, C; Dolder, P; Lang, U; Schmidt, A; Liechti, M; Borgwardt, S

    2017-12-01

    It has been proposed that the thalamocortical system is an important site of action of hallucinogenic drugs and an essential component of the neural correlates of consciousness. Hallucinogenic drugs such as LSD can be used to induce profoundly altered states of consciousness, and it is thus of interest to test the effects of these drugs on this system. 100 μg LSD was administrated orally to 20 healthy participants prior to fMRI assessment. Whole brain thalamic functional connectivity was measured using ROI-to-ROI and ROI-to-voxel approaches. Correlation analyses were used to explore relationships between thalamic connectivity to regions involved in auditory and visual hallucinations and subjective ratings on auditory and visual drug effects. LSD caused significant alterations in all dimensions of the 5D-ASC scale and significantly increased thalamic functional connectivity to various cortical regions. Furthermore, LSD-induced functional connectivity measures between the thalamus and the right fusiform gyrus and insula correlated significantly with subjective auditory and visual drug effects. Hallucinogenic drug effects might be provoked by facilitations of cortical excitability via thalamocortical interactions. Our findings have implications for the understanding of the mechanism of action of hallucinogenic drugs and provide further insight into the role of the 5-HT 2A -receptor in altered states of consciousness. © 2017 The Authors Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  3. Examining frontotemporal connectivity and rTMS in healthy controls: implications for auditory hallucinations in schizophrenia.

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    Gromann, Paula M; Tracy, Derek K; Giampietro, Vincent; Brammer, Michael J; Krabbendam, Lydia; Shergill, Sukhwinder S

    2012-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been shown to have clinically beneficial effects in altering the perception of auditory hallucinations (AH) in patients with schizophrenia. However, the mode of action is not clear. Recent neuroimaging findings indicate that rTMS has the potential to induce not only local effects but also changes in remote, functionally connected brain regions. Frontotemporal dysconnectivity has been proposed as a mechanism leading to psychotic symptoms in schizophrenia. The current study examines functional connectivity between temporal and frontal brain regions after rTMS and the implications for AH in schizophrenia. A connectivity analysis was conducted on the fMRI data of 11 healthy controls receiving rTMS, compared with 11 matched subjects receiving sham TMS, to the temporoparietal junction, before engaging in a task associated with robust frontotemporal activation. Compared to the control group, the rTMS group showed an altered frontotemporal connectivity with stronger connectivity between the right temporoparietal cortex and the dorsolateral prefrontal cortex and the angular gyrus. This finding provides preliminary evidence for the hypothesis that normalizing the functional connectivity between the temporoparietal and frontal brain regions may underlie the therapeutic effect of rTMS on AH in schizophrenia.

  4. Clinical and cognitive correlates of visual hallucinations in dementia with Lewy bodies.

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    Cagnin, Annachiara; Gnoato, Francesca; Jelcic, Nela; Favaretto, Silvia; Zarantonello, Giulia; Ermani, Mario; Dam, Mauro

    2013-05-01

    The presence of recurrent complex visual hallucinations (VHs) is a core feature of dementia with Lewy bodies (DLB). The aim of this study was to investigate which clinical and neuropsychological characteristics are associated with VHs and their predictive value over a 1 year follow-up. 81 DLB patients, 41 with (VH+) and 36 without (VH-) VHs, and 45 patients with Alzheimer's disease (AD), were enrolled. All participants underwent extensive neuropsychological testing. Visual-spatial and perceptual abilities were evaluated with the Visual and Object Space Perception (VOSP) battery. Fluctuations in attention, rapid eye movement sleep behaviour disorder (RBD) symptoms, extrapyramidal signs and behavioural disturbances were studied with dedicated clinical scales. The presence of VHs was associated with older age and later disease onset, but not with disease duration or with fluctuations, RBD or parkinsonism severity. Cognitive correlates of VHs were deficits in visual attention (digit cancellation: pspan forward: pVisual-perceptual and visual-spatial deficits were significantly worse in DLB than in AD patients (VOSP subtests scores 1, 6, 7 and 8) but were not different in DLB VH+ and VH-, except for subtest 6. Poor performance in the visual attention task was an independent predictor of VHs. Impairment of visual-spatial and perceptual abilities in DLB represents a disease related cognitive signature, independent of the presence of VHs, for which it may represent a predisposing condition. Visual attention, instead, is the main cognitive determinant for the genesis of VHs.

  5. Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS?

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    Taylor, Joseph J; Krystal, John H; D'Souza, Deepak C; Gerrard, Jason Lee; Corlett, Philip R

    2017-09-29

    The debilitating and refractory nature of auditory hallucinations (AH) in schizophrenia and other psychiatric disorders has stimulated investigations into neuromodulatory interventions that target the aberrant neural networks associated with them. Internal or invasive forms of brain stimulation such as deep brain stimulation (DBS) are currently being explored for treatment-refractory schizophrenia. The process of developing and implementing DBS is limited by symptom clustering within psychiatric constructs as well as a scarcity of causal tools with which to predict response, refine targeting or guide clinical decisions. Transcranial magnetic stimulation (TMS), an external or non-invasive form of brain stimulation, has shown some promise as a therapeutic intervention for AH but remains relatively underutilized as an investigational probe of clinically relevant neural networks. In this editorial, we propose that TMS has the potential to inform DBS by adding individualized causal evidence to an evaluation processes otherwise devoid of it in patients. Although there are significant limitations and safety concerns regarding DBS, the combination of TMS with computational modeling of neuroimaging and neurophysiological data could provide critical insights into more robust and adaptable network modulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Hear today, not gone tomorrow? An exploratory longitudinal study of auditory verbal hallucinations (hearing voices).

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    Hartigan, Nicky; McCarthy-Jones, Simon; Hayward, Mark

    2014-01-01

    Despite an increasing volume of cross-sectional work on auditory verbal hallucinations (hearing voices), there remains a paucity of work on how the experience may change over time. The first aim of this study was to attempt replication of a previous finding that beliefs about voices are enduring and stable, irrespective of changes in the severity of voices, and do not change without a specific intervention. The second aim was to examine whether voice-hearers' interrelations with their voices change over time, without a specific intervention. A 12-month longitudinal examination of these aspects of voices was undertaken with hearers in routine clinical treatment (N = 18). We found beliefs about voices' omnipotence and malevolence were stable over a 12-month period, as were styles of interrelating between voice and hearer, despite trends towards reductions in voice-related distress and disruption. However, there was a trend for beliefs about the benevolence of voices to decrease over time. Styles of interrelating between voice and hearer appear relatively stable and enduring, as are beliefs about the voices' malevolent intent and power. Although there was some evidence that beliefs about benevolence may reduce over time, the reasons for this were not clear. Our exploratory study was limited by only being powered to detect large effect sizes. Implications for clinical practice and future research are discussed.

  7. Auditory Verbal Hallucinations in Schizophrenia From a Levels of Explanation Perspective.

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    Hugdahl, Kenneth; Sommer, Iris E

    2018-02-15

    In the present article, we present a "Levels of Explanation" (LoE) approach to auditory verbal hallucinations (AVHs) in schizophrenia. Mental phenomena can be understood at different levels of explanation, including cultural, clinical, cognitive, brain imaging, cellular, and molecular levels. Current research on AVHs is characterized by accumulation of data at all levels, but with little or no interaction of findings between levels. A second advantage with a Levels of Explanation approach is that it fosters interdisciplinarity and collaboration across traditional borders, facilitating a real breakthrough in future research. We exemplify a Levels of Explanation approach with data from 3 levels where findings at 1 level provide predictions for another level. More specifically, we show how functional neuroimaging data at the brain level correspond with behavioral data at the cognitive level, and how data at these 2 levels correspond with recent findings of changes in neurotransmitter function at the cellular level. We further discuss implications for new therapeutic interventions, and the article is ended by suggestion how future research could incorporate genetic influences on AVHs at the molecular level of explanation by providing examples for animal work.

  8. Breaking Bad Delirium: Methamphetamine and Boric Acid Toxicity with Hallucinations and Pseudosepsis.

    Science.gov (United States)

    Johnson, Kayla; Stollings, Joanna L; Ely, E Wesley

    2017-02-01

    A 30-year-old patient presented with hallucinations and profound shock. He was initially misdiagnosed as having severe sepsis; once ingestions were considered, he was diagnosed as potentially having arsenic toxicity. The clinical story reveals many instructional lessons that could aid in the evaluation and management of future patients. This man presented with large amounts of blue crystals around his nose and lips from inhaling and eating boric acid (an ant poison) so he could, as he put it, kill the ants "pouring into my mouth and nose and up into my brain." His profound pseudosepsis and sustained delirium were induced by co-ingestion of methamphetamine and a large quantity of boric acid. Delirium is a form of acute brain dysfunction that often is multifactorial in critical illness and, when seen in septic shock, is associated with prolonged mechanical ventilation, increased length of hospital stay, medical costs, higher mortality, and long-term cognitive impairment resembling dementia. Pseudosepsis is a noninfectious condition most commonly seen with ingestions such as salicylate (aspirin) toxicity. This report emphasizes the need to recognize agents that contain boric acid as an etiology of unexplained delirium and profound shock.

  9. Stop, look, listen: the need for philosophical phenomenological perspectives on auditory verbal hallucinations

    Science.gov (United States)

    McCarthy-Jones, Simon; Krueger, Joel; Larøi, Frank; Broome, Matthew; Fernyhough, Charles

    2013-01-01

    One of the leading cognitive models of auditory verbal hallucinations (AVHs) proposes such experiences result from a disturbance in the process by which inner speech is attributed to the self. Research in this area has, however, proceeded in the absence of thorough cognitive and phenomenological investigations of the nature of inner speech, against which AVHs are implicitly or explicitly defined. In this paper we begin by introducing philosophical phenomenology and highlighting its relevance to AVHs, before briefly examining the evolving literature on the relation between inner experiences and AVHs. We then argue for the need for philosophical phenomenology (Phenomenology) and the traditional empirical methods of psychology for studying inner experience (phenomenology) to mutually inform each other to provide a richer and more nuanced picture of both inner experience and AVHs than either could on its own. A critical examination is undertaken of the leading model of AVHs derived from phenomenological philosophy, the ipseity disturbance model. From this we suggest issues that future work in this vein will need to consider, and examine how interdisciplinary methodologies may contribute to advances in our understanding of AVHs. Detailed suggestions are made for the direction and methodology of future work into AVHs, which we suggest should be undertaken in a context where phenomenology and physiology are both necessary, but neither sufficient. PMID:23576974

  10. Decreased middle temporal gyrus connectivity in the language network in schizophrenia patients with auditory verbal hallucinations.

    Science.gov (United States)

    Zhang, Linchuan; Li, Baojuan; Wang, Huaning; Li, Liang; Liao, Qimei; Liu, Yang; Bao, Xianghong; Liu, Wenlei; Yin, Hong; Lu, Hongbing; Tan, Qingrong

    2017-07-13

    As the most common symptoms of schizophrenia, the long-term persistence of obstinate auditory verbal hallucinations (AVHs) brings about great mental pain to patients. Neuroimaging studies of schizophrenia have indicated that AVHs were associated with altered functional and structural connectivity within the language network. However, effective connectivity that could reflect directed information flow within this network and is of great importance to understand the neural mechanisms of the disorder remains largely unknown. In this study, we utilized stochastic dynamic causal modeling (DCM) to investigate directed connections within the language network in schizophrenia patients with and without AVHs. Thirty-six patients with schizophrenia (18 with AVHs and 18 without AVHs), and 37 healthy controls participated in the current resting-state functional magnetic resonance imaging (fMRI) study. The results showed that the connection from the left inferior frontal gyrus (LIFG) to left middle temporal gyrus (LMTG) was significantly decreased in patients with AVHs compared to those without AVHs. Meanwhile, the effective connection from the left inferior parietal lobule (LIPL) to LMTG was significantly decreased compared to the healthy controls. Our findings suggest aberrant pattern of causal interactions within the language network in patients with AVHs, indicating that the hypoconnectivity or disrupted connection from frontal to temporal speech areas might be critical for the pathological basis of AVHs. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Scent of aura? Clinical features of olfactory hallucinations during a migraine attack (OHM).

    Science.gov (United States)

    Mainardi, Federico; Rapoport, Alan; Zanchin, Giorgio; Maggioni, Ferdinando

    2017-02-01

    Introduction Olfactory hallucination during a migraine attack (OHM) is a rare phenomenon. At present, it is not considered a manifestation of migraine aura. Material and methods The clinical features of OHM were collected in 11 patients. Results Of the 11 patients, 10 had migraine without aura and one migraine with aura associated with OHM. Mean age at onset of headache and at appearance of OHM were respectively 17.8 and 32.3 years. Migraine average frequency was 3.9 attacks/month, 19% of them being associated with OHM. The temporal pattern of OHM maintained the same characteristics in the different attacks. OHM onset was described as sudden ( n = 5), gradual ( n = 3), initially sudden and then gradual ( n = 2), or developing in a few seconds ( n = 1). In most of the cases ( n = 8) OHM lasted from 3 to 10 minutes; it persisted during the pain phase (2-24 hours) in only three patients. The type of the perceived smell was invariably constant in nine patients. Conclusion OHM features fulfilled the ICHD-III beta criteria for typical aura.

  12. Short and long term effects of left and bilateral repetitive transcranial magnetic stimulation in schizophrenia patients with auditory verbal hallucinations: a randomized controlled trial.

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    Leonie Bais

    Full Text Available BACKGROUND: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal hallucinations, no studies have used bilateral stimulation. Moreover, little is known about durability effects. We studied the short and long term effects of 1 Hz treatment of the left temporo-parietal junction area in schizophrenia patients with persistent auditory verbal hallucinations, compared to sham stimulation, and added an extra treatment arm of bilateral TPJ area stimulation. METHODS: In this randomized controlled trial, 51 patients diagnosed with schizophrenia and persistent auditory verbal hallucinations were randomly allocated to treatment of the left or bilateral temporo-parietal junction area or sham treatment. Patients were treated for six days, twice daily for 20 minutes. Short term efficacy was measured with the Positive and Negative Syndrome Scale (PANSS, the Auditory Hallucinations Rating Scale (AHRS, and the Positive and Negative Affect Scale (PANAS. We included follow-up measures with the AHRS and PANAS at four weeks and three months. RESULTS: The interaction between time and treatment for Hallucination item P3 of the PANSS showed a trend for significance, caused by a small reduction of scores in the left group. Although self-reported hallucination scores, as measured with the AHRS and PANAS, decreased significantly during the trial period, there were no differences between the three treatment groups. CONCLUSION: We did not find convincing evidence for the efficacy of left-sided rTMS, compared to sham rTMS. Moreover, bilateral rTMS was not superior over left rTMS or sham in improving AVH. Optimizing treatment parameters may result in stronger evidence for the efficacy of rTMS treatment of AVH. Moreover, future research should consider

  13. Aberrant connectivity of areas for decoding degraded speech in patients with auditory verbal hallucinations.

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    Clos, Mareike; Diederen, Kelly M J; Meijering, Anne Lotte; Sommer, Iris E; Eickhoff, Simon B

    2014-03-01

    Auditory verbal hallucinations (AVH) are a hallmark of psychotic experience. Various mechanisms including misattribution of inner speech and imbalance between bottom-up and top-down factors in auditory perception potentially due to aberrant connectivity between frontal and temporo-parietal areas have been suggested to underlie AVH. Experimental evidence for disturbed connectivity of networks sustaining auditory-verbal processing is, however, sparse. We compared functional resting-state connectivity in 49 psychotic patients with frequent AVH and 49 matched controls. The analysis was seeded from the left middle temporal gyrus (MTG), thalamus, angular gyrus (AG) and inferior frontal gyrus (IFG) as these regions are implicated in extracting meaning from impoverished speech-like sounds. Aberrant connectivity was found for all seeds. Decreased connectivity was observed between the left MTG and its right homotope, between the left AG and the surrounding inferior parietal cortex (IPC) and the left inferior temporal gyrus, between the left thalamus and the right cerebellum, as well as between the left IFG and left IPC, and dorsolateral and ventrolateral prefrontal cortex (DLPFC/VLPFC). Increased connectivity was observed between the left IFG and the supplementary motor area (SMA) and the left insula and between the left thalamus and the left fusiform gyrus/hippocampus. The predisposition to experience AVH might result from decoupling between the speech production system (IFG, insula and SMA) and the self-monitoring system (DLPFC, VLPFC, IPC) leading to misattribution of inner speech. Furthermore, decreased connectivity between nodes involved in speech processing (AG, MTG) and other regions implicated in auditory processing might reflect aberrant top-down influences in AVH.

  14. Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial.

    Science.gov (United States)

    du Sert, Olivier Percie; Potvin, Stéphane; Lipp, Olivier; Dellazizzo, Laura; Laurelli, Mélanie; Breton, Richard; Lalonde, Pierre; Phraxayavong, Kingsada; O'Connor, Kieron; Pelletier, Jean-François; Boukhalfi, Tarik; Renaud, Patrice; Dumais, Alexandre

    2018-02-24

    Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7weeks of VRT. A follow-up was ensured 3months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d=1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia. Copyright © 2018. Published by Elsevier B.V.

  15. Discrimination of schizophrenia auditory hallucinators by machine learning of resting-state functional MRI.

    Science.gov (United States)

    Chyzhyk, Darya; Graña, Manuel; Öngür, Döst; Shinn, Ann K

    2015-05-01

    Auditory hallucinations (AH) are a symptom that is most often associated with schizophrenia, but patients with other neuropsychiatric conditions, and even a small percentage of healthy individuals, may also experience AH. Elucidating the neural mechanisms underlying AH in schizophrenia may offer insight into the pathophysiology associated with AH more broadly across multiple neuropsychiatric disease conditions. In this paper, we address the problem of classifying schizophrenia patients with and without a history of AH, and healthy control (HC) subjects. To this end, we performed feature extraction from resting state functional magnetic resonance imaging (rsfMRI) data and applied machine learning classifiers, testing two kinds of neuroimaging features: (a) functional connectivity (FC) measures computed by lattice auto-associative memories (LAAM), and (b) local activity (LA) measures, including regional homogeneity (ReHo) and fractional amplitude of low frequency fluctuations (fALFF). We show that it is possible to perform classification within each pair of subject groups with high accuracy. Discrimination between patients with and without lifetime AH was highest, while discrimination between schizophrenia patients and HC participants was worst, suggesting that classification according to the symptom dimension of AH may be more valid than discrimination on the basis of traditional diagnostic categories. FC measures seeded in right Heschl's gyrus (RHG) consistently showed stronger discriminative power than those seeded in left Heschl's gyrus (LHG), a finding that appears to support AH models focusing on right hemisphere abnormalities. The cortical brain localizations derived from the features with strong classification performance are consistent with proposed AH models, and include left inferior frontal gyrus (IFG), parahippocampal gyri, the cingulate cortex, as well as several temporal and prefrontal cortical brain regions. Overall, the observed findings suggest that

  16. Childhood traumatic events and types of auditory verbal hallucinations in first-episode schizophrenia patients.

    Science.gov (United States)

    Misiak, Błażej; Moustafa, Ahmed A; Kiejna, Andrzej; Frydecka, Dorota

    2016-04-01

    Evidence is accumulating that childhood trauma might be associated with higher severity of positive symptoms in patients with psychosis and higher incidence of psychotic experiences in non-clinical populations. However, it remains unknown whether the history of childhood trauma might be associated with particular types of auditory verbal hallucinations (AVH). We assessed childhood trauma using the Early Trauma Inventory Self-Report - Short Form (ETISR-SF) in 94 first-episode schizophrenia (FES) patients. Lifetime psychopathology was evaluated using the Operational Criteria for Psychotic Illness (OPCRIT) checklist, while symptoms on the day of assessment were examined using the Positive and Negative Syndrome Scale (PANSS). Based on ETISR-SF, patients were divided into those with and without the history of childhood trauma: FES(+) and FES(-) patients. FES(+) patients had significantly higher total number of AVH types and Schneiderian first-rank AVH as well as significantly higher PANSS P3 item score (hallucinatory behavior) in comparison with FES(-) patients. They experienced significantly more frequently third person AVH and abusive/accusatory/persecutory voices. These differences remained significant after controlling for education, PANSS depression factor score and chlorpromazine equivalent. Linear regression analysis revealed that the total number of AVH types was predicted by sexual abuse score after controlling for above mentioned confounders. This effect was significant only in females. Our results indicate that the history of childhood trauma, especially sexual abuse, is associated with higher number AVH in females but not in males. Third person AVH and abusive/accusatory/persecutory voices, representing Schneiderian first-rank symptoms, might be particularly related to childhood traumatic events. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Graph theory reveals dysconnected hubs in 22q11DS and altered nodal efficiency in patients with hallucinations

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    Marie-Christine eOttet

    2013-09-01

    Full Text Available Schizophrenia is postulated to be the prototypical dysconnection disorder, in which hallucinations are the core symptom. Due to high heterogeneity in methodology across studies and the clinical phenotype, it remains unclear whether the structural brain dysconnection is global or focal and if clinical symptoms result from this dysconnection. In the present work, we attempt to clarify this issue by studying a population considered as a homogeneous genetic sub-type of schizophrenia, namely the 22q11.2 deletion syndrome (22q11.2DS. Cerebral MRIs were acquired for 46 patients and 48 age and gender matched controls (aged 6 to 26, respectively mean age = 15.20 ± 4.53 and 15.28 ± 4.35 years old. Using the Connectome mapper pipeline (connectomics.org that combines structural and diffusion MRI, we created a whole brain network for each individual. The graph theory was used to quantify the global and local properties in the brain network organization for each participant. A global degree loss of 6% was found in patients’ network along with an increased Characteristic Path Length. After identifying and comparing hubs, a significant loss of degree in patients’ hubs was found in 58% of them. Based on Allen’s brain network model for hallucinations, we explored the association between local efficiency and symptom severity. Negative correlations were found in the Broca’s area (p<0.004, the Wernicke area (p<0.023 and a positive correlation was found in the dorsolateral prefrontal cortex (DLPFC (p<0.014. In line with the dysconnection findings in schizophrenia, our results provide preliminary evidence for a targeted alteration in the brain network hubs’organisation in individuals with a genetic risk for schizophrenia. The study of specific disorganization in language, speech and thought regulation networks sharing similar network properties may help to understand their role in the hallucination mechanism.

  18. Why people see things that are not there: a novel Perception and Attention Deficit model for recurrent complex visual hallucinations.

    Science.gov (United States)

    Collerton, Daniel; Perry, Elaine; McKeith, Ian

    2005-12-01

    As many as two million people in the United Kingdom repeatedly see people, animals, and objects that have no objective reality. Hallucinations on the border of sleep, dementing illnesses, delirium, eye disease, and schizophrenia account for 90% of these. The remainder have rarer disorders. We review existing models of recurrent complex visual hallucinations (RCVH) in the awake person, including cortical irritation, cortical hyperexcitability and cortical release, top-down activation, misperception, dream intrusion, and interactive models. We provide evidence that these can neither fully account for the phenomenology of RCVH, nor for variations in the frequency of RCVH in different disorders. We propose a novel Perception and Attention Deficit (PAD) model for RCVH. A combination of impaired attentional binding and poor sensory activation of a correct proto-object, in conjunction with a relatively intact scene representation, bias perception to allow the intrusion of a hallucinatory proto-object into a scene perception. Incorporation of this image into a context-specific hallucinatory scene representation accounts for repetitive hallucinations. We suggest that these impairments are underpinned by disturbances in a lateral frontal cortex-ventral visual stream system. We show how the frequency of RCVH in different diseases is related to the coexistence of attentional and visual perceptual impairments; how attentional and perceptual processes can account for their phenomenology; and that diseases and other states with high rates of RCVH have cholinergic dysfunction in both frontal cortex and the ventral visual stream. Several tests of the model are indicated, together with a number of treatment options that it generates.

  19. The prevalence of visual hallucinations in non-affective psychosis, and the role of perception and attention.

    Science.gov (United States)

    van Ommen, M M; van Beilen, M; Cornelissen, F W; Smid, H G O M; Knegtering, H; Aleman, A; van Laar, T

    2016-06-01

    Little is known about visual hallucinations (VH) in psychosis. We investigated the prevalence and the role of bottom-up and top-down processing in VH. The prevailing view is that VH are probably related to altered top-down processing, rather than to distorted bottom-up processing. Conversely, VH in Parkinson's disease are associated with impaired visual perception and attention, as proposed by the Perception and Attention Deficit (PAD) model. Auditory hallucinations (AH) in psychosis, however, are thought to be related to increased attention. Our retrospective database study included 1119 patients with non-affective psychosis and 586 controls. The Community Assessment of Psychic Experiences established the VH rate. Scores on visual perception tests [Degraded Facial Affect Recognition (DFAR), Benton Facial Recognition Task] and attention tests [Response Set-shifting Task, Continuous Performance Test-HQ (CPT-HQ)] were compared between 75 VH patients, 706 non-VH patients and 485 non-VH controls. The lifetime VH rate was 37%. The patient groups performed similarly on cognitive tasks; both groups showed worse perception (DFAR) than controls. Non-VH patients showed worse attention (CPT-HQ) than controls, whereas VH patients did not perform differently. We did not find significant VH-related impairments in bottom-up processing or direct top-down alterations. However, the results suggest a relatively spared attentional performance in VH patients, whereas face perception and processing speed were equally impaired in both patient groups relative to controls. This would match better with the increased attention hypothesis than with the PAD model. Our finding that VH frequently co-occur with AH may support an increased attention-induced 'hallucination proneness'.

  20. A Comprehensive Review of Auditory Verbal Hallucinations: Lifetime Prevalence, Correlates and Mechanisms in Healthy and Clinical Individuals

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    Saskia ede Leede-Smith

    2013-07-01

    Full Text Available Over the years, the prevalence of auditory verbal hallucinations (AVH has been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span. The stages described include childhood, adolescence, adult non-clinical populations, hypnaogogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s. This includes features of the voices such as the negative content, frequency and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example; the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the comparison of underlying

  1. A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals.

    Science.gov (United States)

    de Leede-Smith, Saskia; Barkus, Emma

    2013-01-01

    Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the

  2. A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals

    Science.gov (United States)

    de Leede-Smith, Saskia; Barkus, Emma

    2013-01-01

    Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the

  3. Visual Hallucinations as Incidental Negative Effects of Virtual Reality on Parkinson’s Disease Patients: A Link with Neurodegeneration?

    Directory of Open Access Journals (Sweden)

    Giovanni Albani

    2015-01-01

    Full Text Available We followed up a series of 23 Parkinson’s disease (PD patients who had performed an immersive virtual reality (VR protocol eight years before. On that occasion, six patients incidentally described visual hallucinations (VH with occurrences of images not included in the virtual environment. Curiously, in the following years, only these patients reported the appearance of VH later in their clinical history, while the rest of the group did not. Even considering the limited sample size, we may argue that VR immersive systems can induce unpleasant effects in PD patients who are predisposed to a cognitive impairment.

  4. Cognitive Behavioral Therapy Compared with Non-specialized Therapy for Alleviating the Effect of Auditory Hallucinations in People with Reoccurring Schizophrenia: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Kennedy, Laura; Xyrichis, Andreas

    2017-02-01

    Cognitive behavioral therapy (CBT) is recommended as a psychological intervention for those diagnosed with schizophrenia. The prevalence of auditory hallucinations is high among this group, many of whom are cared for by community mental health teams that may not have easy access to qualified CBT practitioners. This systematic review examined the evidence for the superiority of CBT compared to non-specialized therapy in alleviating auditory hallucinations in community patients with schizophrenia. Two RCTs met the inclusion criteria totaling 105 participants. The Positive and Negative Syndrome Scale (PANSS)-Positive Scale was the outcome measure examined. A meta-analysis revealed a pooled mean difference of -0.86 [95 % CI -2.38, 0.65] in favor of CBT, although this did not reach statistical significance. This systematic review concluded there is no clinically significant difference in the reduction of positive symptoms of schizophrenia when treated by CBT compared to a non-specialized therapy for adults experiencing auditory hallucinations.

  5. 'The devil lay upon her and held her down'. Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664.

    Science.gov (United States)

    Kompanje, E J O

    2008-12-01

    Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664, the Dutch physician Isbrand Van Diemerbroeck (1609-1674) published a collection of case histories. One history with the title 'Of the Night-Mare' describes the nightly experiences of the 50-year-old woman. This case report is subject of this article. The experiences in this case could without doubt be diagnosed as sleep paralysis accompanied by hypnagogic hallucinations. This case from 1664 should be cited as the earliest detailed account of sleep paralysis associated with hypnagogic illusions and as the first observation that sleep paralysis and hypnagogic experiences occur more often in supine position of the body.

  6. External misattribution of internal thoughts and proneness to auditory hallucinations: the effect of emotional valence in the Deese–Roediger–McDermott paradigm

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    Mari eKanemoto

    2013-07-01

    Full Text Available Previous studies have suggested that a tendency to externalize internal thought is related to auditory hallucinations or even proneness to auditory hallucinations (AHp in the general population. However, although auditory hallucinations are related to emotional phenomena, few studies have investigated the effect of emotional valence on the aforementioned relationship. In addition, we do not know what component of psychotic phenomena relate to externalizing bias. The current study replicated our previous research, which suggested that individual differences in auditory hallucination-like experiences are strongly correlated with the external misattribution of internal thoughts, conceptualized in terms of false memory, using the Deese–Roediger–McDermott (DRM paradigm. We found a significant relationship between experimental performance and total scores on the Launay–Slade Hallucination Scale (LSHS. Among the LSHS factors, only vivid mental image, which is said to be a predictor of auditory hallucinations, was significantly related to experimental performance.We then investigated the potential effect of emotional valence using the DRM paradigm. The results indicate that participants with low scores on the LSHS (the low-AHp group in the current study showed an increased discriminability index (d' for positive words and a decreased d' for negative words. However, no effects of emotional valence were found for participants with high LSHS scores (high-AHp group. This study indicated that external misattribution of internal thoughts predicts AHp, and that the high-AHp group showed a smaller emotional valence effect in the DRM paradigm compared with the low-AHp group. We discuss this outcome from the perspective of the dual-process activation-monitoring framework in the DRM paradigm in regard to emotion-driven automatic thought in false memory.

  7. Association of religion with delusions and hallucinations in the context of schizophrenia: implications for engagement and adherence.

    Science.gov (United States)

    Gearing, Robin Edward; Alonzo, Dana; Smolak, Alex; McHugh, Katie; Harmon, Sherelle; Baldwin, Susanna

    2011-03-01

    The relationship of religion and schizophrenia is widely acknowledged, but often minimized by practitioners and under investigated by researchers. In striving to help fill this gap, this paper focuses on examining four aims: 1) how research has investigated the association between religiosity and schizophrenia; 2) how is religiosity associated with delusions and hallucinations; 3) what are the risk and protective factors associated with religiosity and schizophrenia; and 4) does religion influence treatment adherence with individuals diagnosed with schizophrenia. A systematic literature search of PsycINFO and MEDLINE databases from January 1, 1980 through January 1, 2010 was conducted using the terms schizophrenia, schizoaffective, schizophreniform, psychotic disorder not otherwise specified (NOS) and religion, religiosity, spirituality, or faith. Seventy (n=70) original research studies were identified. Religion can act as both a risk and protective factor as it interacts with the schizophrenia symptoms of hallucination and delusions. Cultural influences tend to confound the association of religion and schizophrenia. Adherence to treatment has a mixed association with religiosity. The relationship between religion and schizophrenia may be of benefit to both clinicians and researchers through enhancing adherence to treatment, and enhancement of the protective aspects while minimizing associated risk. The relationship of religion and schizophrenia needs further research that is more nuanced and methodologically rigorous, specifically concerning its influence on engagement and adherence to treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

  8. Impact of Repetitive Transcranial Magnetic Stimulation (rTMS on Brain Functional Marker of Auditory Hallucinations in Schizophrenia Patients

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    Sonia Dollfus

    2013-04-01

    Full Text Available Several cross-sectional functional Magnetic Resonance Imaging (fMRI studies reported a negative correlation between auditory verbal hallucination (AVH severity and amplitude of the activations during language tasks. The present study assessed the time course of this correlation and its possible structural underpinnings by combining structural, functional MRI and repetitive Transcranial Magnetic Stimulation (rTMS. Methods: Nine schizophrenia patients with AVH (evaluated with the Auditory Hallucination Rating scale; AHRS and nine healthy participants underwent two sessions of an fMRI speech listening paradigm. Meanwhile, patients received high frequency (20 Hz rTMS. Results: Before rTMS, activations were negatively correlated with AHRS in a left posterior superior temporal sulcus (pSTS cluster, considered henceforward as a functional region of interest (fROI. After rTMS, activations in this fROI no longer correlated with AHRS. This decoupling was explained by a significant decrease of AHRS scores after rTMS that contrasted with a relative stability of cerebral activations. A voxel-based-morphometry analysis evidenced a cluster of the left pSTS where grey matter volume negatively correlated with AHRS before rTMS and positively correlated with activations in the fROI at both sessions. Conclusion: rTMS decreases the severity of AVH leading to modify the functional correlate of AVH underlain by grey matter abnormalities.

  9. Auditory verbal hallucinations are related to cortical thinning in the left middle temporal gyrus of patients with schizophrenia.

    Science.gov (United States)

    Cui, Y; Liu, B; Song, M; Lipnicki, D M; Li, J; Xie, S; Chen, Y; Li, P; Lu, L; Lv, L; Wang, H; Yan, H; Yan, J; Zhang, H; Zhang, D; Jiang, T

    2018-01-01

    Auditory verbal hallucinations (AVHs) are one of the most common and severe symptoms of schizophrenia, but the neuroanatomical abnormalities underlying AVHs are not well understood. The present study aims to investigate whether AVHs are associated with cortical thinning. Participants were schizophrenia patients from four centers across China, 115 with AVHs and 93 without AVHs, as well as 261 healthy controls. All received 3 T T1-weighted brain scans, and whole brain vertex-wise cortical thickness was compared across groups. Correlations between AVH severity and cortical thickness were also determined. The left middle part of the middle temporal gyrus (MTG) was significantly thinner in schizophrenia patients with AVHs than in patients without AVHs and healthy controls. Inferences were made using a false discovery rate approach with a threshold at p < 0.05. Left MTG thickness did not differ between patients without AVHs and controls. These results were replicated by a meta-analysis showing them to be consistent across the four centers. Cortical thickness of the left MTG was also found to be inversely correlated with hallucination severity across all schizophrenia patients. The results of this multi-center study suggest that an abnormally thin left MTG could be involved in the pathogenesis of AVHs in schizophrenia.

  10. Repeated measurements of cerebral blood flow in the left superior temporal gyrus reveal tonic hyperactivity in patients with auditory verbal hallucinations: A possible trait marker

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    Philipp eHoman

    2013-06-01

    Full Text Available Background: The left superior temporal gyrus (STG has been suggested to play a key role in auditory verbal hallucinations in patients with schizophrenia. Methods: Eleven medicated subjects with schizophrenia and medication-resistant auditory verbal hallucinations and 19 healthy controls underwent perfusion magnetic resonance imaging with arterial spin labeling. Three additional repeated measurements were conducted in the patients. Patients underwent a treatment with transcranial magnetic stimulation (TMS between the first 2 measurements. The main outcome measure was the pooled cerebral blood flow (CBF, which consisted of the regional CBF measurement in the left superior temporal gyrus (STG and the global CBF measurement in the whole brain.Results: Regional CBF in the left STG in patients was significantly higher compared to controls (p < 0.0001 and to the global CBF in patients (p < 0.004 at baseline. Regional CBF in the left STG remained significantly increased compared to the global CBF in patients across time (p < 0.0007, and it remained increased in patients after TMS compared to the baseline CBF in controls (p < 0.0001. After TMS, PANSS (p = 0.003 and PSYRATS (p = 0.01 scores decreased significantly in patients.Conclusions: This study demonstrated tonically increased regional CBF in the left STG in patients with schizophrenia and auditory hallucinations despite a decrease in symptoms after TMS. These findings were consistent with what has previously been termed a trait marker of auditory verbal hallucinations in schizophrenia.

  11. A clinical study of auditory hallucination by single photon emission computed tomography (SPECT) using N-isopropyl-p-[123I] iodoamphetamine (IMP)

    International Nuclear Information System (INIS)

    Gyobu, Tsuyoshi; Inao, Gyoshun; Ii, Masayasu; Matsuda, Hiroshi; Hisada, Kinichi.

    1988-01-01

    SPECT images with N-isopropyl-p-I-123 iodoamphetamine (IMP) were reviewed in 24 right-handed patients with hallucination (H Group), comprising schizophrenic disorder (20), alcohol hallucinosis (2), epileptic hallucinosis (one), and organic mental disorder (one), and 50 subjects without hallucination (non-H Group), consisting of 39 patients with mental or organic central nervous system disorder and 11 healthy volunteers. Early SPECT images showed an increased uptake of IMP in the auditory area and angular gyrus in 23 patients of H Group and 3 persons of non-H Group. A similar uptake of IMP was seen on delayed SPECT images in 12 patients of H Group and 4 patients with a history of hallucination of non-H Group. There were no SPECT findings specific to diseases. For schizophrenic patients, increased and decreased uptakes of IMP were seen in the striatolimbic region and in the bilateral frontal lobes, respectively, irrespective of hallucination. Factors contributing to increased uptake of IMP are discussed. (Namekawa, K.) 84 refs

  12. Resting-state functional connectivity in medication-naïve schizophrenia patients with and without auditory verbal hallucinations : A preliminary report

    NARCIS (Netherlands)

    Chang, Xiao; Collin, Guusje; Xi, Yibin; Cui, Longbiao; Scholtens, Lianne H.; Sommer, Iris E.; Wang, Huaning; Yin, Hong; Kahn, René S.; van den Heuvel, Martijn P.

    2017-01-01

    Auditory verbal hallucinations (AVH) are a cardinal feature of schizophrenia that has been associated with activation in language processing areas, in concert with higher-order cognitive brain networks. It remains to be determined whether, and if so how, the functional dynamics between these brain

  13. Voxel-based gray and white matter morphometry correlates of hallucinations in schizophrenia: The superior temporal gyrus does not stand alone.

    Science.gov (United States)

    van Tol, Marie-José; van der Meer, Lisette; Bruggeman, Richard; Modinos, Gemma; Knegtering, Henderikus; Aleman, André

    2014-01-01

    Auditory verbal hallucinations (AVH) in schizophrenia (SZ) have been proposed to result from abnormal local, interregional and interhemispheric integration of brain signals in regions involved in language production and perception. This abnormal functional integration may find its base in morphological abnormalities. Structurally, AVHs have been frequently linked to abnormal morphology of the superior temporal gyrus (STG), but only a few studies investigated the relation of hallucination presence with both whole-brain gray matter (GM) and white matter (WM) morphometry. Using a unified voxel-based morphometry-DARTEL approach, we investigated correlates of AVH presence in 51 schizophrenia patients (20 non-hallucinating [SZ -], 31 hallucinating [SZ +]), and included 51 age and sex matched healthy participants. Effects are reported at p frontal and right parahippocampal gyrus, and higher WM volume of the left postcentral and superior parietal lobule than controls. Finally, volume of the putamen was lower in SZ + compared to SZ -. No effects on corpus callosum morphometry were observed. Delusion severity, general positive and negative symptomatology illness duration, and medication status could not explain the results. Results suggest that STG GM abnormalities underlie the general susceptibility to experience psychotic symptoms and that additional abnormalities in a network of medial temporal, ventrolateral, putaminal, and parietal regions related to verbal memory and speech production may specifically increase the likelihood of experiencing AVH. Future studies should clarify the meaning of morphometry abnormalities for functional interregional communication.

  14. [The Effects of Auditory Hallucination Simulation on Empathy, Knowledge, Social Distance, and Attitudes Toward Patients With Mental Illness Among Undergraduate Students: A Systemic Review and Meta-Analysis].

    Science.gov (United States)

    Lee, Ming-Feng; Lin, Ching-Lan Esther

    2017-10-01

    The negative attitudes of the general public toward mental illness frequently influence the integration of mental illness patients into the community. Auditory hallucination simulation may be considered as a creative teaching strategy to improve the attitudes of learners toward mental illness. However, the empirical effects of auditory hallucination simulation to change the negative attitudes toward mental illness remains uncertain. To compare and analyze, using a systematic review and meta-analysis, the effectiveness of auditory hallucination simulation in improving empathy, knowledge, social distance, and attitudes toward mental illness in undergraduates. A search using the keywords "auditory hallucination" and "simulation" and the 4 outcome indicators of empathy, knowledge, social distance, and attitudes toward mental illness was conducted to identify related articles published between 2008 and 2016 in 6 Chinese and English electronic databases, including Cochrane Library, EBSCO-CINAHL, MEDLINE, PsycINFO, PubMed, and Airiti Library. Research quality was appraised using the Modified Jadad Scale (MJS), the Oxford Centre for Evidence-Based Medicine Level of Evidence (OCEBM LoE), and the Cochrane Risk of Bias tool. Eleven studies were recruited, and 7 studies with sufficient data were included in the meta-analysis. The meta-analysis showed that hallucination simulation significantly improved the empathy and knowledge of participants, with respective effect sizes of 0.63 (95% CI [0.21, 1.05]) and 0.69 (95% CI [0.43-0.94]). However, this intervention also increased social distance, with an effect size of 0.60 (95% CI [0.01, 1.19]), and did not change attitudes toward mental illness significantly, with an effect size of 0.33 (95% CI [-0.11, 0.77]). Auditory hallucination simulation is an effective teaching strategy for improving the empathy and knowledge of undergraduates. However, related evidence for the effects of social distance and attitudes toward mental illness

  15. Reduced neuronal activity in language-related regions after transcranial magnetic stimulation therapy for auditory verbal hallucinations.

    Science.gov (United States)

    Kindler, Jochen; Homan, Philipp; Jann, Kay; Federspiel, Andrea; Flury, Richard; Hauf, Martinus; Strik, Werner; Dierks, Thomas; Hubl, Daniela

    2013-03-15

    Transcranial magnetic stimulation (TMS) is a novel therapeutic approach, used in patients with pharmacoresistant auditory verbal hallucinations (AVH). To investigate the neurobiological effects of TMS on AVH, we measured cerebral blood flow with pseudo-continuous magnetic resonance-arterial spin labeling 20 ± 6 hours before and after TMS treatment. Thirty patients with schizophrenia or schizoaffective disorder were investigated. Fifteen patients received a 10-day TMS treatment to the left temporoparietal cortex, and 15 received the standard treatment. The stimulation location was chosen according to an individually determined language region determined by a functional magnetic resonance imaging language paradigm, which identified the sensorimotor language area, area Spt (sylvian parietotemporal), as the target region. TMS-treated patients showed positive clinical effects, which were indicated by a reduction in AVH scores (p ≤ .001). Cerebral blood flow was significantly decreased in the primary auditory cortex (p ≤ .001), left Broca's area (p ≤ .001), and cingulate gyrus (p ≤ .001). In control subjects, neither positive clinical effects nor cerebral blood flow decreases were detected. The decrease in cerebral blood flow in the primary auditory cortex correlated with the decrease in AVH scores (p ≤ .001). TMS reverses hyperactivity of language regions involved in the emergence of AVH. Area Spt acts as a gateway to the hallucination-generating cerebral network. Successful therapy corresponded to decreased cerebral blood flow in the primary auditory cortex, supporting its crucial role in triggering AVH and contributing to the physical quality of the false perceptions. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  16. Clinico-Epidemiological Comparison of Delusion-Prominent and Hallucination-Prominent Clinical Subgroups of Paranoid Schizophrenia.

    Science.gov (United States)

    Kreinin, Anatoly; Krishtul, Vladimir; Kirsh, Zvi; Menuchin, Michael

    2015-01-01

    Though hallucinations and delusions are prominent basic impairments in schizophrenia, reports of the relationship between hallucinatory and delusional symptoms among schizophrenia patients are scant. To examine the epidemiological and clinical differences between mainly hallucinatory and mainly delusional subgroups of paranoid schizophrenia patients. One hundred schizophrenia patients, paranoid type, were recruited. In a cross-sectional study, participants were divided into Mainly Hallucinatory (H) and Mainly Delusional (D) subgroups. Demographic variables were compared and clinical characteristics were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Clinical Global Impression Scale. The Quality-of-Life Enjoyment and Satisfaction Questionnaire-18 was used to assess quality of life. Clinically, the H group was more heterogeneous as expressed by the broader range of scores that described the clinical picture of patients in that subgroup (in 43 of 78 variables, 55.13%) and similar ranges of scores (31 of 78 variables, 39.74%) for patients in the D group. Duration of hospitalization was significantly longer in group H than in group D (p=0.047). There was no statistically significant difference between the H and D subgroups in demographic characteristics. There are distinct epidemiological and clinical differences between the H and D subgroups, with more severe positive and negative symptoms and greater functional impairment in the H group. Paranoid schizophrenia patients with prominent hallucinations have poorer prognosis and need intensive therapeutic rehabilitation beginning with onset-of-illness. Further genetic studies and comparisons of fMRI and/or PET findings are warranted to investigate additional distinctive characteristics of these subgroups.

  17. Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy?

    Science.gov (United States)

    Daalman, K; Diederen, K M J; Hoekema, L; van Lutterveld, R; Sommer, I E C

    2016-07-01

    Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls). Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale. Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group. These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.

  18. L’hallucination de la connaissance : La Tentation de saint Antoine de Flaubert

    Directory of Open Access Journals (Sweden)

    Dagmar Stöferle

    2010-12-01

    Full Text Available En représentant les démons dans la Tentation de saint Antoine, Flaubert transforme un concept chrétien par un concept psychologique élaboré par Alfred Maury, à savoir celui de l’hallucination hypnagogique. Mais ce n’est qu’à travers les différentes variantes du texte qu’on peut observer ce processus de substitution. Dans la première version de 1849, les apparitions sont toujours appelées des « démons ». Quand on lit Die christliche Mystik de Joseph von Görres que Flaubert a connu par la traduction de Charles Sainte-Foi (La mystique divine, naturelle et diabolique, Paris, 1862 on peut faire une découverte intéressante : Görres opère une distinction entre une « vraie » mystique chrétienne et une « fausse » mystique démoniaque. Ce qui là s’appelle l’extase est ici la possession par les démons. Toute la démonologie est expliquée par une conception hérétique du Mal, laquelle repose sur une fausse substantialisation, et dont il voit la manifestation la plus pure dans la religion gnostique du manichéisme. Or, comme l’on sait, Antoine est fortement attiré par la Gnose qui est, au sens grec du terme, une religion de la connaissance. Avec les adhérents de la Gnose il partage le dualisme entre un monde matériel, terrestre et un principe premier d’essence divine dans l’au-delà. Ainsi faut-il se poser la question s’il réussit finalement à surmonter le dualisme en recevant la connaissance ou bien si les dualismes continuent à persister dans le texte. La lecture de la Tentation mène à un double résultat : D’un point de vue macro-structurel, l’élément gnostique reste le non-surmontement du dualisme, lequel s’exprime sur le plan rhétorique par la résistance de l’allégorique dans le texte. En revanche, à la fin du texte, le dualisme est surmonté une seule fois dans la mise en scène d’une inversion du monisme (être-dans-le-monde et du dualisme (acosmisme.Representing the demons

  19. Seduction as a Game of Reversals and Death. Understanding Jean Baudrillard’s Seduction through Patricia Duncker’s Hallucinating Foucault (La seducción como un juego de inversiones y muerte. Comprender Seduction, de Jean Baudrillard mediante Hallucinating Foucault, de Patricia Duncker

    Directory of Open Access Journals (Sweden)

    Alejandra Giangiulio Lobo

    2014-11-01

    Full Text Available Se estudia la teoría de la seducción de Jean Baudrillard mediante el análisis de la novela Hallucinating Foucault, de Patricia Duncker, para mostrar que el proceso de lectura es un acto seductor y un juego obsesivo entre lector y escritor. Estas características se comprueban con la inversión de las jerarquías presentes, del cambio de roles y de una muerte literal y metafórica. Hallucinating Foucault muestra la complejidad entre lector y escritor, vistos como compañeros de juego, parte de una relación que respectivamente alimenta su imaginación y su creatividad. Jean Baudrillard’s theory of seduction is studied by the analysis of the novel Hallucinating Foucault, by Patricia Duncker, to verify that the process of reading is a seductive act and a compulsive game among readers and writers. These features are shown by the reversal of the hierarchies present, the changing of roles and a literal and metaphorical death. Thus, Hallucinating Foucault shows the complexity between readers and writers, seen as playmates and partners that mutually feed one another’s imagination and creativity.

  20. Activation of serotonin 2A receptors underlies the psilocybin-induced effects on α oscillations, N170 visual-evoked potentials, and visual hallucinations.

    Science.gov (United States)

    Kometer, Michael; Schmidt, André; Jäncke, Lutz; Vollenweider, Franz X

    2013-06-19

    Visual illusions and hallucinations are hallmarks of serotonergic hallucinogen-induced altered states of consciousness. Although the serotonergic hallucinogen psilocybin activates multiple serotonin (5-HT) receptors, recent evidence suggests that activation of 5-HT2A receptors may lead to the formation of visual hallucinations by increasing cortical excitability and altering visual-evoked cortical responses. To address this hypothesis, we assessed the effects of psilocybin (215 μg/kg vs placebo) on both α oscillations that regulate cortical excitability and early visual-evoked P1 and N170 potentials in healthy human subjects. To further disentangle the specific contributions of 5-HT2A receptors, subjects were additionally pretreated with the preferential 5-HT2A receptor antagonist ketanserin (50 mg vs placebo). We found that psilocybin strongly decreased prestimulus parieto-occipital α power values, thus precluding a subsequent stimulus-induced α power decrease. Furthermore, psilocybin strongly decreased N170 potentials associated with the appearance of visual perceptual alterations, including visual hallucinations. All of these effects were blocked by pretreatment with the 5-HT2A antagonist ketanserin, indicating that activation of 5-HT2A receptors by psilocybin profoundly modulates the neurophysiological and phenomenological indices of visual processing. Specifically, activation of 5-HT2A receptors may induce a processing mode in which stimulus-driven cortical excitation is overwhelmed by spontaneous neuronal excitation through the modulation of α oscillations. Furthermore, the observed reduction of N170 visual-evoked potentials may be a key mechanism underlying 5-HT2A receptor-mediated visual hallucinations. This change in N170 potentials may be important not only for psilocybin-induced states but also for understanding acute hallucinatory states seen in psychiatric disorders, such as schizophrenia and Parkinson's disease.

  1. Differentiating between visual hallucination-free dementia with Lewy bodies and corticobasal syndrome on the basis of neuropsychology and perfusion single-photon emission computed tomography

    OpenAIRE

    Misch, Michael R; Mitchell, Sara; Francis, Philip L; Sherborn, Kayla; Meradje, Katayoun; McNeely, Alicia A; Honjo, Kie; Zhao, Jiali; Scott, Christopher JM; Caldwell, Curtis B; Ehrlich, Lisa; Shammi, Prathiba; MacIntosh, Bradley J; Bilbao, Juan M; Lang, Anthony E

    2014-01-01

    Introduction Dementia with Lewy bodies (DLB) and Corticobasal Syndrome (CBS) are atypical parkinsonian disorders with fronto-subcortical and posterior cognitive dysfunction as common features. While visual hallucinations are a good predictor of Lewy body pathology and are rare in CBS, they are not exhibited in all cases of DLB. Given the clinical overlap between these disorders, neuropsychological and imaging markers may aid in distinguishing these entities. Methods Prospectively recruited ca...

  2. Abnormal Degree Centrality of Bilateral Putamen and Left Superior Frontal Gyrus in Schizophrenia with Auditory Hallucinations: A Resting-state Functional Magnetic Resonance Imaging Study.

    Science.gov (United States)

    Chen, Cheng; Wang, Hui-Ling; Wu, Shi-Hao; Huang, Huan; Zou, Ji-Lin; Chen, Jun; Jiang, Tian-Zi; Zhou, Yuan; Wang, Gao-Hua

    2015-12-05

    Dysconnectivity hypothesis of schizophrenia has been increasingly emphasized. Recent researches showed that this dysconnectivity might be related to occurrence of auditory hallucination (AH). However, there is still no consistent conclusion. This study aimed to explore intrinsic dysconnectivity pattern of whole-brain functional networks at voxel level in schizophrenic with AH. Auditory hallucinated patients group (n = 42 APG), no hallucinated patients group (n = 42 NPG) and normal controls (n = 84 NCs) were analyzed by resting-state functional magnetic resonance imaging. The functional connectivity metrics index (degree centrality [DC]) across the entire brain networks was calculated and evaluated among three groups. DC decreased in the bilateral putamen and increased in the left superior frontal gyrus in all the patients. However, in APG, the changes of DC were more obvious compared with NPG. Symptomology scores were negatively correlated with the DC of bilateral putamen in all patients. AH score of APG positively correlated with the DC in left superior frontal gyrus but negatively correlated with the DC in bilateral putamen. Our findings corroborated that schizophrenia was characterized by functional dysconnectivity, and the abnormal DC in bilateral putamen and left superior frontal gyrus might be crucial in the occurrence of AH.

  3. The impact of social deprivation on paranoia, hallucinations, mania and depression: the role of discrimination social support, stress and trust.

    Directory of Open Access Journals (Sweden)

    Sophie Wickham

    Full Text Available The negative implications of living in a socially unequal society are now well documented. However, there is poor understanding of the pathways from specific environmental risk to symptoms. Here we examine the associations between social deprivation, depression, and psychotic symptoms using the 2007 Adult Psychiatric Morbidity Survey, a cross-sectional dataset including 7,353 individuals. In addition we looked at the mediating role of stress, discrimination, trust and lack of social support. We found that the participants' neighbourhood index of multiple deprivation (IMD significantly predicted psychosis and depression. On inspection of specific psychotic symptoms, IMD predicted paranoia, but not hallucinations or hypomania. Stress and trust partially mediated the relationship between IMD and paranoid ideation. Stress, trust and a lack of social support fully mediated the relationship between IMD and depression. Future research should focus on the role deprivation and social inequalities plays in specific manifestations of psychopathology and investigate mechanisms to explain those associations that occur. Targeting the mediating mechanisms through appropriate psychological intervention may go some way to dampen the negative consequences of living in an unjust society; ameliorating economic injustice may improve population mental health.

  4. The impact of social deprivation on paranoia, hallucinations, mania and depression: the role of discrimination social support, stress and trust.

    Science.gov (United States)

    Wickham, Sophie; Taylor, Peter; Shevlin, Mark; Bentall, Richard P

    2014-01-01

    The negative implications of living in a socially unequal society are now well documented. However, there is poor understanding of the pathways from specific environmental risk to symptoms. Here we examine the associations between social deprivation, depression, and psychotic symptoms using the 2007 Adult Psychiatric Morbidity Survey, a cross-sectional dataset including 7,353 individuals. In addition we looked at the mediating role of stress, discrimination, trust and lack of social support. We found that the participants' neighbourhood index of multiple deprivation (IMD) significantly predicted psychosis and depression. On inspection of specific psychotic symptoms, IMD predicted paranoia, but not hallucinations or hypomania. Stress and trust partially mediated the relationship between IMD and paranoid ideation. Stress, trust and a lack of social support fully mediated the relationship between IMD and depression. Future research should focus on the role deprivation and social inequalities plays in specific manifestations of psychopathology and investigate mechanisms to explain those associations that occur. Targeting the mediating mechanisms through appropriate psychological intervention may go some way to dampen the negative consequences of living in an unjust society; ameliorating economic injustice may improve population mental health.

  5. Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem.

    Science.gov (United States)

    Wickham, S; Sitko, K; Bentall, R P

    2015-05-01

    A growing body of research has investigated associations between insecure attachment styles and psychosis. However, despite good theoretical and epidemiological reasons for hypothesising that insecure attachment may be specifically implicated in paranoid delusions, few studies have considered the role it plays in specific symptoms. We examined the relationship between attachment style, paranoid beliefs and hallucinatory experiences in a sample of 176 people with a diagnosis of schizophrenia spectrum disorders and 113 healthy controls. We also investigated the possible role of negative self-esteem in mediating this association. Insecure attachment predicted paranoia but not hallucinations after co-morbidity between the symptoms was controlled for. Negative self-esteem partially mediated the association between attachment anxiety and clinical paranoia, and fully mediated the relationship between attachment avoidance and clinical paranoia. It may be fruitful to explore attachment representations in psychological treatments for paranoid patients. If future research confirms the importance of disrupted attachment as a risk factor for persecutory delusions, consideration might be given to how to protect vulnerable young people, for example those raised in children's homes.

  6. Hearing the unheard: An interdisciplinary, mixed methodology study of women’s experiences of hearing voices (auditory verbal hallucinations

    Directory of Open Access Journals (Sweden)

    Simon eMcCarthy-Jones

    2015-12-01

    Full Text Available This paper explores the experiences of women who ‘hear voices’ (auditory verbal hallucinations. We begin by examining historical understandings of women hearing voices, showing these have been driven by androcentric theories of how women’s bodies functioned, leading to women being viewed as requiring their voices be interpreted by men. We show the twentieth-century was associated with recognition that the mental violation of women’s minds (represented by some voice-hearing was often a consequence of the physical violation of women’s bodies. We next report the results of a qualitative study into voice-hearing women’s experiences (N=8. This found similarities between women’s relationships with their voices and their relationships with others and the wider social context. Finally, we present results from a quantitative study comparing voice-hearing in women (n=65 and men (n=132 in a psychiatric setting. Women were more likely than men to have certain forms of voice-hearing (voices conversing and to have antecedent events of trauma, physical illness, and relationship problems. Voices identified as female may have more positive affect than male voices. We conclude that women voice-hearers have and continue to face specific challenges necessitating research and activism, and hope this paper will act as a stimulus to such work.

  7. Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?

    Science.gov (United States)

    McCarthy-Jones, Simon; Longden, Eleanor

    2015-01-01

    Auditory verbal hallucinations (AVH: 'hearing voices') are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual's personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed 'dissociative AVH') and AVH in schizophrenia (so-called 'psychotic AVH') needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.

  8. Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?

    Directory of Open Access Journals (Sweden)

    Simon eMccarthy-Jones

    2015-07-01

    Full Text Available Auditory verbal hallucinations (AVH: ‘hearing voices’ are found in both schizophrenia and post-traumatic stress disorder (PTSD. In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual’s personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed ‘dissociative AVH’ and AVH in schizophrenia (so-called ‘psychotic AVH’ needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.

  9. Glutamate in dorsolateral prefrontal cortex and auditory verbal hallucinations in patients with schizophrenia: A 1H MRS study.

    Science.gov (United States)

    Ćurčić-Blake, Branislava; Bais, Leonie; Sibeijn-Kuiper, Anita; Pijnenborg, Hendrika Maria; Knegtering, Henderikus; Liemburg, Edith; Aleman, André

    2017-08-01

    Glutamatergic models of psychosis propose that dysfunction of N-methyl-d-aspartate (NMDA) receptors, and associated excess of glutamate, may underlie psychotic experiences in people with schizophrenia. However, little is known about the specific relation between glutamate and auditory verbal hallucinations (AVH) in patients with psychosis. In this study, levels of glutamate+glutamine (Glx) in the left lateral prefrontal lobe were determined using proton magnetic resonance spectroscopy ( 1 H MRS) to calculate their association with AVH. Sixty-seven patients with schizophrenia and thirty healthy control participants (HC) underwent magnetic resonance spectroscopy (MRS) to estimate levels of Glx in the white matter of the left prefrontal lobe. The spectrum was estimated from an 8mm 3 voxel placed in the left lateral prefrontal region, belonging to both the cingulum and forceps minor. Patients with lifetime AVH (AVH group; n=45) and patients without lifetime AVH were compared (NoAVH group; n=22) to control participants. Levels of Glx were significantly different between the groups (F(2,94)=5.27, p=0.007). Planned comparisons showed that higher Glx levels were found in control participants than in the total patient group (p=0.010). However, patients with lifetime AVH had higher levels of Glx compared to patients without lifetime AVH (p=0.019). Creatin levels were similar in all three groups. We found no association between Glx and the severity of symptoms (item P3 of the PANSS or PANSS positive subscale). The higher Glx levels in patients with lifetime AVH as compared to patients without lifetime AVH suggest a mediating role for Glx in AVH. Our results are consistent with a previous study that found similar decreased levels of Glx in patients with schizophrenia, and increased levels in an AVH group as compared to a NoAVH group. The role of the glutamatergic system deserves further investigation, for example in different brain regions and in relation to clinical variables

  10. Differentiating between visual hallucination-free dementia with Lewy bodies and corticobasal syndrome on the basis of neuropsychology and perfusion single-photon emission computed tomography.

    Science.gov (United States)

    Misch, Michael R; Mitchell, Sara; Francis, Philip L; Sherborn, Kayla; Meradje, Katayoun; McNeely, Alicia A; Honjo, Kie; Zhao, Jiali; Scott, Christopher Jm; Caldwell, Curtis B; Ehrlich, Lisa; Shammi, Prathiba; MacIntosh, Bradley J; Bilbao, Juan M; Lang, Anthony E; Black, Sandra E; Masellis, Mario

    2014-01-01

    Dementia with Lewy bodies (DLB) and Corticobasal Syndrome (CBS) are atypical parkinsonian disorders with fronto-subcortical and posterior cognitive dysfunction as common features. While visual hallucinations are a good predictor of Lewy body pathology and are rare in CBS, they are not exhibited in all cases of DLB. Given the clinical overlap between these disorders, neuropsychological and imaging markers may aid in distinguishing these entities. Prospectively recruited case-control cohorts of CBS (n =31) and visual hallucination-free DLB (n =30), completed neuropsychological and neuropsychiatric measures as well as brain perfusion single-photon emission computed tomography and structural magnetic resonance imaging (MRI). Perfusion data were available for forty-two controls. Behavioural, perfusion, and cortical volume and thickness measures were compared between the groups to identify features that serve to differentiate them. The Lewy body with no hallucinations group performed more poorly on measures of episodic memory compared to the corticobasal group, including the delayed and cued recall portions of the California Verbal Learning Test (F (1, 42) =23.1, P reproduction of the Wechsler Memory Scale-Revised (F (1, 36) =9.7, P =0.004). The Lewy body group also demonstrated reduced perfusion in the left occipital pole compared to the corticobasal group (F (1,57) =7.4, P =0.009). At autopsy, the Lewy body cases all demonstrated mixed dementia with Lewy bodies, Alzheimer's disease and small vessel arteriosclerosis, while the corticobasal cases demonstrated classical corticobasal degeneration in five, dementia with agyrophilic grains + corticobasal degeneration + cerebral amyloid angiopathy in one, Progressive Supranuclear Palsy in two, and Frontotemporal Lobar Degeneration-Ubiquitin/TAR DNA-binding protein 43 proteinopathy in one. MRI measures were not significantly different between the patient groups. Reduced perfusion in the left occipital region and worse

  11. Targeting treatment-resistant auditory verbal hallucinations in schizophrenia with fMRI-based neurofeedback – exploring different cases of schizophrenia

    Directory of Open Access Journals (Sweden)

    Miriam S. Dyck

    2016-03-01

    Full Text Available Auditory verbal hallucinations (AVHs are a hallmark of schizophrenia and can significantly impair patients’ emotional, social, and occupational functioning. Despite progress in psychopharmacology, over 25% of schizophrenia patients suffer from treatment-resistant hallucinations. In the search for alternative treatment methods, neurofeedback (NF emerges as a promising therapy tool. NF based on real-time functional magnetic resonance imaging (rt-fMRI allows voluntarily change of the activity in a selected brain region – even in patients with schizophrenia. This study explored effects of NF on ongoing AVHs. The selected participants were trained in the self-regulation of activity in the anterior cingulate cortex (ACC, a key monitoring region involved in generation and intensity modulation of AVHs. Using rt-fMRI, three right-handed patients, suffering from schizophrenia and ongoing, treatment-resistant AVHs, learned control over ACC activity on three separate days. The effect of NF training on hallucinations’ severity was assessed with the Auditory Vocal Hallucination Rating Scale (AVHRS and on the affective state – with the Positive and Negative Affect Schedule (PANAS.All patients yielded significant up-regulation of the ACC and reported subjective improvement in some aspects of AVHs (AVHRS such as disturbance and suffering from the voices. In general, mood (PANAS improved during NF training, though two patients reported worse mood after NF on the third day. ACC and reward system activity during NF learning and specific effects on mood and symptoms varied across the participants. None of them profited from the last training set in the prolonged 3-session training. Moreover, individual differences emerged in brain networks activated with NF and in symptom changes, which were related to the patients’ symptomatology and disease history.NF based on rt-fMRI seems a promising tool in therapy of AVHs. The patients, who suffered from continuous

  12. Brain functional connectivity during the experience of thought blocks in schizophrenic patients with persistent auditory verbal hallucinations: an EEG study.

    Science.gov (United States)

    Angelopoulos, Elias; Koutsoukos, Elias; Maillis, Antonis; Papadimitriou, George N; Stefanis, Costas

    2014-03-01

    Thought blocks (TBs) are characterized by regular interruptions in the stream of thought. Outward signs are abrupt and repeated interruptions in the flow of conversation or actions while subjective experience is that of a total and uncontrollable emptying of the mind. In the very limited bibliography regarding TB, the phenomenon is thought to be conceptualized as a disturbance of consciousness that can be attributed to stoppages of continuous information processing due to an increase in the volume of information to be processed. In an attempt to investigate potential expression of the phenomenon on the functional properties of electroencephalographic (EEG) activity, an EEG study was contacted in schizophrenic patients with persisting auditory verbal hallucinations (AVHs) who additionally exhibited TBs. In this case, we hypothesized that the persistent and dense AVHs could serve the role of an increased information flow that the brain is unable to process, a condition that is perceived by the person as TB. Phase synchronization analyses performed on EEG segments during the experience of TBs showed that synchrony values exhibited a long-range common mode of coupling (grouped behavior) among the left temporal area and the remaining central and frontal brain areas. These common synchrony-fluctuation schemes were observed for 0.5 to 2s and were detected in a 4-s window following the estimated initiation of the phenomenon. The observation was frequency specific and detected in the broad alpha band region (6-12Hz). The introduction of synchrony entropy (SE) analysis applied on the cumulative synchrony distribution showed that TB states were characterized by an explicit preference of the system to be functioned at low values of synchrony, while the synchrony values are broadly distributed during the recovery state. Our results indicate that during TB states, the phase locking of several brain areas were converged uniformly in a narrow band of low synchrony values and in a

  13. Frequency, prevalence, incidence and risk factors associated with visual hallucinations in a sample of patients with Parkinson's disease: a longitudinal 4-year study.

    Science.gov (United States)

    Gibson, G; Mottram, P G; Burn, D J; Hindle, J V; Landau, S; Samuel, M; Hurt, C S; Brown, R G; M Wilson, K C

    2013-06-01

    To examine the prevalence, incidence and risk factors associated with visual hallucinations (VHs) amongst people suffering from Parkinson's disease (PD). We recruited 513 patients with PD from movement disorder and PD clinics within three sites in the UK. Patients were interviewed using a series of standardised clinical rating scales at baseline, 12, 24 and 36 months. Data relating to VHs were collected using the North-East Visual Hallucinations Interview. Prevalence rates for VHs at each assessment were recorded. Associations were determined using multiple regression analysis. Cross-sectional prevalence rates for VHs at baseline, 12, 24 and 36 months indicated VHs in approximately 50% of patients. A cumulative frequency of 82.7% of cases at the end of the study period exhibited VHs. The incidence rate for VHs was 457 cases per 1000 population. Longer disease duration, greater impairment in activities of daily living and higher rates of anxiety were most commonly associated with VHs. No factors predictive of VHs could be ascertained. When examined longitudinally, VHs affect more patients than is commonly assumed in cross-sectional prevalence studies. Clinicians should routinely screen for VHs throughout the disease course. Disease duration, impairment in activities of daily living and anxiety presented as co-morbidities associated with VHs in PD, and therefore those presenting with VHs should be screened for anxiety disorder and vice versa. Copyright © 2012 John Wiley & Sons, Ltd.

  14. Auditory Hallucinations in Polyglots*

    African Journals Online (AJOL)

    1971-12-18

    Dec 18, 1971 ... that they were false. Schizophrenics on ... memory. Verbal as well as non-verbal thinking is em- ployed by everyone, and probably is essential in the forma- ... qualities or emotions such as anger or joy or threats from the voice ...

  15. COMT ValMet moderation of cannabis-induced psychosis: a momentary assessment study of 'switching on' hallucinations in the flow of daily life.

    Science.gov (United States)

    Henquet, C; Rosa, A; Delespaul, P; Papiol, S; Fananás, L; van Os, J; Myin-Germeys, I

    2009-02-01

    A functional polymorphism in the catechol-o-methyltransferase gene (COMT Val(158)Met) may moderate the psychosis-inducing effects of cannabis. In order to extend this finding to dynamic effects in the flow of daily life, a momentary assessment study of psychotic symptoms in response to cannabis use was conducted. The experience sampling technique was used to collect data on cannabis use and occurrence of symptoms in daily life in patients with a psychotic disorder (n = 31) and healthy controls (n = 25). Carriers of the COMT Val(158)Met Val allele, but not subjects with the Met/Met genotype, showed an increase in hallucinations after cannabis exposure, conditional on prior evidence of psychometric psychosis liability. The findings confirm that in people with psychometric evidence of psychosis liability, COMT Val(158)Met genotype moderates the association between cannabis and psychotic phenomena in the flow of daily life.

  16. Hallucination- and speech-specific hypercoupling in frontotemporal auditory and language networks in schizophrenia using combined task-based fMRI data: An fBIRN study.

    Science.gov (United States)

    Lavigne, Katie M; Woodward, Todd S

    2018-04-01

    Hypercoupling of activity in speech-perception-specific brain networks has been proposed to play a role in the generation of auditory-verbal hallucinations (AVHs) in schizophrenia; however, it is unclear whether this hypercoupling extends to nonverbal auditory perception. We investigated this by comparing schizophrenia patients with and without AVHs, and healthy controls, on task-based functional magnetic resonance imaging (fMRI) data combining verbal speech perception (SP), inner verbal thought generation (VTG), and nonverbal auditory oddball detection (AO). Data from two previously published fMRI studies were simultaneously analyzed using group constrained principal component analysis for fMRI (group fMRI-CPCA), which allowed for comparison of task-related functional brain networks across groups and tasks while holding the brain networks under study constant, leading to determination of the degree to which networks are common to verbal and nonverbal perception conditions, and which show coordinated hyperactivity in hallucinations. Three functional brain networks emerged: (a) auditory-motor, (b) language processing, and (c) default-mode (DMN) networks. Combining the AO and sentence tasks allowed the auditory-motor and language networks to separately emerge, whereas they were aggregated when individual tasks were analyzed. AVH patients showed greater coordinated activity (deactivity for DMN regions) than non-AVH patients during SP in all networks, but this did not extend to VTG or AO. This suggests that the hypercoupling in AVH patients in speech-perception-related brain networks is specific to perceived speech, and does not extend to perceived nonspeech or inner verbal thought generation. © 2017 Wiley Periodicals, Inc.

  17. Effects of low frequency rTMS treatment on brain networks for inner speech in patients with schizophrenia and auditory verbal hallucinations.

    Science.gov (United States)

    Bais, Leonie; Liemburg, Edith; Vercammen, Ans; Bruggeman, Richard; Knegtering, Henderikus; Aleman, André

    2017-08-01

    Efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) targeting the temporo-parietal junction (TPJ) for the treatment of auditory verbal hallucinations (AVH) remains under debate. We assessed the influence of a 1Hz rTMS treatment on neural networks involved in a cognitive mechanism proposed to subserve AVH. Patients with schizophrenia (N=24) experiencing medication-resistant AVH completed a 10-day 1Hz rTMS treatment. Participants were randomized to active stimulation of the left or bilateral TPJ, or sham stimulation. The effects of rTMS on neural networks were investigated with an inner speech task during fMRI. Changes within and between neural networks were analyzed using Independent Component Analysis. rTMS of the left and bilateral TPJ areas resulted in a weaker network contribution of the left supramarginal gyrus to the bilateral fronto-temporal network. Left-sided rTMS resulted in stronger network contributions of the right superior temporal gyrus to the auditory-sensorimotor network, right inferior gyrus to the left fronto-parietal network, and left middle frontal gyrus to the default mode network. Bilateral rTMS was associated with a predominant inhibitory effect on network contribution. Sham stimulation showed different patterns of change compared to active rTMS. rTMS of the left temporo-parietal region decreased the contribution of the left supramarginal gyrus to the bilateral fronto-temporal network, which may reduce the likelihood of speech intrusions. On the other hand, left rTMS appeared to increase the contribution of functionally connected regions involved in perception, cognitive control and self-referential processing. These findings hint to potential neural mechanisms underlying rTMS for hallucinations but need corroboration in larger samples. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Human-Avatar Symbiosis for the Treatment of Auditory Verbal Hallucinations in Schizophrenia through Virtual/Augmented Reality and Brain-Computer Interfaces.

    Science.gov (United States)

    Fernández-Caballero, Antonio; Navarro, Elena; Fernández-Sotos, Patricia; González, Pascual; Ricarte, Jorge J; Latorre, José M; Rodriguez-Jimenez, Roberto

    2017-01-01

    This perspective paper faces the future of alternative treatments that take advantage of a social and cognitive approach with regards to pharmacological therapy of auditory verbal hallucinations (AVH) in patients with schizophrenia. AVH are the perception of voices in the absence of auditory stimulation and represents a severe mental health symptom. Virtual/augmented reality (VR/AR) and brain computer interfaces (BCI) are technologies that are growing more and more in different medical and psychological applications. Our position is that their combined use in computer-based therapies offers still unforeseen possibilities for the treatment of physical and mental disabilities. This is why, the paper expects that researchers and clinicians undergo a pathway toward human-avatar symbiosis for AVH by taking full advantage of new technologies. This outlook supposes to address challenging issues in the understanding of non-pharmacological treatment of schizophrenia-related disorders and the exploitation of VR/AR and BCI to achieve a real human-avatar symbiosis.

  19. Distinct pattern of cerebral blood flow alterations specific to schizophrenics experiencing auditory verbal hallucinations with and without insight: a pilot study.

    Science.gov (United States)

    Jing, Rixing; Huang, Jiangjie; Jiang, Deguo; Lin, Xiaodong; Ma, Xiaolei; Tian, Hongjun; Li, Jie; Zhuo, Chuanjun

    2018-01-23

    Schizophrenia is associated with widespread and complex cerebral blood flow (CBF) disturbance. Auditory verbal hallucinations (AVH) and insight are the core symptoms of schizophrenia. However, to the best of our knowledge, very few studies have assessed the CBF characteristics of the AVH suffered by schizophrenic patients with and without insight. Based on our previous findings, Using a 3D pseudo-continuous ASL (pcASL) technique, we investigated the differences in AVH-related CBF alterations in schizophrenia patients with and without insight. We used statistical parametric mapping (SPM8) and statistical non-parametric mapping (SnPM13) to perform the fMRI analysis. We found that AVH-schizophrenia patients without insight showed an increased CBF in the left temporal pole and a decreased CBF in the right middle frontal gyrus when compared to AVH-schizophrenia patients with insight. Our novel findings suggest that AVH-schizophrenia patients without insight possess a more complex CBF disturbance. Simultaneously, our findings also incline to support the idea that the CBF aberrant in some specific brain regions may be the common neural basis of insight and AVH. Our findings support the mostly current hypotheses regarding AVH to some extent. Although our findings come from a small sample, it provide the evidence that indicate us to conduct a larger study to thoroughly explore the mechanisms of schizophrenia, especially the core symptoms of AVHs and insight.

  20. Real-time fMRI neurofeedback to down-regulate superior temporal gyrus activity in patients with schizophrenia and auditory hallucinations: a proof-of-concept study.

    Science.gov (United States)

    Orlov, Natasza D; Giampietro, Vincent; O'Daly, Owen; Lam, Sheut-Ling; Barker, Gareth J; Rubia, Katya; McGuire, Philip; Shergill, Sukhwinder S; Allen, Paul

    2018-02-12

    Neurocognitive models and previous neuroimaging work posit that auditory verbal hallucinations (AVH) arise due to increased activity in speech-sensitive regions of the left posterior superior temporal gyrus (STG). Here, we examined if patients with schizophrenia (SCZ) and AVH could be trained to down-regulate STG activity using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF). We also examined the effects of rtfMRI-NF training on functional connectivity between the STG and other speech and language regions. Twelve patients with SCZ and treatment-refractory AVH were recruited to participate in the study and were trained to down-regulate STG activity using rtfMRI-NF, over four MRI scanner visits during a 2-week training period. STG activity and functional connectivity were compared pre- and post-training. Patients successfully learnt to down-regulate activity in their left STG over the rtfMRI-NF training. Post- training, patients showed increased functional connectivity between the left STG, the left inferior prefrontal gyrus (IFG) and the inferior parietal gyrus. The post-training increase in functional connectivity between the left STG and IFG was associated with a reduction in AVH symptoms over the training period. The speech-sensitive region of the left STG is a suitable target region for rtfMRI-NF in patients with SCZ and treatment-refractory AVH. Successful down-regulation of left STG activity can increase functional connectivity between speech motor and perception regions. These findings suggest that patients with AVH have the ability to alter activity and connectivity in speech and language regions, and raise the possibility that rtfMRI-NF training could present a novel therapeutic intervention in SCZ.

  1. Homemade heroin substitute causing hallucinations

    African Journals Online (AJOL)

    came to the UK illegally from Romania to be with her boyfriend who was already working in the country. She lives in several different locations, depending on where she is needed to work. Informed consent for publication of case material was provided. AB had been taking drugs since her arrival in the UK, to help with the ...

  2. Adjuvant low-frequency rTMS in treating auditory hallucinations in recent-onset schizophrenia: a randomized controlled study investigating the effect of high-frequency priming stimulation.

    Science.gov (United States)

    Ray, Prasenjit; Sinha, Vinod Kumar; Tikka, Sai Krishna

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been found to be effective in reducing frequency and duration of auditory verbal hallucinations (AVH). Priming stimulation, which involves high-frequency rTMS stimulation followed by low-frequency rTMS, has been shown to markedly enhance the neural response to the low-frequency stimulation train. However, this technique has not been investigated in recent onset schizophrenia patients. The aim of this randomized controlled study was to investigate whether the effects of rTMS on AVH can be enhanced with priming rTMS in recent onset schizophrenia patients. Forty recent onset schizophrenia patients completed the study. Patients were randomized over two groups: one receiving low-frequency rTMS preceded by priming and another receiving low-frequency rTMS without priming. Both treatments were directed at the left temporo-parietal region. The severity of AVH and other psychotic symptoms were assessed with the auditory hallucination subscale (AHRS) of the Psychotic Symptom Rating Scales (PSYRATS), the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression (CGI). We found that all the scores of these ratings significantly reduced over time (i.e. baseline through 1, 2, 4 and 6 weeks) in both the treatment groups. We found no difference between the two groups on all measures, except for significantly greater improvement on loudness of AVH in the group with priming stimulation during the follow-ups (F = 2.72; p low-frequency rTMS alone and high-frequency priming of low-frequency rTMS do not elicit significant differences in treatment of overall psychopathology, particularly AVH when given in recent onset schizophrenia patients. Add on priming however, seems to be particularly better in faster reduction in loudness of AVH.

  3. Effects of low frequency repetitive transcrinail magnetic stimulation on auditory hallucination in patients with schizophrenia%低频重复经颅磁刺激治疗精神分裂症患者的顽固性幻听

    Institute of Scientific and Technical Information of China (English)

    权文香; 周东丰; 王向群; 乔宏; 赵志宇; 张五芳; 任艳萍; 谭云龙; 王志仁; 田菊; 杨淑珍

    2012-01-01

    Objective: To investigate the effects and safety of low frequency repetitive transcrinail magnetic stimulation (rTMS) on obstinate auditory hallucination in schizophrenia patients. Methods: Totally 122 schizophrenia patients with obstinate hallucination who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-FV) from outpatient and inpatient department They were randomly allocated to receive 1 Hz (n =88,80%MT) or sham (n = 34) rTMS on left dorsolateral prefrontal cortex for 20 sessions (5 session per week and two weeks' break after 10 sessions). The Positive and Negative Syndrome Scale (PANSS), Audi-tory Hallucination Rating Scale( AHRS) and Clinical Global Impressions Scale( CGI) were used to assess the effect of rTMS on clinical features. Subjects in lHz group were followed up in time point of 3rd, 6th and 9th month after treatment Results: Totally 108 patients finished 20 treatment sessions. There were no significant differences between two groups in scores of PANSS, AHRS, CGI at any time point of treatment ( Ps > 0. 05). Meanwhile, in patients with course of disease less than 10 years [ (16. 2 ±4. 9 vs. 20. 3 ±4. 0) ] and 10 - 20 years [ (19. 2 ± 5. 5 vs. 23. 1 ± 6. 5], the AHRS scores were significantly lower in 1 Hz group than in the sham group (Ps < 0. 05). There was no other side effect complaints, except that 4 patients reported headache in treatment Conclusion: It suggests that 1 Hz repetitive transcrinail magnetic stimulation is a safe approach showing efficacy on obstinate auditory hallucination in schizophrenic patients whose course of disease are less than 20 years.%目的:探讨左背外侧前额叶低频重复经颅磁刺激(rTMS)治疗精神分裂症患者顽固性幻听的临床疗效.方法:本研究为随机双盲对照研究.根据美国精神障碍诊断统计手册第4版( DSM-Ⅳ)的诊断标准,选取122例伴顽固性幻听的精神分裂症患者按2∶1随机分为治疗组(n=88)

  4. Tolerância ao fenômeno alucinatório induzido pelo zolpidem: relato de caso Tolerancia al fenómeno alucinatorio inducido por el zolpidem: relato de caso Tolerance to zolpidem-induced hallucinations: case report

    Directory of Open Access Journals (Sweden)

    Saint-Clair Bahls

    2005-12-01

    Full Text Available INTRODUÇÃO: O hipnótico zolpidem é considerado efetivo e seguro, entretanto, existem na literatura alguns relatos de caso de fenômeno alucinatório associado ao seu uso. Relataremos mais um caso de alucinações induzidas pelo zolpidem em paciente jovem do sexo feminino. DISCUSSÃO: Este caso, segundo nosso conhecimento, é o primeiro descrito na literatura que sugere a possibilidade de ocorrer, em alguns pacientes, o desenvolvimento de tolerância a esse efeito alucinatório adverso raro, porém, importante. Apresentamos uma discussão sobre algumas hipóteses farmacocinéticas e farmacodinâmicas deste fenômeno. CONCLUSÕES: Alertamos para a necessidade de atenção ao fato da indução alucinatória pelo zolpidem e sua tolerância, assim como a importância de seu melhor entendimento.INTRODUCTION: El hipnótico zolpidem es considerado efectivo y seguro. Sin embargo, hay en la literatura algunos relatos de caso de fenómeno alucinatorio asociado a su uso. Relataremos un caso más sobre alucinaciones inducidas por zolpidem en una paciente joven de sexo femenino. DISCUSIÓN: Este caso, según nuestro conocimiento, es el primero descrito en la literatura que sugiere la posibilidad de que en algunos pacientes ocurra el desarrollo de tolerancia a este efecto alucinatorio, adverso y raro, sin embargo, importante. Presentamos una discusión sobre algunas hipótesis farmacocinéticas y farmacodinámicas de este fenómeno. CONCLUSION: Por la necesidad de atención, alertamos al hecho de la inducción alucinatoria relacionada al zolpidem y a su tolerancia, así como a la importancia de comprenderla mejor.BACKGROUND: Zolpidem is reported to be a safe and effective hypnotic agent. In the literature, there are some case reports of hallucinations after zolpidem administration. We report one more case in witch zolpidem lead to hallucinations in young adult female. DISCUSSION: This case, to our knowledge, is the first to suggest the possibility of

  5. [Paroxysmal perceptual alteration in comparison with hallucination--a review of its clinical reports and discussion of its pathophysiological mechanism in the present day, when second generation antipsychotics are widely used].

    Science.gov (United States)

    Watanabe, Ken

    2009-01-01

    The syndrome of paroxysmal perceptual alteration (PPA) was first described by Yamaguchi in 1985. Since then, many PPA cases have been reported, and its pathophysiological mechanism has been proposed: a suppressed (blocked) mesolimbic and mesocortical dopaminergic system and sequential compensatory increase of noradrenergic neuronal activity are crucial for the occurrence of PPA. PPA is characterized by hypersensitivity of perception, psychedelic experience (brightening of colors, sharpening of contrast, visual distortion, etc.), and somatic schema disorder (one feels that one is floating, one's extremities are being pulled and elongated, etc.). PPA in chronic schizophrenic patients occurs abruptly like an attack mainly in the evening, often precipitated by fatigue. During the attack, patients also suffer from mood and thought alteration (anxiety, agitation, depressive mood, and inability to distract their thoughts from one thing), but they are aware that symptoms of PPA are not real and apprehensive about them. The attack ceases gradually and spontaneously while the patient rests or sleeps. These clinical features are clearly different from those of schizophrenic hallucinations. It is believed that PPA is closely related to neuroleptic treatment by conventional antipsychotics. I reported the prevalence of PPA as 4.0% in 1991 when high potential D2 blocking agents were prevailing. The occurrence of PPA has been significantly reduced to the present, when second generation (atypical) antipsychotics are prevailing. However, in my inquiry in 2004, the prevalence of PPA was 3.6% in cases treated with risperidone (RIS), while the rates were 0 in cases treated with olanzapine (OLZ), quetiapine (QTP), and perospirone (PRS). Several cases of PPA have been reported in patients who were treated with OLZ and PRS. Until now, no cases of PPA have been reported who were treated with QTP and aripiprazole (APZ). The prevalence of PPA among cases treated with these second generation

  6. Virtual reality and hallucination: a technoetic perspective

    Science.gov (United States)

    Slattery, Diana R.

    2008-02-01

    Virtual Reality (VR), especially in a technologically focused discourse, is defined by a class of hardware and software, among them head-mounted displays (HMDs), navigation and pointing devices; and stereoscopic imaging. This presentation examines the experiential aspect of VR. Putting "virtual" in front of "reality" modifies the ontological status of a class of experience-that of "reality." Reality has also been modified [by artists, new media theorists, technologists and philosophers] as augmented, mixed, simulated, artificial, layered, and enhanced. Modifications of reality are closely tied to modifications of perception. Media theorist Roy Ascott creates a model of three "VR's": Verifiable Reality, Virtual Reality, and Vegetal (entheogenically induced) Reality. The ways in which we shift our perceptual assumptions, create and verify illusions, and enter "the willing suspension of disbelief" that allows us entry into imaginal worlds is central to the experience of VR worlds, whether those worlds are explicitly representational (robotic manipulations by VR) or explicitly imaginal (VR artistic creations). The early rhetoric surrounding VR was interwoven with psychedelics, a perception amplified by Timothy Leary's presence on the historic SIGGRAPH panel, and the Wall Street Journal's tag of VR as "electronic LSD." This paper discusses the connections-philosophical, social-historical, and psychological-perceptual between these two domains.

  7. Clomiphene citrate-induced visual hallucinations: a case report

    OpenAIRE

    Venkatesh, Ramesh; Gujral, Gaganjeet Singh; Gurav, Prachi; Tibrewal, Shailja; Mathur, Umang

    2017-01-01

    Background Polycystic ovary syndrome is a common cause of chronic anovulation and infertility in otherwise healthy fertile couples. Clomiphene citrate is used as a first-line ovulation induction therapy in patients with polycystic ovary syndrome. Clomiphene citrate can cause both systemic and ocular side effects. We report a rare side effect of illusory palinopsias in a patient with polycystic ovary syndrome treated with ovulation induction therapy with clomiphene citrate, and emphasize the n...

  8. Phantom eye syndrome: types of visual hallucinations and related phenomena

    DEFF Research Database (Denmark)

    Roed Rasmussen, Marie Louise; Prause, Jan U; Johnson, Martin

    2009-01-01

    most often white or colored light, as a continuous sharp light or as moving dots. The most frequent triggers were darkness, closing of the eyes, fatigue, and psychological stress; 54% of patients had the experience more than once a week. Ten patients were so visually disturbed that it interfered...

  9. The Application of Cognitive Therapy for Command Hallucinations

    Science.gov (United States)

    Singer, Alisa R.; Addington, Donald E.

    2009-01-01

    It has become increasingly recognized that cognitive therapy (CT) is an effective treatment for the positive symptoms of schizophrenia yet there are few cognitive therapists in North America who are specialized to work with this patient population. There is a need for further dissemination of CT for schizophrenia in order to increase its…

  10. Decreased language lateralization is characteristic of psychosis, not auditory hallucinations

    NARCIS (Netherlands)

    Diederen, Kelly M. J.; De Weijer, Antoin D.; Daalman, Kirstin; Blom, Jan Dirk; Neggers, Sebastiaan F. W.; Kahn, Rene S.; Sommer, Iris E. C.

    2010-01-01

    Decreased language lateralization is a well-replicated finding in psychotic patients. It is currently unclear, however, whether this abnormality is related to a particular symptom of psychosis or to psychosis in general. It has been argued that decreased language lateralization may be related to

  11. Increased psychophysiological parameters of attention in non-psychotic individuals with auditory verbal hallucinations

    DEFF Research Database (Denmark)

    van Lutterveld, Remko; Oranje, Bob; Abramovic, Lucija

    2010-01-01

    with an auditory oddball paradigm in 18 non-psychotic individuals with AVH and 18 controls. RESULTS: P300 amplitude was increased in the AVH group as compared to controls, reflecting superior effortful attention. A trend in the same direction was found for processing negativity. No significant differences were...... found for mismatch negativity. CONCLUSION: Contrary to our expectations, non-psychotic individuals with AVH show increased rather than decreased psychophysiological measures of effortful attention compared to healthy controls, refuting a pivotal role of decreased effortful attention...

  12. Relationship between self-focused attention, mindfulness and distress in individuals with auditory verbal hallucinations.

    Science.gov (United States)

    Úbeda-Gómez, J; León-Palacios, M G; Escudero-Pérez, S; Barros-Albarrán, M D; López-Jiménez, A M; Perona-Garcelán, S

    2015-01-01

    The purpose of this study was to investigate the relationships among self-focused attention, mindfulness and distress caused by the voices in psychiatric patients. Fifty-one individuals with a psychiatric diagnosis participated in this study. The Psychotic Symptom Rating Scale (PSYRATS) emotional factor was applied to measure the distress caused by the voices, the Self-Absorption Scale (SAS) was given for measuring the levels of self-focused attention, and the Mindful Attention Awareness Scale (MAAS) was used to measure mindfulness. The results showed that distress caused by the voices correlated positively with self-focused attention (private and public) and negatively with mindfulness. A negative correlation was also found between mindfulness and self-focused attention (private and public). Finally, multiple linear regression analysis showed that public self-focus was the only factor predicting distress caused by the voices. Intervention directed at diminishing public self-focused attention and increasing mindfulness could improve distress caused by the voices.

  13. Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders A meta-analysis***

    Institute of Scientific and Technical Information of China (English)

    Yingli Zhang; Wei Liang; Shichang Yang; Ping Dai; Lijuan Shen; Changhong Wang

    2013-01-01

    OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hal ucination of patients with schizophrenia spectrum disorders. DATA SOURCES: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Control ed Trials databases from January 1985 to May 2012. Key words were “transcranial magnetic stimulation”, “TMS”, “repetitive transcranial magnetic stimulation”, and “hal ucination”. STUDY SELECTION: Selected studies were randomized control ed trials assessing therapeutic ef-ficacy of repetitive transcranial magnetic stimulation for hal ucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hal ucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES: The primary outcome was total scores of Auditory Hal ucinations Rating Scale, Auditory Hal ucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hal ucination item, and Hal ucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. Al data were completely effective, involving 398 patients. Overal mean weighted effect size for repeti-tive transcranial magnetic stimulation versus sham stimulation was statistical y significant (MD =-0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P =0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repeti-tive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching. CONCLUSION: Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hal ucination in schizophrenia spectrum disorders.

  14. Abnormal synchrony and effective connectivity in patients with schizophrenia and auditory hallucinations

    Directory of Open Access Journals (Sweden)

    Maria de la Iglesia-Vaya

    2014-01-01

    These data indicate that an anomalous process of neural connectivity exists when patients with AH process emotional auditory stimuli. Additionally, a central role is suggested for the cerebellum in processing emotional stimuli in patients with persistent AH.

  15. The borderlands of waking: Quantifying the transition from reflective thought to hallucination in sleep onset.

    Science.gov (United States)

    Speth, Clemens; Speth, Jana

    2016-04-01

    We lose waking consciousness spontaneously and regularly over the circadian cycle. It seems that every time we fall asleep, reflective thinking gradually gives way to our interactions with an imaginary, hallucinatory world that brings multimodal experiences in the absence of adequate external stimuli. The present study investigates this transition, proposing a new measure of hallucinatory states. Reflective thinking and motor imagery were quantified in 150 mentation reports provided by 16 participants after forced awakenings from different physiology-monitored time intervals after sleep onset. Cognitive agency analysis and motor agency analysis--which are objective (grammatical-semantic) tools derived from linguistic theories--show (i) a decrease in reflective thinking which sleepers would need to acknowledge the hallucinatory quality of their state, and (ii) an increase in motor imagery, indicating interactions with a hallucinatory world. By mapping these spontaneous changes in human consciousness onto physiology, we can in the long run explore the conditions of its decline, and possibilities for treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Neuropsychiatric Model of Biological and Psychological Processes in the Remission of Delusions and Auditory Hallucinations

    NARCIS (Netherlands)

    van der Gaag, M.

    2006-01-01

    This selective review combines cognitive models and biological models of psychosis into a tentative integrated neuropsychiatric model. The aim of the model is to understand better, how pharmacotherapy and cognitive-behavior therapy come forward as partners in the treatment of psychosis and play

  17. Dreams, hallucinations, moving statues, and Ekphrasis in Ludwig Tieck's visual writings

    OpenAIRE

    Rockelmann, Joseph D

    2014-01-01

    When reading Ludwig Tieck's texts the reader becomes aware that dreams, the unconscious, and art play a key role. This study seeks to posit that Ekphrasis and dream interpretation are similar due to both analyzing a visual image and attempting to translate the visual into the verbal in order to gain a better and more complete understanding of it. G.E. Lessing believed that poetry and the visual arts were equal since each art form has its own strengths and when combined they create a complete ...

  18. Glutamate in dorsolateral prefrontal cortex and auditory verbal hallucinations in patients with schizophrenia : A (1)H MRS study

    NARCIS (Netherlands)

    Curcic-Blake, Branisalava; Bais, Leonie; Sibeijn-Kuiper, Anita; Pijnenborg, Hendrika Maria; Knegtering, Henderikus; Liemburg, Edith; Aleman, André

    2017-01-01

    Purpose: Glutamatergic models of psychosis propose that dysfunction of N-methyl-D-aspartate (NMDA) receptors, and associated excess of glutamate, may underlie psychotic experiences in people with schizophrenia. However, little is known about the specific relation between glutamate and auditory

  19. Voxel-based gray and white matter morphometry correlates of hallucinations in schizophrenia: The superior temporal gyrus does not stand alone

    Directory of Open Access Journals (Sweden)

    Marie-José van Tol

    2014-01-01

    Discussion: Results suggest that STG GM abnormalities underlie the general susceptibility to experience psychotic symptoms and that additional abnormalities in a network of medial temporal, ventrolateral, putaminal, and parietal regions related to verbal memory and speech production may specifically increase the likelihood of experiencing AVH. Future studies should clarify the meaning of morphometry abnormalities for functional interregional communication.

  20. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    NARCIS (Netherlands)

    Droogleever Fortuyn, H.A.; Lappenschaar, G.A.; Nienhuis, F.J.; Furer, J.W.; Hodiamont, P.P.G.; Rijnders, C.A.T.; Lammers, G.J.; Renier, W.O.; Buitelaar, J.K.; Overeem, S.

    2009-01-01

    OBJECTIVE: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  1. Psychotic symptoms in narcolepsy : phenomenology and a comparison with schizophrenia

    NARCIS (Netherlands)

    Fortuyn, Hal A. Droogleever; Lappenschaar, G. A.; Nienhuis, Fokko J.; Furer, Joop W.; Hodiamont, Paul P.; Rijnders, Cees A.; Lammers, Gert Jan; Renier, Willy O.; Buitelaar, Jan K.; Overeem, Sebastlaan

    2009-01-01

    Objective: Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and

  2. Underconstrained perception or underconstrained theory?

    NARCIS (Netherlands)

    Aleman, A; de Haan, EHF; Kahn, RS

    2004-01-01

    Although the evidence remains tentative at best, the conception of hallucinations in schizophrenia as being underconstrained perception resulting from intrinsic thalamocortical resonance in sensory areas might complement current models of hallucination. However, in itself, the approach falls short

  3. [Reconsideration of nicotine and other substance dependence: a clue from dependence-related mentation including reward, motivation, learning, delusion and hallucination toward understanding the concept of non-substance-related addiction].

    Science.gov (United States)

    Miyata, Hisatsugu

    2013-11-01

    Nicotine produces core symptoms of substance dependence (craving and withdrawal) without any psychotic symptoms. The psychopharmacological structure of craving is hypothesized to be constituted by three components: the primary reinforcing property of a substance, the secondary reinforcing property of that substance (conditioned aspects of the environment, such as contextual or specific cues associated with substance taking), and the negative affective motivational property during withdrawal (i.e. the desire to avoid the dysphoric withdrawal symptoms elicits craving). Among the three components, the primary reinforcing property of a substance forms the most fundamental factor for establishing substance dependence. Sensitization or reverse tolerance observed in locomotor activity of animals, which had been believed to be a methamphetamine psychosis model, is demonstrated to reflect the establishment of conditioned reinforcement. Finally, non-substance-related addiction such as gambling, internet, and sex is discussed. From the aspect of the above hypothetical psychopharmacological structure of craving, the most significant difference between substance dependence and non-substance-related addiction is that the primary reinforcing property of non-substance reward is relatively intangible in comparison with that of a substance of abuse.

  4. Cortical serotonin-S2 receptor binding in Lewy body dementia, Alzheimer's and Parkinson's diseases.

    Science.gov (United States)

    Cheng, A V; Ferrier, I N; Morris, C M; Jabeen, S; Sahgal, A; McKeith, I G; Edwardson, J A; Perry, R H; Perry, E K

    1991-11-01

    The binding of the selective 5-HT2 antagonist [3H]ketanserin has been investigated in the temporal cortex of patients with Alzheimer's disease (SDAT), Parkinson's disease (PD), senile dementia of Lewy body type (SDLT) and neuropathologically normal subjects (control). 5-HT2 binding was reduced in SDAT, PD with dementia and SDLT. SDAT showed a 5-HT2 receptor deficit across most of the cortical layers. A significant decrease in 5-HT2 binding in the deep cortical layers was found in those SDLT cases without hallucinations. SDLT cases with hallucinations only showed a deficit in one upper layer. There was a significant difference in cortical layers III and V between SDLT without hallucinations and SDLT with hallucinations. The results confirm an abnormality of serotonin binding in various forms of dementia and suggest that preservation of 5-HT2 receptor in the temporal cortex may differentiate hallucinating from non-hallucinating cases of SDLT.

  5. Dimenhydrinate

    Science.gov (United States)

    ... sleepiness excitation or hyperactivity hallucinations (seeing things or hearing voices that do not exist) difficulty understanding reality confusion difficulty speaking or swallowing unsteadiness seizures ...

  6. Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate

    Directory of Open Access Journals (Sweden)

    Tomi eSarkanen

    2014-08-01

    Full Text Available Aim: Hypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy.Method: We present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia.Results: Three out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone alleviated psychotic symptoms in two cases. Conclusion: Psychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia however the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.

  7. Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate.

    Science.gov (United States)

    Sarkanen, Tomi; Niemelä, Valter; Landtblom, Anne-Marie; Partinen, Markku

    2014-01-01

    Hypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy, and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB) treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy. We present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia. Three out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone) alleviated psychotic symptoms in two cases. Psychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia; however, the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.

  8. Contac overdose

    Science.gov (United States)

    Symptoms of a Contac overdose include: Blurred vision Depression Delirium Disorientation, nervousness, hallucinations Drowsiness Enlarged pupils Fever Inability to urinate or completely empty the bladder Increased ...

  9. Potato plant poisoning - green tubers and sprouts

    Science.gov (United States)

    ... large ingestions. These poisonings can be very dangerous. Symptoms may include: Vomiting Stomach or abdominal pain Diarrhea Fever Delirium Dilated pupils Hallucinations Headache Loss of sensation Lower ...

  10. Central pontine myelinolysis

    Science.gov (United States)

    Symptoms may include any of the following: Confusion , delirium , hallucinations Balance problems, tremor Problem swallowing Reduced alertness , drowsiness or sleepiness , lethargy , poor responses Slurred speech ...

  11. Pareidolias: complex visual illusions in dementia with Lewy bodies.

    Science.gov (United States)

    Uchiyama, Makoto; Nishio, Yoshiyuki; Yokoi, Kayoko; Hirayama, Kazumi; Imamura, Toru; Shimomura, Tatsuo; Mori, Etsuro

    2012-08-01

    Patients rarely experience visual hallucinations while being observed by clinicians. Therefore, instruments to detect visual hallucinations directly from patients are needed. Pareidolias, which are complex visual illusions involving ambiguous forms that are perceived as meaningful objects, are analogous to visual hallucinations and have the potential to be a surrogate indicator of visual hallucinations. In this study, we explored the clinical utility of a newly developed instrument for evoking pareidolic illusions, the Pareidolia test, in patients with dementia with Lewy bodies-one of the most common causes of visual hallucinations in the elderly. Thirty-four patients with dementia with Lewy bodies, 34 patients with Alzheimer's disease and 26 healthy controls were given the Pareidolia test. Patients with dementia with Lewy bodies produced a much greater number of pareidolic illusions compared with those with Alzheimer's disease or controls. A receiver operating characteristic analysis demonstrated that the number of pareidolias differentiated dementia with Lewy bodies from Alzheimer's disease with a sensitivity of 100% and a specificity of 88%. Full-length figures and faces of people and animals accounted for >80% of the contents of pareidolias. Pareidolias were observed in patients with dementia with Lewy bodies who had visual hallucinations as well as those who did not have visual hallucinations, suggesting that pareidolias do not reflect visual hallucinations themselves but may reflect susceptibility to visual hallucinations. A sub-analysis of patients with dementia with Lewy bodies who were or were not treated with donepzil demonstrated that the numbers of pareidolias were correlated with visuoperceptual abilities in the former and with indices of hallucinations and delusional misidentifications in the latter. Arousal and attentional deficits mediated by abnormal cholinergic mechanisms and visuoperceptual dysfunctions are likely to contribute to the development

  12. A case study on acupuncture in the treatment of schizophrenia

    NARCIS (Netherlands)

    Bosch, M.P.C.; Staudte, H.; Noort, M.W.M.L. van den; Lim, S.

    2014-01-01

    This report describes the use of acupuncture as an add on treatment for a patient with chronic schizophrenia. The 63-year-old woman suffered from persistent hallucinations and even physical pain as a result of the hallucination of a black bird that kept pecking her back. The patient received 12

  13. Low awareness of the Charles Bonnet syndrome in patients attending a retinal clinic

    DEFF Research Database (Denmark)

    Singh, Amardeep; Subhi, Yousif; Sørensen, Torben Lykke

    2014-01-01

    Visually impaired patients may experience visual hallucinations due to the Charles Bonnet syndrome (CBS). While benign in nature, these hallucinations may cause distress in those unfamiliar with the phenomenon. The overall purpose of this study was to determine the degree of awareness of CBS...

  14. Pareidolia in Parkinson's disease without dementia: A positron emission tomography study.

    Science.gov (United States)

    Uchiyama, Makoto; Nishio, Yoshiyuki; Yokoi, Kayoko; Hosokai, Yoshiyuki; Takeda, Atsushi; Mori, Etsuro

    2015-06-01

    Pareidolia, which is a particular type of complex visual illusion, has been reported to be a phenomenon analogous to visual hallucinations in patients with dementia with Lewy bodies. However, whether pareidolia is observed in Parkinson's disease (PD) or whether there are common underlying mechanisms of these two types of visual misperceptions remains to be elucidated. A test to evoke pareidolia, the Pareidolia test, was administered to 53 patients with PD without dementia and 24 healthy controls. The regional cerebral metabolic rate of glucose was measured using 18F-fluorodeoxyglucose positron emission tomography in the PD patients. PD patients without dementia produced a greater number of pareidolic illusions compared with the controls. Pareidolia was observed in all of the patients having visual hallucinations as well as a subset of those without visual hallucinations. The number of pareidolic illusions was correlated with hypometabolism in the bilateral temporal, parietal and occipital cortices. The index of visual hallucinations was correlated with hypometabolism in the left parietal cortex. A region associated with both pareidolia and visual hallucinations was found in the left parietal lobe. Our study suggests that PD patients without dementia experience pareidolia more frequently than healthy controls and that posterior cortical dysfunction could be a common neural mechanism of pareidolia and visual hallucinations. Pareidolia could represent subclinical hallucinations or a predisposition to visual hallucinations in Lewy body disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Prevalence and clinical presentation of HIV positive female ...

    African Journals Online (AJOL)

    Nine of the 19 HIV positive patients (47%) had a pre-existing primary psychiatric diagnosis, most commonly Bipolar Disorder, recent episode mania with psychotic symptoms. The most common psychotic symptoms were grandiose delusions followed by auditory hallucinations, paranoid delusions and visual hallucinations.

  16. Charles Bonnet Syndrome in a Patient With Right Medial Occipital Lobe Infarction: Epileptic or Deafferentation Phenomenon?

    Science.gov (United States)

    Kumral, Emre; Uluakay, Arzu; Dönmez, İlknur

    2015-07-01

    Charles Bonnet syndrome (CBS) is an uncommon disorder characterized by complex and recurrent visual hallucinations in patients with visual pathway pathologic defects. To describe a patient who experienced complex visual hallucinations following infarction in the right occipital lobe and epileptic seizure who was diagnosed as having CBS. A 65-year-old man presented acute ischemic stroke caused by artery to artery embolism involving the right occipital lobe. Following ischemic stroke, complex visual hallucinations in the left visual field not associated with loss of consciousness or delusion developed in the patient. Hallucinations persisted for >1 month and during hallucination, no electrographic seizures were recorded through 24 hours of videoelectroencephalographic monitoring. CBS may develop in a patient with occipital lobe infarction following an embolic event. CBS associated with medial occipital lobe infarction and epilepsy may coexist and reflects the abnormal functioning of an integrated neuronal network.

  17. Memory binding in clinical and non-clinical psychotic experiences: how does the continuum model fare?

    Science.gov (United States)

    Chhabra, S; Badcock, J C; Maybery, M T

    2013-07-01

    Both clinical and non-clinical auditory hallucinations (AH) have been associated with source memory deficits, supporting a continuum of underlying cognitive mechanisms, though few studies have employed the same task in patient and nonpatient samples. Recent commentators have called for more debate on the continuum model of psychosis. Consequently, the current study investigated the continuity model of AH with reference to memory binding. We used an identical voice and word recognition memory task to assess binding in two separate studies of: (1) healthy hallucination-prone individuals and controls (30 high and 30 low scorers on the Launay-Slade Hallucination Scale-Revised) and (2) schizophrenia patient samples (32 with AH, 32 without AH) and 32 healthy controls. There was no evidence of impaired binding in high hallucination-prone, compared to low hallucination-prone individuals. In contrast, individuals with schizophrenia (both with and without AH) had difficulties binding (remembering "who said what"), alongside difficulties remembering individual words and voices. Binding ability and memory for voices were also negatively linked to the loudness of hallucinated voices reported by patients with AH. These findings suggest that different mechanisms may exist in clinical and non-clinical hallucinators, adding to the growing debate on the continuum model of psychotic symptoms.

  18. Schizophrenia-like symptoms in narcolepsy type 1: shared and distinctive clinical characteristics.

    Science.gov (United States)

    Plazzi, Giuseppe; Fabbri, Chiara; Pizza, Fabio; Serretti, Alessandro

    2015-01-01

    The occurrence of psychotic symptoms in narcolepsy type 1 (NT1) has been reported as responsible for delayed diagnosis due to the misdiagnosis of schizophrenia. This study aimed to identify shared and distinctive clinical characteristics between NT1 and schizophrenia, with the focus on psychotic symptoms. A total of 28 NT1 and 21 schizophrenia patients were included. Hallucination characteristics and PANSS (Positive and Negative Syndrome Scale), HRSD (Hamilton Rating Scale for Depression), DES (Dissociative Experiences Scale), and STAI (State-Trait Anxiety Inventory) scores were collected. Symptom overlap was investigated by χ(2), Fisher's or t tests and multiple logistic regression models. Hallucinations and illusions frequently occurred in both diseases. Unimodal hallucinations were more common in schizophrenia (p = 6.30e-07) and multimodal hallucinations in NT1, but no clear difference was identified in their sensory modality. Hypnagogic/hypnopompic hallucinations were typical of NT1 (p = 5.22e-07), and 25% of NT1 patients exhibited some degree of insight deficit. Hypnagogic/hypnopompic hallucinations, unimodal hallucinations and PANSS score were the most distinctive clinical characteristics. Clinical overlap was found in the dissociative and anxiety domains, while higher depressive scores were observed in schizophrenia. The overlap between NT1 and schizophrenia should be further investigated under a clinical and pathogenetic point of view to improve diagnostic and therapeutic approaches. © 2015 S. Karger AG, Basel.

  19. Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

    Science.gov (United States)

    Fortuyn, Hal A Droogleever; Lappenschaar, G A; Nienhuis, Fokko J; Furer, Joop W; Hodiamont, Paul P; Rijnders, Cees A; Lammers, Gert Jan; Renier, Willy O; Buitelaar, Jan K; Overeem, Sebastiaan

    2009-01-01

    Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal psychotic disorders between narcolepsy patients and controls. We used SCAN 2.1 interviews to compare psychotic symptoms between 60 patients with narcolepsy, 102 with schizophrenia and 120 matched population controls. In addition, qualitative data was collected to enable a detailed description of hypnagogic hallucinations in narcolepsy. There were clear differences in the pattern of hallucinatory experiences in narcolepsy vs. schizophrenia patients. Narcoleptics reported multisensory "holistic" hallucinations rather than the predominantly verbal-auditory sensory mode of schizophrenia patients. Psychotic symptoms such as delusions were not more frequent in narcolepsy compared to population controls. In addition, the prevalence of formal psychotic disorders was not increased in patients with narcolepsy. Almost half of narcoleptics reported moderate interference with functioning due to hypnagogic hallucinations, mostly due to related anxiety. Hypnagogic hallucinations in narcolepsy can be differentiated on a phenomenological basis from hallucinations in schizophrenia which is useful in differential diagnostic dilemmas.

  20. The Speaker Behind The Voice: Therapeutic Practice from the Perspective of Pragmatic Theory

    Directory of Open Access Journals (Sweden)

    Felicity eDeamer

    2015-06-01

    Full Text Available Many attempts at understanding auditory verbal hallucinations (AVHs have tried to explain why there is an auditory experience in the absence of an appropriate stimulus. We suggest that many instance of voice-hearing should be approached differently. More specifically, they could be viewed primarily as hallucinated acts of communication, rather than hallucinated sounds. We suggest that this change of perspective is reflected in, and helps to explain, the successes of two recent therapeutic techniques. These two techniques are: Relating Therapy for Voices and Avatar Therapy.

  1. Self-Inflicted Needle Injuries to the Eye: A Curing Pain

    Directory of Open Access Journals (Sweden)

    Shahrokh Amiri

    2015-01-01

    Full Text Available There are few reports of severe self-injury to eyes in patients with schizophrenia. We report on a 41-year-old woman, primarily visiting for symptoms of endophthalmitis resulting from self-inflicted needles. Further evaluations established the diagnosis of schizophrenia because of arguing and commenting on auditory hallucinations and negative symptoms including social isolation, decreased self-care, blunt affect, and a monotone voice. The patient had been suffering from auditory hallucinations for several years and found relief in bodily pain caused by needles. The patient received 6 mg of risperidone. Hallucinations were resolved and self-injury behaviour was not repeated.

  2. What Is Psychiatry?

    Medline Plus

    Full Text Available ... as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more ... After Disaster, Trauma Internet Gaming Share Your Story Suicide Prevention Warning Signs of Mental Illness What is ...

  3. Rasagiline

    Science.gov (United States)

    ... an arm or leg hallucinating (seeing things or hearing voices that do not exist) extreme restlessness difficulty thinking clearly or understanding reality Rasagiline may cause other side effects. Call ...

  4. A specific metabolic pattern related to the hallucinatory activity in schizophrenia

    International Nuclear Information System (INIS)

    Huret, J.D.; Martinot, J.L.; Lesur, A.; Mazoyer, B.; Pappata, S.; Syrota, A.; Baron, J.C.; Lemperiere, T.

    1988-01-01

    A clinical and PEI study using 18 F - fluorodesoxyglucose for measuring local cerebral glucose metabolism with the aim of showing a specific pattern related to the hallucinatory activity, is presented in schizophrenic patients all experiencing hallucinations or pseudo-halluccinations

  5. Inhalant Abuse: Is Your Child at Risk?

    Science.gov (United States)

    ... dizziness, headache, slurred speech, and loss of coordination, inhibition and control. Hallucinations and delusions are possible. If ... counselor or a local drug rehabilitation facility. The support of a mental health professional can be valuable ...

  6. What Is Psychiatry?

    Medline Plus

    Full Text Available ... as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more ... Expert Coping After Disaster, Trauma Share Your Story Suicide Prevention Warning Signs of Mental Illness What is ...

  7. What Is Psychiatry?

    Medline Plus

    Full Text Available ... Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders. Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder. Sedatives and ...

  8. Mind Over Matter: Methamphetamine

    Science.gov (United States)

    ... Teaching Guide and Series / Methamphetamine Mind Over Matter: Methamphetamine (Meth) Print Order Free Publication in: English Spanish ... paranoia, aggressiveness, and hallucinations. The Brain's Response to Methamphetamine Hi, my name's Sara Bellum. Welcome to my ...

  9. Self‐Disorders as schizophrenia spectrum vulnerability phenotypes

    DEFF Research Database (Denmark)

    Raballo, Andrea

    2011-01-01

    Schizophrenia spectrum disorders are characterised by manifold psychopathological expressions, which might include major symptoms (such as delusions, hallucinations or social withdrawal), psychobehavioural enduring personality patterns (e.g. schizoid/schizotypal traits), or more subtle, quasi...

  10. Rekreacyjne używanie leków dostępnych w odręcznej sprzedaży: odurzanie i doping mózgu

    Directory of Open Access Journals (Sweden)

    Aleksandra Piątek

    2015-03-01

    Pseudoephedrine, an amphetamine-like stimulant, produces mood improvement or even euphoria, hallucinations and psychosis. However, the real health threat is associated with the use of substances produced from pseudoephedrine: ephedrone and methamphetamine.

  11. What Are Bath Salts?

    Science.gov (United States)

    ... bath salts can produce: feelings of joy increased social interaction increased sex drive paranoia nervousness hallucinations (see or ... Institutes of Health; U.S. Department of Health and Human Services. Cite this article APA Style MLA Style ...

  12. Dopaminergic stimulation enhances confidence and accuracy in seeing rapidly presented words

    DEFF Research Database (Denmark)

    Lou, Hans Olav Christensen; Skewes, Joshua Charles; Thomsen, Kristine Rømer

    2011-01-01

    Liberal acceptance, overconfidence, and increased activity of the neurotransmitter dopamine have been proposed to account for abnormal sensory experiences, for instance, hallucinations in schizophrenia. In normal subjects, increased sensory experience in Yoga Nidra meditation is linked to striatal...

  13. What Is Psychiatry?

    Medline Plus

    Full Text Available ... used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder. Sedatives and anxiolytics – used to treat ... Personality Disorders Postpartum Depression Posttraumatic Stress Disorder (PTSD) Schizophrenia Sleep Disorders Somatic Symptom Disorder Specific Learning Disorder ...

  14. Parkinson's Disease Videos

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    Full Text Available ... for Parkinson's Care Partners OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis What Is the Progression ... Disease? What Are Some Strategies to Improve the Quality of Community Care for PD Patients? Hallucinations and ...

  15. Rabies (image)

    Science.gov (United States)

    ... messages between the brain and the body. The rabies virus spreads through the nerves, first causing flu- ... to hallucinations, delirium, and insomnia. If left untreated, rabies is nearly always fatal.

  16. What Is Psychiatry?

    Medline Plus

    Full Text Available ... anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders. Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder. Sedatives and ...

  17. An Evaluation of Neuropsychiatric Symptoms in Parkinson's Disease ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... Parkinson's disease (PD) is a chronic, progressive, and neurodegenerative disease which may present with complaints of tremor, bradykinesia, rigidity, and postural imbalance. Besides motor symptoms, neuropsychiatric symptoms such as depression, hallucination, anxiety, sleep disorders, and psychosis.

  18. Lewy Body Disease

    Science.gov (United States)

    ... range of symptoms, including Changes in alertness and attention Hallucinations Problems with movement and posture Muscle stiffness Confusion Loss of memory Lewy body disease can be hard to diagnose, ...

  19. Alternative psychosis (forced normalisation) in epilepsy

    African Journals Online (AJOL)

    changed, this should always be considered as a potential cause of a new or ... psychosis with thought disorder, delusions, hallucinations. • significant .... On mental status examination, the patient's behaviour was .... appeared for the first time.

  20. What Is Psychiatry?

    Medline Plus

    Full Text Available ... addressed to individuals in the European Economic Area. As described in the Privacy Policy, this website utilizes ... many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, ...

  1. Parkinson's Disease Videos

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    Full Text Available ... PD: What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model ... Disease Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in Parkinson's Disease ...

  2. Parkinson's Disease Videos

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    Full Text Available ... the Urinary System? What Are the Risks and Benefits of DBS Surgery? NPF Caregiver Summit 2016: Tools ... Depression and Parkinson's Disease? What Are the Neuroprotective Benefits of Exercise for PD Patients? Hallucinations and Delusions ...

  3. Parkinson's Disease Videos

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    Full Text Available ... Bringing Care to You Expert Care Programs Professional Education Expert Care Research shows people with Parkinson’s who ... Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Interdisciplinary Education on Parkinson's Disease Expert Briefings: Getting Around: Transportation ...

  4. Generalized tonic-clonic seizure

    Science.gov (United States)

    ... tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This ... longer (called the post-ictal state) Loss of memory (amnesia) about the seizure episode Headache Weakness of ...

  5. Parkinson's Disease Videos

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    Full Text Available ... Gene and Cell Therapies Expert Briefings: Dealing with Dementia in PD Expert Briefings: Anxiety in Parkinson's Disease ... Lobo: Música en vivo con Lobo! Dealing with Dementia Hallucinations and Parkinson's with Dr. Friedman CareMAP: Putting ...

  6. Parkinson's Disease Videos

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    Full Text Available ... Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and Parkinson's Nurse: ... Psychosis Hallucinations and Parkinson's with Dr. Friedman CareMAP: Travel and Transportation: Part 2 Caregiver Summit 2016: Caregiving: ...

  7. Sleep Issues and Sundowning

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  8. Grief and Loss as Alzheimer's Progresses

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  9. Changes to Your Relationships

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  10. Late-Stage Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  11. Middle-State Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  12. Stages and Behaviors

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  13. Early-Stage Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  14. Vilazodone

    Science.gov (United States)

    ... nausea vomiting unusual bleeding or bruising nosebleeds small red or purple dots on the skin hallucinations (seeing things or hearing voices that do not exist) headache difficulty concentrating memory problems weakness problems with coordination increased falls fainting ...

  15. Efavirenz as a cause of ataxia in children

    African Journals Online (AJOL)

    more side-effects of these drugs. We report ... negative; however, a CT scan of her brain was suggestive of possible ... posterior fossa structures revealed a normal brain. .... reported dizziness, ataxia, insomnia, bad dreams and hallucinations.

  16. Escitalopram

    Science.gov (United States)

    ... works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental ... that do not exist (hallucinating) fever, sweating, confusion, fast or ... the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  17. Safinamide

    Science.gov (United States)

    ... works by increasing the amount of dopamine (a natural substance that is needed to control movement) in ... are not real) agitation, hallucinations, fever, sweating, confusion, fast ... the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  18. Lewy body-demens

    DEFF Research Database (Denmark)

    Ziebell, Morten; Korbo, Lise; Hasselbalch, Steen G

    2010-01-01

    in mind when physicians encounter elderly demented patients with visual hallucinations, fluctuations and parkinsonism, as 50% of patients with DLB have severe sensitivity to antipsychotics. With new clinical criteria including SPECT of dopaminergic transporters, diagnosis has become sufficiently accurate...

  19. Parkinson's Disease Videos

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    Full Text Available ... Swallowing: Part 2 What Is the Relationship Between Depression and Parkinson's Disease? What Is Patient-Centered Care? Hallucinations and Delusions Dealing with Dementia CareMAP: Medicamentos ...

  20. Parkinson's Disease Videos

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    Full Text Available ... What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model Interventions ... Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in Parkinson's Disease Nurse ...

  1. Lenini ilmumine Salvador Dalile / Ants Juske

    Index Scriptorium Estoniae

    Juske, Ants, 1956-2016

    2007-01-01

    Salvador Dali maali "Osaline kangastus. Kuus Lenini ilmumist tiibklaveril" ("Hallucination partielle. Six apparitions de Lénine sur un piano") verbaalsest interpretatsioonist Harkovi ülikooli uurija Oleg Zaslavski teooria alusel

  2. Parkinson's Disease Videos

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    Full Text Available ... When Is It Time to Get Help? Unconditional Love CareMAP: Rest and Sleep: Part 1 What Are ... Around the House: Part 2 What Is the Relationship Between Depression and Parkinson's Disease? Hallucinations and Delusions ...

  3. Wernicke's encephalopathy as a complication of gastroparesis after ...

    African Journals Online (AJOL)

    of visual hallucinations and new-onset generalised tonic-clonic ... appeared very wasted, with reduced muscle bulk. ... anastomosis created by previous surgery. ... Department of Neurology, Faculty of Health Sciences, University of the Free ...

  4. Toxic cannabis psychosis IS a valid entIty

    African Journals Online (AJOL)

    1990-10-20

    Oct 20, 1990 ... Psychotic features included: formal thought disorder; hallucinations; delusions; ..... Major depressive episode. Manic episode ... Anxiety disorder. Temporal ... admission to hospital were in fact suffering from a mixed dagga and ...

  5. Parkinson's Disease Videos

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    Full Text Available ... Marijuana and PD: What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science ... Briefings: Parkinson's Disease Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in ...

  6. GABAergic Mechanisms in Schizophrenia : Linking Postmortem and In Vivo Studies

    NARCIS (Netherlands)

    de Jonge, Jeroen C; Vinkers, Christiaan H; Hulshoff Pol, Hilleke E; Marsman, Anouk

    2017-01-01

    Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and impairments in cognitive functioning. Evidence from postmortem studies suggests that alterations in cortical γ-aminobutyric acid (GABAergic) neurons contribute to the clinical features of

  7. What Are the Signs and Symptoms of Rabies?

    Science.gov (United States)

    ... the site of bite, progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, and insomnia. The acute period ...

  8. Fexofenadine and Pseudoephedrine

    Science.gov (United States)

    ... a fast, pounding, or irregular heartbeat after taking adrenergic medications such as phenylephrine (Neo-Synephrine), or epinephrine ( ... difficulty falling asleep or staying asleep weakness fear, anxiety, or tenseness hallucinating (seeing things or hearing voices ...

  9. High Peak Power Microwaves: A Health Hazard

    Science.gov (United States)

    1993-12-01

    administration of specific drugs, including beta blockers , can significantly enhance these effects, as evidenced by a lowered damage threshold exposure...impotence, hot flashes, weight gain, palpitations, sle.p disruption, muscle cramps, bladder spasms, hallucinations, salivation increased, tremors , scizurcs

  10. Visual hallucinatory syndromes and the anatomy of the visual brain.

    Science.gov (United States)

    Santhouse, A M; Howard, R J; ffytche, D H

    2000-10-01

    We have set out to identify phenomenological correlates of cerebral functional architecture within Charles Bonnet syndrome (CBS) hallucinations by looking for associations between specific hallucination categories. Thirty-four CBS patients were examined with a structured interview/questionnaire to establish the presence of 28 different pathological visual experiences. Associations between categories of pathological experience were investigated by an exploratory factor analysis. Twelve of the pathological experiences partitioned into three segregated syndromic clusters. The first cluster consisted of hallucinations of extended landscape scenes and small figures in costumes with hats; the second, hallucinations of grotesque, disembodied and distorted faces with prominent eyes and teeth; and the third, visual perseveration and delayed palinopsia. The three visual psycho-syndromes mirror the segregation of hierarchical visual pathways into streams and suggest a novel theoretical framework for future research into the pathophysiology of neuropsychiatric syndromes.

  11. An Evaluation of Neuropsychiatric Symptoms in Parkinson's Disease ...

    African Journals Online (AJOL)

    2016-08-22

    Aug 22, 2016 ... KEYWORDS: Depression, Parkinson's disease, psychosis. An Evaluation ... depression, hallucination, anxiety, sleep disorders, and psychosis .... relationship was the same in early and late stage PD. .... giver stress. J Neurol ...

  12. Genetics Home Reference: Lafora progressive myoclonus epilepsy

    Science.gov (United States)

    ... also experience occipital seizures, which can cause temporary blindness and visual hallucinations. Over time, the seizures worsen ... a continued loss of intellectual function (dementia) impairs memory, judgment, and thought. Affected people lose the ability ...

  13. Subself theory and reincarnation/possession.

    Science.gov (United States)

    Lester, David

    2004-12-01

    A subself model of the mind is used to account for multiple personality, possession, the spirit controls of mediums, reincarnation, and the auditory hallucinations of schizophrenics, with suggestions for empirical research.

  14. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Managing Depression, Anxiety & Psychosis OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis What Is the Relationship Between Depression and Parkinson's Disease? What Are Some Strategies for Problems with Urination? Hallucinations and Delusions CareMAP: ...

  15. ALCOHOLIC HALLUCINOSIS AND PARANOID SCHIZOPHRENIA?A COMPARATIVE (CLINICAL AND FOLLOW UP) STUDY

    OpenAIRE

    Sampath, G.; Kumar, Y. Vikram; Channabasavanna, S. M.; Keshavan, M. S.

    1980-01-01

    SUMMARY In a Study Of 90 patients of Alcoholic Hallucinosis and 30 patients of Paranoid Schizophrenia, it was found that delusions, delusions of infidelity, third person and running commentary auditory hallucinations and insight were not different in the two groups. Delusions of grandeur, passivity, thought echo and thought broadcast were significantly more frequent in paranoid schizophrenic patients. Anxiety, visual iiafracinatians and hallucinations in more than one modality at the same tim...

  16. Acute Psychotic Symptoms due to Benzydamine Hydrochloride Abuse with Alcohol

    Directory of Open Access Journals (Sweden)

    Yahya Ayhan Acar

    2014-01-01

    Full Text Available Benzydamine hydrochloride is a locally acting nonsteroidal anti-inflammatory drug. Benzydamine hydrochloride overdose can cause stimulation of central nervous system, hallucinations, and psychosis. We presented a young man with psychotic symptoms due to benzydamine hydrochloride abuse. He received a total dose of 1000 mg benzydamine hydrochloride with alcohol for its hallucinative effects. Misuse of benzydamine hydrochloride must be considered in differential diagnosis of first-episode psychosis and physicians should consider possibility of abuse in prescribing.

  17. The predictive value of baseline NAA/Cr for treatment response of first-episode schizophrenia: A ¹H MRS study.

    Science.gov (United States)

    Liu, Weibo; Yu, Hualiang; Jiang, Biao; Pan, Bing; Yu, Shaohua; Li, Huichun; Zheng, Leilei

    2015-07-23

    The study focused on the predictive value of baseline metabolite ratios in bilateral hippocampus of first-episode schizophrenia by using proton magnetic resonance spectroscopy ((1)H MRS). (1)H MRS data were acquired from 23 hallucination and 17 non-hallucination first-episode schizophrenia patients compared with 17 healthy participants. Clinical characteristics of patients were rated using the Positive and Negative Syndrome Scale (PANSS) before and after 3-month treatment. The schizophrenia patients showed lower NAA/Cr ratio than healthy participants respectively (p=0.024; p=0.001), and non-hallucination patients had even lower NAA/Cr ratio than hallucination patients (p=0.033). After 3-month treatment, hallucination patients had greater improvement in negative symptoms than non-hallucination patients (p=0.018). The reduction of PANSS total score and negative factor score was positively correlated with the left NAA/Cr in both group patients (pNAA/Cr had predictive value for the whole treatment response, and the left hippocampal NAA/Cr can predict the prognosis of negative symptoms during acute phase medication in first-episode schizophrenia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. [Transient charles bonnet syndrome after excision of a right occipital meningioma: a case report].

    Science.gov (United States)

    Arai, Takao; Hasegawa, Yuzuru; Tanaka, Toshihide; Kato, Naoki; Watanabe, Mitsuyoshi; Nakamura, Aya; Murayama, Yuichi

    2014-05-01

    Charles Bonnet syndrome is a condition characterized by visual hallucinations. These simple or complex visual hallucinations are more common in elderly individuals with impaired peripheral vision. The current report describes a case of transient Charles Bonnet syndrome appearing after the removal of a meningioma. The patient was a 61-year-old man who already had impaired visual acuity due to diabetic retinopathy. Brain MRI revealed a cystic tumor severely compressing the right occipital lobe. Starting on day 2 postoperatively, the patient was troubled by recurring visual hallucinations involving people, flowers, pictures, and familiar settings(the train and a coffee shop). These continued for 3.5 months. This period roughly coincided with the time for the occipital lobe to recover from the compression caused by the tumor, a fact that was confirmed by several MRI scans. ¹²³I-IMP SPECT performed 1 month after the surgical operation showed an area of hypoperfusion in the right parieto-occipital lobe. Based on the patient's clinical course and MRI findings, the mechanism of onset of visual hallucinations in this patient was put forward. The release of pressure in the brain by tumor removal and subsequent recovery changed the blood flow to the brain. This triggered visual hallucinations in the patient, who was already predisposed to developing Charles Bonnet syndrome because of diabetic retinopathy. This case is interesting since it indicates that central neurological factors, as well as visual deficits, may induce the appearance of visual hallucinations in Charles Bonnet syndrome.

  19. HUBUNGAN APLIKASI CARING DENGAN ASUHAN KEPERAWATAN KLIEN DENGAN HALUSINASI DENGAR DI RUMAH SAKIT JIWA SOEHARTO HEERDJAN

    Directory of Open Access Journals (Sweden)

    Ani Nuraeni

    2012-11-01

    Full Text Available Background: Nursing practices contain ethical assumptions and concepts embedded in the assumptions and principles of the theory that guide nurses' thinking and actions. In nursing practices are called upon for their expert ethical knowledged to formulate policies and provide counsel for what are deemed to be ethical dilemmas. The origin of ethical dilemma on tile psychiatric patient is paternalistic patterns. Paternalistic practices, where in providers confer a treatment or service upon a person or persons without their consent, ostensibly by reason of their limited autonomy or diminished capacity, are common in the psychiatric nursing. Objective: Nursing contributes critical self-decision regarding the auditory hallucination patients, but looks on when ethical analysis is needed. What implications does this have for nursing? What does it related to practice for caring in nursing ethically? How are the caring philosophical underpinnings of nursing ethics? Methods: The study design was a quasi experiment that aims to examine the influences of nursing care on the self-decision making among the auditory hallucination patient using caring perspectives at Soeharto Heerdjan Hospital, Jakarta. Twenty three clients with auditory hallucination were chosen. To examine the influences of nursing intervention on the self-decision making among the auditory hallucination patient, multiple linear regressions was used. Results: The correlation analysis at a= 0 05 showed that ethical aspects (p = 0.030; OR= 2.683; Cl 95% 1.101-6.538 had significant relationship with self-decision making among the auditory hallucination patient. Conclusion: The use of caring in professional nursing practice is important. Ethnical aspect in the nursing care can support the auditory hallucination patient increasing  his or herself-decision making Key words: caring, legal and ethical aspects, self-decision making, auditory hallucination patient

  20. Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 the Adult Psychiatric Morbidity Survey.

    Science.gov (United States)

    Bentall, Richard P; Wickham, Sophie; Shevlin, Mark; Varese, Filippo

    2012-06-01

    Previous studies have reported associations between childhood adversities, eg, loss of a parent, being raised in institutional care, sexual and other kinds of abuse by adults and bullying by peers, and psychosis in adulthood. However, the mechanisms by which these adversities lead to psychotic experiences are poorly understood. From models of the psychological processes involved in positive symptoms, it was predicted that childhood sexual abuse would be specifically associated with auditory hallucinations in adulthood, and that disruption of early attachment relations and more chronic forms of victimization such as bullying would be specifically associated with paranoid ideation. We therefore examined the associations between sexual trauma, physical abuse, bullying, and being brought up in institutional or local authority care and reports of auditory hallucinations and paranoid beliefs in the 2007 Adult Psychiatric Morbidity Survey. All simple associations between childhood adversities and the two symptom types were significant. Childhood rape was associated only with hallucinations (OR 8.9, CI = 1.86-42.44) once co-occurring paranoia was controlled for. Being brought up in institutional care (OR = 11.08, CI = 3.26-37.62) was specifically associated with paranoia once comorbid hallucinations had been controlled for. For each symptom, dose-response relationships were observed between the number of childhood traumas and the risk of the symptom. The specific associations observed are consistent with current psychological theories about the origins of hallucinations and paranoia. Further research is required to study the psychological and biological mediators of these associations.

  1. [Current peculiarities of alcoholic psychosis].

    Science.gov (United States)

    Aleksin, D S; Egorov, A Iu

    2011-01-01

    The follow-up study of alcoholic psychoses in male patients admitted to a clinical department of a psychiatric hospital in 2005-2007 was carried out. Patients with alcoholic psychoses made up from 15 to 30% of all patients. The number of psychosis had seasonal variations with the elevations in spring and autumn, peaks in January, lune and October. Alcoholic delirium morbidity made up from 69 to 82% of the total number of alcoholic psychoses, alcoholic hallucinosis varied from 14 to 27%. Other forms were presented by single cases. In alcoholic delirium hallucinations had brighter, sated character. The most specific were visual hallucinations in the form of zoohallucinations, hallucinations of an oral cavity ("sensation of threads, hair etc"). The most often observable characters were "extraneous people, animal, demons". In alcoholic hallucinosis, verbal contrast hallucinations, making comment hallucinations, visual illusions were most frequent. The family history of mental disorders and alcoholism was noted in 30% of patients with alcoholic psychosis. The probability of occurrence of alcoholic psychoses depended on the quality of consumed drinks. The presence of a cranial-brain injury in the anamnesis considerably aggravated the disease forecast and increased the risk of seizure syndrome.

  2. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders.

    Science.gov (United States)

    McKetin, Rebecca; Baker, Amanda L; Dawe, Sharon; Voce, Alexandra; Lubman, Dan I

    2017-05-01

    We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine. Copyright © 2017. Published by Elsevier B.V.

  3. A model of memory impairment in schizophrenia: cognitive and clinical factors associated with memory efficiency and memory errors.

    Science.gov (United States)

    Brébion, Gildas; Bressan, Rodrigo A; Ohlsen, Ruth I; David, Anthony S

    2013-12-01

    Memory impairments in patients with schizophrenia have been associated with various cognitive and clinical factors. Hallucinations have been more specifically associated with errors stemming from source monitoring failure. We conducted a broad investigation of verbal memory and visual memory as well as source memory functioning in a sample of patients with schizophrenia. Various memory measures were tallied, and we studied their associations with processing speed, working memory span, and positive, negative, and depressive symptoms. Superficial and deep memory processes were differentially associated with processing speed, working memory span, avolition, depression, and attention disorders. Auditory/verbal and visual hallucinations were differentially associated with specific types of source memory error. We integrated all the results into a revised version of a previously published model of memory functioning in schizophrenia. The model describes the factors that affect memory efficiency, as well as the cognitive underpinnings of hallucinations within the source monitoring framework. © 2013.

  4. Autoscopic phenomena and one's own body representation in dreams.

    Science.gov (United States)

    Occhionero, Miranda; Cicogna, Piera Carla

    2011-12-01

    Autoscopic phenomena (AP) are complex experiences that include the visual illusory reduplication of one's own body. From a phenomenological point of view, we can distinguish three conditions: autoscopic hallucinations, heautoscopy, and out-of-body experiences. The dysfunctional pattern involves multisensory disintegration of personal and extrapersonal space perception. The etiology, generally either neurological or psychiatric, is different. Also, the hallucination of Self and own body image is present during dreams and differs according to sleep stage. Specifically, the representation of the Self in REM dreams is frequently similar to the perception of Self in wakefulness, whereas in NREM dreams, a greater polymorphism of Self and own body representation is observed. The parallels between autoscopic phenomena in pathological cases and the Self-hallucination in dreams will be discussed to further the understanding of the particular states of self awareness, especially the complex integration of different memory sources in Self and body representation. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Dementia, Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Docu Any Axelerad

    2017-12-01

    Full Text Available Disordered arousal leads to a confusional state with an incoherent line of thought, temporal disorientation, poor recall, visual illusions, hallucinations and disordered behavior. With the exception of dementia with Lewy bodies, which is characterized by fluctuating confusion, other disorders causing dementia persist and deteriorate over months or years, and are not characterized by fluctuations or confusional episodes, except when other medical or environmental perturbations disrupt the arousal systems of the brain (e.g. intercurrent infection, anoxia. Sometimes, their hallucinations are different, with a religious tendency, and maybe we must insist with anamnesis related to previous religious beliefs, to see if it is possible to correlate some damaged area than cause hallucinations, are reliable with our faith.

  6. Parkinson's disease and narcolepsy-like symptoms.

    Science.gov (United States)

    Ylikoski, Ari; Martikainen, Kirsti; Sarkanen, Tomi; Partinen, Markku

    2015-04-01

    Various sleep-related problems, for example, insomnia and symptoms of rapid eye movement behavior disorder (RBD), are common in patients with Parkinson's disease (PD). We studied the prevalence of symptoms of narcolepsy (NARC), hallucinations, and RBD and their association with other symptoms. Altogether, 1447 randomly selected patients with PD, aged 43-89 years, participated in a questionnaire study. A structured questionnaire with 207 items was based on the Basic Nordic Sleep Questionnaire. Questions on demographics, PD, RBD, and other issues were included. The response rate was 59.0%; of these patients, 73% had answered to all questions that were used in the analyses (N = 623). The occurrence of suspected narcolepsy (Ullanlinna Narcolepsy Scale ≥ 14 and Epworth Sleepiness Scale ≥ 11) was observed in 9.3% of the subjects (PD with NARC), RBD (REM Sleep Behavior Disorder Screening Questionnaire ≥ 6) in 39.2% of all patients with PD, and in 62.1% of those with PD and NARC. In patients with PD, hallucinations before going to bed in the evening occurred in 5.8%, hypnagogic hallucinations in 4.0%, hallucinations during night 8.3%, and hypnopompic hallucinations in 3.2%. Cataplexy symptoms occurred in 43.1% of subjects with PD and NARC. In a logistic regression analysis, PD with NARC was associated with RBD, all types of hallucinations, daytime sleepiness, fatigue, insomnia, and intense dreaming also when adjusted for age, sex, disease duration, and levodopa. Narcolepsy-like symptoms may be present in patients with PD. Symptoms of RBD were associated with symptoms of narcolepsy including symptoms of cataplexy. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... el Comportamiento, Parte 1 CareMAP: Medicamentos y la Salud en General, Parte 1 Expert Briefings: Apathy or ... Caregiving Hallucinations and Delusions CareMAP: Medicamentos y la Salud en General, Parte 2 Dra. Claudia Martinez, MAPC - ...

  8. AMANTADINE HYDROCHWRIDE IN THE TREATMENT OF ...

    African Journals Online (AJOL)

    1971-04-17

    Apr 17, 1971 ... seemed beneficial. Side-effects occurred in 22% of patients and consisted of restlessness. insomnia, abdominal uneasiness, dizzi- ness, depression, confusion and, in a few cases, hallucinations. In most cases side-effects were controlled by reducing the dose of amantadine or of concomitant medication.

  9. A pilot study of the relations within which hearing voices participates: Towards a functional distinction between voice hearers and controls

    NARCIS (Netherlands)

    McEnteggart, C.; Barnes-Holmes, Y.; Egger, J.I.M.; Barnes-Holmes, D.

    2016-01-01

    The current research used the Implicit Relational Assessment Procedure (IRAP) as a preliminary step toward bringing a broad, functional approach to understanding psychosis, by focusing on the specific phenomenon of auditory hallucinations of voices and sounds (often referred to as hearing voices).

  10. African Journal of Psychiatry - Vol 16, No 6 (2013)

    African Journals Online (AJOL)

    Scientific Letter: Homemade heroin substitute causing hallucinations · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. TI Lemon. http://dx.doi.org/10.4314/ajpsy.v16i6.51 ...

  11. 58 HIV/AIDS: COMPLICATIONS AND CHALLENGES; THE ...

    African Journals Online (AJOL)

    drclement

    HIV-1 is found worldwide and is responsible for the worldwide pandemic, and HIV-2, ... appears to be more virulent than all the ... At the end of 2003, 40 million people ... under age 15years make up 10% of the .... Extensive drug interactions may result in ... (causes hallucinations, nightmare day .... Science 280:1863, 1998.

  12. Psychiatric consultations and the management of associated ...

    African Journals Online (AJOL)

    of medicine: 'the psychosomatic unity of the body and ... ¹ Department of Psychiatry, Faculty of Health Sciences, University of the ... assessment, and was more likely to be managed in the medical wards for delirium, ... and ongoing interaction between mental disorders and general ..... such as hallucinations and delusions.

  13. Managing terminal restlessness

    African Journals Online (AJOL)

    Repro

    In contrast, allowing such a person to remain restless is ... Look for the following features:1. • Sudden onset ... Dementia has a more insidious onset with progressive ... aggression and hallucinations. However, .... Many researchers have shown that dehydration ... clear intent is to make the ... certain drug interactions may be.

  14. Volume 9 Number 3

    African Journals Online (AJOL)

    OLUWOLE

    Agro-Science Journal of Tropical Agriculture, Food, Environment and Extension ... There is therefore an urgent need to find alternative sources of plant protein. ... candidates to fill the gap created by high cost of ... Mucuna is consumed by the people of ... one of the best green manure, cover crops and ... hallucinations and.

  15. Schizophrenia among Sesotho speakers in South Africa | Mosotho ...

    African Journals Online (AJOL)

    Results: Core symptoms of schizophrenia among Sesotho speakers do not differ significantly from other cultures. However, the content of psychological symptoms such as delusions and hallucinations is strongly affected by cultural variables. Somatic symptoms such as headaches, palpitations, dizziness and excessive ...

  16. A review of non-obstetric spontaneous pneumo-mediastinum and ...

    African Journals Online (AJOL)

    A review of non-obstetric spontaneous pneumo-mediastinum and subcutaneous emphysema. M Brand, B Bizos, L Burnell. Abstract. A man in his early twenties was admitted from the streets. He was hallucinating and incoherent. His vital signs were normal and there was no sign of injury. There was subcutaneous ...

  17. Parkinson's Disease Videos

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    Full Text Available ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? How Do I Know if My Loved One Has Experienced Hallucinations or Delusions? Caregiver Summit 2016: Coping Strategy: Mindfulness Ask the Helpline: What Is a Movement Disorder Specialist? How Do I Manage Non-Motor Problems ...

  18. Use of repetitive transcranial magnetic stimulation for treatment in psychiatry.

    Science.gov (United States)

    Aleman, André

    2013-08-01

    The potential of noninvasive neurostimulation by repetitive transcranial magnetic stimulation (rTMS) for improving psychiatric disorders has been studied increasingly over the past two decades. This is especially the case for major depression and for auditory-verbal hallucinations in schizophrenia. The present review briefly describes the background of this novel treatment modality and summarizes evidence from clinical trials into the efficacy of rTMS for depression and hallucinations. Evidence for efficacy in depression is stronger than for hallucinations, although a number of studies have reported clinically relevant improvements for hallucinations too. Different stimulation parameters (frequency, duration, location of stimulation) are discussed. There is a paucity of research into other psychiatric disorders, but initial evidence suggests that rTMS may also hold promise for the treatment of negative symptoms in schizophrenia, obsessive compulsive disorder and post-traumatic stress disorder. It can be concluded that rTMS induces alterations in neural networks relevant for psychiatric disorders and that more research is needed to elucidate efficacy and underlying mechanisms of action.

  19. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Spouse About Sexual Dysfunction? Attachment: consultation.jpg OHSU - Therapeutic Approaches for PD: Depression, Anxiety & Psychosis What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Travel and Transportation: Part 2 Hallucinations and Delusions CareMAP: ...

  20. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    Science.gov (United States)

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,…

  1. The Validity and Sensitivity of PANSS-6 in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Study

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Foldager, Leslie; Mors, Ole

    2017-01-01

    It was recently demonstrated in acutely exacerbated schizophrenia that a 6-item version (PANSS-6: P1 = delusions, P2 = conceptual disorganization, P3 = hallucinations, N1 = blunted affect, N4 = social withdrawal, N6 = lack of spontaneity/flow of conversation) of the 30-item Positive and Negative...

  2. The central anticholinergic syndrome in the postoperative period

    NARCIS (Netherlands)

    J. Rupreht (Joze); B. Dworacek (B.)

    1990-01-01

    markdownabstractRésumé Le syndrome anticholinergique central (SAC) comporte des signes centraux (somnolence, confusion, amnésie, agitation, hallucination, dysarthrie, ataxie, délire, stupeur, coma) et des signes périphériques (sécheresse buccale et/ou cutanée, tachycardie, troubles visuels et

  3. Hallucinatory Side Effects of ADHD Drugs

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-04-01

    Full Text Available Clinical trial and postmarketing surveillance data for drugs used in treatment of attention deficit hyperactivity disorder were analyzed to determine the frequency of hallucinations and other psychotic side effects, in a study at the US Food and Drug Administration, and Department of Health and Human Services, Maryland.

  4. Use of Repetitive Transcranial Magnetic Stimulation for Treatment in Psychiatry

    NARCIS (Netherlands)

    Aleman, Andre

    The potential of noninvasive neurostimulation by repetitive transcranial magnetic stimulation (rTMS) for improving psychiatric disorders has been studied increasingly over the past two decades. This is especially the case for major depression and for auditory verbal hallucinations in schizophrenia.

  5. Pharmacological Interventions for the MATRICS Cognitive Domains in Schizophrenia: What's the Evidence?

    NARCIS (Netherlands)

    Vingerhoets, Wilhelmina A. M.; Bloemen, Oswald J. N.; Bakker, Geor; van Amelsvoort, Therese A. M. J.

    2013-01-01

    Schizophrenia is a disabling, chronic psychiatric disorder with a prevalence rate of 0.5-1% in the general population. Symptoms include positive (e.g., delusions, hallucinations), negative (e.g., blunted affect, social withdrawal), as well as cognitive symptoms (e.g., memory and attention problems).

  6. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Following a Medication Schedule? CareMAP: Medications and General Health Part 1 What Is Patient-Centered Care? Hallucinations ... Thinking Changes: Part 2 CareMAP: Medications and General Health Part 2 ¿Cómo Se Diagnostica el Parkinson? CareMAP: ...

  7. Better theory-of-mind skills in children hearing voices mitigate the risk of secondary delusion formation

    NARCIS (Netherlands)

    Bartels-Velthuis, A. A.; Blijd-Hoogewys, E. M. A.; van Os, J.

    Objective: To examine the social cognitive vulnerabilities mediating delusion formation in children presenting with hallucinatory experiences. Method: A sample of 259 12- and 13-year-old children, from a baseline case-control sample of children with and without auditory hallucinations (AH), were

  8. Social cognition in schizophrenia

    NARCIS (Netherlands)

    Maat, A.

    2014-01-01

    Schizophrenia is a chronic psychiatric disorder, incorporating a wide range of symptoms that may occur at certain stages of the disease. The core symptoms can largely be divided into positive symptoms, e.g. hallucinations and delusions, and negative symptoms, e.g. apathia and emotional flattening.

  9. Stop, look, listen

    DEFF Research Database (Denmark)

    McCarthy-Jones, Simon; Krueger, Joel William; Larøi, Frank

    2013-01-01

    One of the leading cognitive models of auditory verbal hallucinations (AVHs) proposes such experiences result from a disturbance in the process by which inner speech is attributed to the self. Research in this area has, however, proceeded in the absence of thorough cognitive and phenomenological ...

  10. Predicting Psychotic-Like Experiences during Sensory Deprivation

    Science.gov (United States)

    Daniel, Christina; Mason, Oliver J.

    2015-01-01

    Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs) reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis. PMID:25811027

  11. Predicting Psychotic-Like Experiences during Sensory Deprivation

    Directory of Open Access Journals (Sweden)

    Christina Daniel

    2015-01-01

    Full Text Available Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis.

  12. Monosymptomatic Hypochondriacal Psychosis (somatic delusional ...

    African Journals Online (AJOL)

    bodily sensations or functions; such as feeling malodorous, ... of symptoms of psychiatric disability other than the central delusion ... psychotic or physical illness.3,6-9 The following two cases of ... history of olfactory hallucinations of bad odour coming from ... withdrew from social activities, avoided interaction with people.

  13. Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey.

    Science.gov (United States)

    Sitko, Katarzyna; Bentall, Richard P; Shevlin, Mark; O'Sullivan, Noreen; Sellwood, William

    2014-07-30

    Accumulated evidence over the past decade consistently demonstrates a relationship between childhood adversity and psychosis in adulthood. There is some evidence of specific associations between childhood sexual abuse and hallucinations, and between insecure attachment and paranoia. Data from the National Comorbidity Survey were used in assessing whether current attachment styles influenced the association between adverse childhood experiences and psychotic symptoms in adulthood. Hallucinations and paranoid beliefs were differentially associated with sexual abuse (rape and sexual molestation) and neglect, respectively. Sexual abuse and neglect were also associated with depression. The relationship between neglect and paranoid beliefs was fully mediated via anxious and avoidant attachment. The relationship between sexual molestation and hallucinations was independent of attachment style. The relationship between rape and hallucinations was partially mediated via anxious attachment; however this effect was no longer present when depression was included as a mediating variable. The findings highlight the importance of addressing and understanding childhood experiences within the context of current attachment styles in clinical interventions for patients with psychosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Morphine sparing effect of low dose ketamine during patient ...

    African Journals Online (AJOL)

    Measurements: Morphine consumption, visual analogue pain score (VAPS), pulse oximetry oxygen saturation (SpO2), respiratory rate (RR), verbal descriptive sedation score (VDSS), nausea, pruritis, dreaming, and hallucinations were recorded at 1, 4, 24 and 48 hours. Equivalence of the two groups was assessed by ...

  15. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... and Parkinson's Disease? Hallucinations and Delusions CareMAP: Balancing Life and Caregiving CareMAP: Travel and Transportation: Part 1 ...

  16. The nature of emotional abnormalities in schizophrenia: Evidence from patients and high-risk individuals

    NARCIS (Netherlands)

    Wout, M. van 't

    2006-01-01

    Schizophrenia is a psychiatric disorder that affects about one out of 100 people with symptoms generally emerging in early adulthood. According to the DSM-IV, schizophrenia is characterized by psychotic symptoms, such as hallucinations, delusions, bizarre behavior or speech and negative symptoms

  17. Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

    DEFF Research Database (Denmark)

    Ziebell, Morten; Andersen, Birgitte B; Pinborg, Lars H

    2013-01-01

    cognitively evaluated with the Mini Mental State Examination. RESULTS: There was no correlation between Mini Mental State Examination, Hoehn and Yahr score, fluctuations or hallucinations, and striatal DAT availability as measured with (123)I-PE2I and SPECT. CONCLUSION: In patients with newly diagnosed DLB...

  18. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and Parkinson's Nurse: ... the Relationship Between Depression and Parkinson's Disease? CareMAP: Travel and Transportation: Part 1 Hallucinations and Delusions CareMAP: ...

  19. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... One Is It? CareMAP: El Descanso y el Sueño, Parte 1 Expert Briefings: What's in the PD ... Care Between Appointments? CareMAP: El Descanso y el Sueño, Parte 2 Hallucinations and Parkinson's with Dr. Friedman ...

  20. Bipolar disorder: an overview | Bronkhorst | South African Family ...

    African Journals Online (AJOL)

    The typical presentation of these episodes of mania includes high energy hallucinations and delusions, sleep deprivation, fast speech and a constant need to be active. Risk factors that contribute to development of BD include the use of cannabis, influenza during the third trimester of pregnancy, as well as smoking during ...

  1. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Movement and Falls: Part 1 What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Plans and Scheduling: Part 2 Hallucinations and Delusions What Are the Common Sleep Disorders Encountered in Patients with PD? CareMAP: Medicamentos y la Salud en ...

  2. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Health Part 2 How Does the DBS Device Work? ¿Cómo Se Diagnostica el Parkinson? CareMAP: Cambios para ... OHSU - Overview of Parkinson's Disease CareMAP: Activities at Home Hallucinations and Parkinson's with Dr. Friedman CareMAP: Caring ...

  3. Narcolepsy induced by chronic heavy alcohol consumption: a case report

    Science.gov (United States)

    Wang, Xinyuan

    2012-01-01

    Summary Narcolepsy is a chronic neurological disorder, characterized by uncontrollable excessive daytime sleepiness, cataplectic episodes, sleep paralysis, hypnagogic hallucinations, and night time sleep disruption. The paper reviewed the related literature and reported a case of long-term drinking induced narcolepsy which was significantly improved after treatment with paroxetine and dexzopiclone. PMID:25328357

  4. Unravelling narcolepsy : from pathophysiology to measuring treatment effects

    NARCIS (Netherlands)

    Heide, van der A.

    2017-01-01

    Narcolepsy is a disorder of the regulation of sleep and wakefulness, with as its major features excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, sleep paralysis and disturbed nocturnal sleep. The first part of this thesis concernes an overview of the pathophysiology,

  5. Complex Movement Disorders at Disease Onset in Childhood Narcolepsy with Cataplexy

    Science.gov (United States)

    Plazzi, Giuseppe; Pizza, Fabio; Palaia, Vincenzo; Franceschini, Christian; Poli, Francesca; Moghadam, Keivan K.; Cortelli, Pietro; Nobili, Lino; Bruni, Oliviero; Dauvilliers, Yves; Lin, Ling; Edwards, Mark J.; Mignot, Emmanuel; Bhatia, Kailash P.

    2011-01-01

    Narcolepsy with cataplexy is characterized by daytime sleepiness, cataplexy (sudden loss of bilateral muscle tone triggered by emotions), sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. Narcolepsy with cataplexy is most often associated with human leucocyte antigen-DQB1*0602 and is caused by the loss of…

  6. The Psychosocial Problems of Children with Narcolepsy and Those with Excessive Daytime Sleepiness of Uncertain Origin

    Science.gov (United States)

    Stores, Gregory; Montgomery, Paul; Wiggs, Luci

    2007-01-01

    Background: Narcolepsy is a predominantly rapid eye movement sleep disorder with onset usually in the second decade but often in earlier childhood. Classically it is characterized by combinations of excessive sleepiness especially sleep attacks, cataplexy, hypnagogic hallucinations, and sleep paralysis. The psychosocial effects of this lifelong…

  7. An integrated network model of psychotic symptoms

    NARCIS (Netherlands)

    Looijestijn, Jasper; Blom, Jan Dirk; Aleman, Andre; Hoek, Hans W.; Goekoop, Rutger

    2015-01-01

    The full body of research on the nature of psychosis and its determinants indicates that a considerable number of factors are relevant to the development of hallucinations, delusions, and other positive symptoms, ranging from neurodevelopmental parameters and altered connectivity of brain regions to

  8. Steroid-Responsive Chronic Schizophreniform Syndrome in the Context of Mildly Increased Antithyroid Peroxidase Antibodies

    Directory of Open Access Journals (Sweden)

    Ludger Tebartz van Elst

    2017-04-01

    Full Text Available BackgroundSchizophreniform syndromes can be divided into primary forms from polygenic causes or secondary forms due to immunological, epileptiform, monogenic, or degenerative causes. Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT is a secondary immunological form associated with increased thyroid antibodies, such as antithyroid peroxidase antibodies and shows a good response to corticosteroids.Case presentationWe present the case of a 41-year-old woman suffering from a schizophreniform syndrome. Starting at the age of 35, she developed psychotic exacerbations with formal thought disorder, acoustic hallucinations, cenesthopathic experiences, and loss of ego boundaries. At the same time, she began to suffer from chronic sexual delusions and olfactory hallucinations, which did not respond to neuroleptic medication. Her levels of antithyroid peroxidase antibodies were slightly increased, and the blood–brain barrier was disturbed. An electroencephalogram (EEG showed intermittent generalized slowing, and cerebral magnetic resonance imaging (cMRI depicted mild temporolateral atrophy. High-dose corticosteroid treatment led to convincing improvement of attentional performance and the disappearance of delusions and olfactory hallucinations.ConclusionSREAT can mimic typical symptoms of schizophreniform syndromes. The increased titer of antithyroid peroxidase antibodies in combination with the EEG slowing, blood–brain barrier dysfunction, and the cMRI alterations were the basis for suspecting an immunological cause in our patient. Chronic delusions, olfactory hallucinations, and cognitive deficits were successfully treated with corticosteroids. The occurrence of secondary immunological forms of schizophreniform syndromes demonstrates the need for innovative immunosuppressive treatment options.

  9. dnAGEnetics: genomic copy number variants and parental age as risk factors for psychiatric disorders

    NARCIS (Netherlands)

    Buizer - Voskamp, J.E.

    2011-01-01

    Introduction: Schizophrenia is a debilitating psychiatric disorder with a life-time risk of 0.46 – 1% in the general population. It is characterized by psychotic symptoms, including delusions and hallucinations. Its predisposition is influenced by a complex interaction of genetic and environmental

  10. Respiratory arrest at the onset of idiopathic childhood occipital epilepsy of Gastaut.

    Science.gov (United States)

    Funata, Keiko; Shike, Tatsuhiko; Takenouchi, Toshiki; Yamashita, Yukio; Takahashi, Takao

    2018-01-01

    Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure. Upon arrival at the local hospital, she was unconscious and soon thereafter, developed respiratory arrest. She was resuscitated and initiated on mechanical ventilation. An electroencephalogram taken three days after seizure cessation showed frequent occipital spikes, consistent with the diagnosis of ICOEG. The sequence of acute elementary visual hallucination followed by a motor seizure, and then witnessed respiratory arrest illustrated occurrence of life-threatening autonomic involvement at initial onset in ICOEG. We speculate that the epileptic propagation from the occipital lobes eventually compromised the respiratory center in the brainstem. The possibility of occipital lobe epilepsy should be considered in school-age children presenting with acute visual hallucination followed by respiratory arrest. Such a presentation should prompt an urgent electroencephalogram and initiation of antiepileptic treatment if indicated. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  11. Irreversible brain damage caused by methamphetamine

    Directory of Open Access Journals (Sweden)

    Sebastian Moeller

    2016-03-01

    Full Text Available Methamphetamine is an addictive scene substance usage of which is increasing rapidly. While methamphetamine often causes neuropsychiatric symptoms like anxiety, psychosis and hallucinations, reports of structural ongoing cerebral alterations are rare. We here report a case of this kind of damage caused through methamphetamine use.

  12. Behavioral and Psychologic Symptoms in Different Types of Dementia

    Directory of Open Access Journals (Sweden)

    Ming-Jang Chiu

    2006-01-01

    Conclusion: A strategy of targeting type-specific BPSD may be beneficial, such as environmental stimulus control for DLB patients who are prone to have hallucinations, design of a pacing path for patients with FTD who need support for symptoms of wandering and emotional support for patients with VaD who are susceptible to depression.

  13. Comparing the experience of voices in borderline personality disorder with the experience of voices in a psychotic disorder: A systematic review.

    Science.gov (United States)

    Merrett, Zalie; Rossell, Susan L; Castle, David J

    2016-07-01

    In clinical settings, there is substantial evidence both clinically and empirically to suggest that approximately 50% of individuals with borderline personality disorder experience auditory verbal hallucinations. However, there is limited research investigating the phenomenology of these voices. The aim of this study was to review and compare our current understanding of auditory verbal hallucinations in borderline personality disorder with auditory verbal hallucinations in patients with a psychotic disorder, to critically analyse existing studies investigating auditory verbal hallucinations in borderline personality disorder and to identify gaps in current knowledge, which will help direct future research. The literature was searched using the electronic database Scopus, PubMed and MEDLINE. Relevant studies were included if they were written in English, were empirical studies specifically addressing auditory verbal hallucinations and borderline personality disorder, were peer reviewed, used only adult humans and sample comprising borderline personality disorder as the primary diagnosis, and included a comparison group with a primary psychotic disorder such as schizophrenia. Our search strategy revealed a total of 16 articles investigating the phenomenology of auditory verbal hallucinations in borderline personality disorder. Some studies provided evidence to suggest that the voice experiences in borderline personality disorder are similar to those experienced by people with schizophrenia, for example, occur inside the head, and often involved persecutory voices. Other studies revealed some differences between schizophrenia and borderline personality disorder voice experiences, with the borderline personality disorder voices sounding more derogatory and self-critical in nature and the voice-hearers' response to the voices were more emotionally resistive. Furthermore, in one study, the schizophrenia group's voices resulted in more disruption in daily functioning

  14. Acute LSD effects on response inhibition neural networks.

    Science.gov (United States)

    Schmidt, A; Müller, F; Lenz, C; Dolder, P C; Schmid, Y; Zanchi, D; Lang, U E; Liechti, M E; Borgwardt, S

    2017-10-02

    Recent evidence shows that the serotonin 2A receptor (5-hydroxytryptamine2A receptor, 5-HT2AR) is critically involved in the formation of visual hallucinations and cognitive impairments in lysergic acid diethylamide (LSD)-induced states and neuropsychiatric diseases. However, the interaction between 5-HT2AR activation, cognitive impairments and visual hallucinations is still poorly understood. This study explored the effect of 5-HT2AR activation on response inhibition neural networks in healthy subjects by using LSD and further tested whether brain activation during response inhibition under LSD exposure was related to LSD-induced visual hallucinations. In a double-blind, randomized, placebo-controlled, cross-over study, LSD (100 µg) and placebo were administered to 18 healthy subjects. Response inhibition was assessed using a functional magnetic resonance imaging Go/No-Go task. LSD-induced visual hallucinations were measured using the 5 Dimensions of Altered States of Consciousness (5D-ASC) questionnaire. Relative to placebo, LSD administration impaired inhibitory performance and reduced brain activation in the right middle temporal gyrus, superior/middle/inferior frontal gyrus and anterior cingulate cortex and in the left superior frontal and postcentral gyrus and cerebellum. Parahippocampal activation during response inhibition was differently related to inhibitory performance after placebo and LSD administration. Finally, activation in the left superior frontal gyrus under LSD exposure was negatively related to LSD-induced cognitive impairments and visual imagery. Our findings show that 5-HT2AR activation by LSD leads to a hippocampal-prefrontal cortex-mediated breakdown of inhibitory processing, which might subsequently promote the formation of LSD-induced visual imageries. These findings help to better understand the neuropsychopharmacological mechanisms of visual hallucinations in LSD-induced states and neuropsychiatric disorders.

  15. The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems.

    Science.gov (United States)

    Cederlöf, Martin; Pettersson, Erik; Sariaslan, Amir; Larsson, Henrik; Östberg, Per; Kelleher, Ian; Långström, Niklas; Gumpert, Clara Hellner; Lundström, Sebastian; Lichtenstein, Paul

    2016-03-01

    Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  16. [Non-delirious toxic psychoses in children (author's transl)].

    Science.gov (United States)

    Eggers, C

    1975-01-01

    There is an increasing occurrence of drug-intoxications in infancy, thus psychopathological changes due to intoxication also occur more frequently in children. 6 children were described with cases of acute and reversible toxic psychoses whose--mainly visual--hallucinations together with conditions of excitation and hyperactivity were the most striking features of the psychopathological picture; in contrast to the more frequent delirious confusion (delirium) disturbances of consciousness and orientation were missing. The phenomenological characteristics of halucinosis in children-a condition so far not specified in the case of infants and children-have been elaborated with regard to other psychotic phenomena during infancy and adult age. Relevant neurophysiological and psychodevelopmental findings lead to the following four theorems: 1. Drugs with hallucinotic effects facilitate the occurrence of "internal" pictures independent of external perceptions which are described phenomenologically as hallucinations. This theory is based on the fact that hallucinogenic drugs intensify the electrical potentials which are evoked by optic stimulation in the visual area, while an intracortical impulse propagation is inhibited. 2. A change in emotion either caused by situation or by exogenous or endogenous factors facilitates the development of hallucinations, especially if emotions dominate to such a degree that rational control of reality is being suppressed. Since hallucinogenic drugs exert their effects not only on the sensory system but also on brain structures which influence directly or indirectly emotional functions, hallucinations might also be evoked via this mechanism. 3. Brain stem has-apart from its importance in emotional processes-a filter effect and a controlling function of sensoric stimuli originating in the periphery. Hallucinogenic drugs can influence this screening function and have a disinhibitory effect which cause an inundation of the brain cortex by

  17. Different patterns of auditory cortex activation revealed by functional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Formisano, E; Pepino, A; Bracale, M [Department of Electronic Engineering, Biomedical Unit, Universita di Napoli, Federic II, Italy, Via Claudio 21, 80125 Napoli (Italy); Di Salle, F [Department of Biomorphological and Functional Sciences, Radiologucal Unit, Universita di Napoli, Federic II, Italy, Via Claudio 21, 80125 Napoli (Italy); Lanfermann, H; Zanella, F E [Department of Neuroradiology, J.W. Goethe Universitat, Frankfurt/M. (Germany)

    1999-12-31

    In the last few years, functional Magnetic Resonance Imaging (fMRI) has been widely accepted as an effective tool for mapping brain activities in both the sensorimotor and the cognitive field. The present work aims to assess the possibility of using fMRI methods to study the cortical response to different acoustic stimuli. Furthermore, we refer to recent data collected at Frankfurt University on the cortical pattern of auditory hallucinations. Healthy subjects showed broad bilateral activation, mostly located in the transverse gyrus of Heschl. The analysis of the cortical activation induced by different stimuli has pointed out a remarkable difference in the spatial and temporal features of the auditory cortex response to pulsed tones and pure tones. The activated areas during episodes of auditory hallucinations match the location of primary auditory cortex as defined in control measurements with the same patients and in the experiments on healthy subjects. (authors) 17 refs., 4 figs.

  18. Musical hallucinosis: case reports and possible neurobiological models.

    Science.gov (United States)

    Mocellin, Ramon; Walterfang, Mark; Velakoulis, Dennis

    2008-04-01

    The perception of music without a stimulus, or musical hallucination, is reported in both organic and psychiatric disorders. It is most frequently described in the elderly with associated hearing loss and accompanied by some degree of insight. In this setting it is often referred to as 'musical hallucinosis'. The aim of the authors was to present examples of this syndrome and review the current understanding of its neurobiological basis. We describe three cases of persons experiencing musical hallucinosis in the context of hearing deficits with varying degrees of associated central nervous system abnormalities. Putative neurobiological mechanisms, in particular those involving de-afferentation of a complex auditory recognition system by complete or partial deafness, are discussed in the light of current information from the literature. Musical hallucinosis can be experienced in those patients with hearing impairment and is phenomenologically distinct for hallucinations described in psychiatric disorders.

  19. Acute Psychosis Associated with Subcortical Stroke: Comparison between Basal Ganglia and Mid-Brain Lesions

    Directory of Open Access Journals (Sweden)

    Aaron McMurtray

    2014-01-01

    Full Text Available Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result of frontal lobe dysfunction causing impairment of reality checking pathways in the brain, while visual hallucinations due to mid-brain lesions are theorized to develop due to dysregulation of inhibitory control of the ponto-geniculate-occipital system. Psychotic symptoms occurring due to stroke demonstrate varied clinical characteristics that depend on the location of the stroke within the brain. Treatment with antipsychotic medications may provide symptomatic relief.

  20. Novel psychoactive substance intoxication resulting in attempted murder.

    Science.gov (United States)

    Stevenson, Richard; Tuddenham, Laurence

    2014-07-01

    A man in his twenties who had no previous history of violence, snorted large quantities of two substances he identified as 3-methoxyphencyclidine (3-MeO-PCP), and methylenedioxypyrovalerone (MDPV); both are recognised as novel psychoactive substances, or commonly described in the media as "legal highs". He also inhaled butane gas. He experienced vivid hallucinations and developed bizarre ideas. During this state of mind he stabbed his father multiple times and was arrested and charged with attempted murder. He had a previous history of drug induced psychosis and although he had some slight residual symptoms before he consumed the substances, these were not considered relevant to his criminal liability at the time of the offence. The hallucinations caused by the use of these substances took six weeks to completely recede. He was convicted of attempted murder and sentenced to four years in prison. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Different patterns of auditory cortex activation revealed by functional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Formisano, E.; Pepino, A.; Bracale, M.; Di Salle, F.; Lanfermann, H.; Zanella, F.E.

    1998-01-01

    In the last few years, functional Magnetic Resonance Imaging (fMRI) has been widely accepted as an effective tool for mapping brain activities in both the sensorimotor and the cognitive field. The present work aims to assess the possibility of using fMRI methods to study the cortical response to different acoustic stimuli. Furthermore, we refer to recent data collected at Frankfurt University on the cortical pattern of auditory hallucinations. Healthy subjects showed broad bilateral activation, mostly located in the transverse gyrus of Heschl. The analysis of the cortical activation induced by different stimuli has pointed out a remarkable difference in the spatial and temporal features of the auditory cortex response to pulsed tones and pure tones. The activated areas during episodes of auditory hallucinations match the location of primary auditory cortex as defined in control measurements with the same patients and in the experiments on healthy subjects. (authors)

  2. Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy

    Science.gov (United States)

    Ivanenko, Anna

    2009-01-01

    Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

  3. Mike Davis, guérilla dans les sciences sociales.

    Directory of Open Access Journals (Sweden)

    Yveline Lévy-Piarroux

    2009-03-01

    Full Text Available « La plaine est morne et morte ― et la ville la mange. » Emile Verhaeren, « La plaine » in Les villes tentaculaires Le titre anglais de l’ouvrage de Mike Davis et Daniel B. Monk est Evil Paradises: Dreamworlds of Neoliberalism (2007. Les traducteurs ont conservé l’oxymore de la première formulation. Les « mondes de rêve » sont devenus « les villes hallucinées », allusion croisée à deux recueils de poésie d’Émile Verhaeren, Les campagnes hallucinées (1893 ...

  4. Hashimoto's encephalopathy: Report of three cases

    Directory of Open Access Journals (Sweden)

    Jan-Shun Chang

    2014-11-01

    Full Text Available Both severe thyrotoxicosis and hypothyroidism may affect brain function and cause a change in consciousness, as seen with a thyroid storm or myxedema coma. However, encephalopathy may also develop in patients with autoimmune thyroid diseases independent of actual thyroid function level, and this is known as Hashimoto's encephalopathy. Although most patients are found to have Hashimoto's thyroiditis, less frequently they have Graves' disease. Clinical manifestations include epilepsy, disturbance of consciousness, cognitive impairment, memory loss, myoclonus, hallucinations, stroke-like episodes, tremor, involuntary movements, language impairment, and gait impairment. Hashimoto's encephalopathy is a relatively rare disease. As a good response can be obtained with corticosteroid therapy, early diagnosis and treatment is very beneficial for patients. Here we report three patients with Hashimoto's encephalopathy with typical manifestations of hallucinations that were associated with hypothyroidism, hyperthyroidism, and euthyroid status, respectively. They all showed a dramatic response to methylprednisolone pulse therapy.

  5. Alcoholic hallucinosis: case report

    OpenAIRE

    Bárbara Werner Griciunas; Norton Yoshiaki Kitanishi; Patricia Motta Carvalho; Daniel Azevedo Cavalcante; Leonardo Mattiolli Marini

    2017-01-01

    Case report of patient who has been an alcoholic for 40 years and, after reducing alcohol intake, developed auditory and visual hallucinations, which caused behavior change. Neurological issues, electrolyte disturbances and other organ dysfunctions were excluded as cause of said change. After intake of haloperidol and risperidone, the patient had regression of symptoms and denied having presented hallucinatory symptoms. The Manual Diagnóstico e Estatístico de Transtornos Mentais – 5ª edição (...

  6. On the nose: Olfactory disturbances in patients with transient epileptic amnesia.

    Science.gov (United States)

    Savage, Sharon A; Butler, Christopher R; Milton, Fraser; Han, Yang; Zeman, Adam Z

    2017-01-01

    While olfactory hallucinations are relatively rare in epilepsy, a high prevalence (up to 42%) has been reported in one form - Transient Epileptic Amnesia (TEA). TEA is characterized by recurring amnestic seizures and is commonly associated with persistent interictal memory deficits. Despite reports of changes in smell, olfactory ability has not been objectively assessed in this group. The aim of this study was to measure olfactory ability in patients with TEA and explore whether olfactory symptoms relate to other clinical variables. Fifty-five participants with TEA were recruited from The Impairment of Memory in Epilepsy project database. The presence of olfactory symptoms was obtained via case notes and clinical interview. Participants completed questionnaires to evaluate their olfaction and memory function subjectively. Olfactory ability was measured using the University of Pennsylvania Smell Identification Test (UPSIT). TEA participants' performance was compared to 50 matched healthy control participants. A subset of TEA participants (n=26) also completed a battery of memory tests including standard neuropsychological measures, and assessment of accelerated long-term forgetting and autobiographical memory. Olfactory hallucinations were reported in 55% of patients with TEA. A significant reduction in smell identification (UPSIT) was found between patients with TEA and healthy controls (polfactory hallucinations, were not predictive of olfactory ability. Patients reported ongoing memory difficulties and performed below normative values on objective tests. While no correlation was found between objective measures of memory and olfactory performance, subjective complaints of route finding difficulty was associated with UPSIT score. Impairments in odor identification are common in patients with TEA and exceed changes that occur in normal aging. Olfactory hallucinations occurs in approximately half of patients with TEA, but do not always coincide with reduced sense of

  7. Olfactory dreams, olfactory interest, and imagery : Relationships to olfactory memory

    OpenAIRE

    Arshamian, Artin

    2007-01-01

    Existing evidence for olfactory imagery is mixed and mainly based on reports from hallucinations and volitional imagery. Using a questionnaire, Stevenson and Case (2005) showed that olfactory dreams provided a good source for olfactory imagery studies. This study applied an extended version of the same questionnaire and examined olfactory dreams and their relation to real-life experienced odors, volitional imagery, and olfactory interest. Results showed that olfactory dreams were similar to r...

  8. Schizophrenia and Violence: Systematic Review and Meta-Analysis

    OpenAIRE

    Fazel, Seena; Gulati, Gautam; Linsell, Louise; Geddes, John R.; Grann, Martin

    2009-01-01

    Editors' Summary Background Schizophrenia is a lifelong, severe psychotic condition. One in 100 people will have at least one episode of schizophrenia during their lifetime. Symptoms include delusions (for example, patients believe that someone is plotting against them) and hallucinations (hearing or seeing things that are not there). In men, schizophrenia usually starts in the late teens or early 20s; women tend to develop schizophrenia a little later. The causes of schizophrenia include gen...

  9. Joan of Arc: Sanctity, witchcraft or epilepsy?

    Science.gov (United States)

    Nicastro, Nicolas; Picard, Fabienne

    2016-04-01

    The objective of this article is to describe whether Joan of Arc had epilepsy and how that may have influenced her sense of mission and ability to encourage thousands of people to help her to chase the English out of France. Documentation of her Trial of Condemnation in 1431 provides a description of her episodes of experienced voices and visions. From the age of thirteen, Joan of Arc experienced frequent episodes of auditory hallucinations associated with elementary or complex visual hallucinations (e.g., a great light or human faces). These had sudden onset, lasting seconds or minutes at most, and occurred when awake or during sleep, arousing her. Some could be triggered by an auditory stimulus. She had no disorganized thought between the episodes. The semiology of the episodes is very suggestive of epileptic seizures, which have been considered as ecstatic by some authors or as partial epilepsy with auditory features by others, which seems more concordant with the ictal symptoms. The auditory and visual hallucinations could have had a religious content because during her childhood and adolescence, she was brought up in a religious environment, insomuch as this content first undefined only appeared after a few seizures. We can suppose that such hallucinations, without the knowledge of their medical origin, gave her a sense of divine mission, hence, a real strength to try to accomplish the orders she heard during the episodes. Her role during the Hundred Years' War and her narration of her strange episodes led her to be burned for heresy at the age of nineteen, yet rehabilitated 25 years later and to be canonized for her achievements in 1920. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity". Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2011-03-01

    Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.

  11. Occipital lobe seizures: Rare hyperglycemic sequelae of type 1 diabetes mellitus.

    Science.gov (United States)

    Jalal, Muhammed Jasim Abdul; Menon, Murali Krishna; Kumar, K Arun; Gomez, Ramesh

    2015-01-01

    A 15-year-old boy presented with osmotic symptoms and photopsia. He had short-term memory impairment, visual hallucinations, and headache. His random blood sugar was 474 mg/dl, HbA1c -9.4%, and glutamic acid decarboxylase -65 >2000 IU/ml. Magnetic resonance imaging brain and cerebrospinal fluid study were normal. Digital electroencephalography was suggestive of bilateral hemispheric occipital lobe seizures. He responded well to insulin and antiepileptic medications.

  12. OCCIPITAL LOBE SYNDROME

    OpenAIRE

    Shahdevi Nandar Kurniawan

    2016-01-01

    The ability to recognize objects and words is not just depend on the integrity of visual pathway and primary vision area on cerebral cortex (Brodmann area 17), but also secondary vision area 18 and tertiary vision area 19 on occipital lobe. Lesion in occipital lobe could disturb of human visual function such as visual field defects, inability to recognize colors, inability to recognize words, visual hallucinations and illusions, occipital lobe epilepsy, and Anton’s syndrome. Some causes of oc...

  13. Psychosis in dengue fever

    OpenAIRE

    Suprakash Chaudhury; Biswajit Jagtap; Deepak Kumar Ghosh

    2017-01-01

    An 18-year-old male student developed abnormal behavior while undergoing treatment for dengue fever. He was ill-kempt, irritable and had auditory and visual hallucinations and vague persecutory delusions in clear sensorium with impaired insight. The psychotic episode had a temporal correlation with dengue fever. Psychiatric comorbidities of dengue fever including mania, anxiety, depression, and catatonia are mentioned in literature but the literature on the psychosis following dengue is spars...

  14. Kleine Levin syndrome in Malaysia: first typical case

    OpenAIRE

    Bahari, Rafidah; Ahmad, Syed Hassan

    2012-01-01

    A 13-year-old boy presented with a 2 weeks history of tearfulness, childish behaviour, separation anxiety, hypersomnia, hyperphagia and sexual disinhibition following a brief episode of fever. He had been experiencing the episodes since he was seven. The episodes lasted from a few days to 3 weeks and would normally occur once in a year. Most of the time it started with fever and resolved spontaneously. In the past he described auditory hallucination but not this time. Examination revealed a s...

  15. Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2012-07-01

    Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.

  16. Mathematical neuroscience: from neurons to circuits to systems.

    Science.gov (United States)

    Gutkin, Boris; Pinto, David; Ermentrout, Bard

    2003-01-01

    Applications of mathematics and computational techniques to our understanding of neuronal systems are provided. Reduction of membrane models to simplified canonical models demonstrates how neuronal spike-time statistics follow from simple properties of neurons. Averaging over space allows one to derive a simple model for the whisker barrel circuit and use this to explain and suggest several experiments. Spatio-temporal pattern formation methods are applied to explain the patterns seen in the early stages of drug-induced visual hallucinations.

  17. Dream features in the early stages of Parkinson's disease.

    Science.gov (United States)

    Bugalho, Paulo; Paiva, Teresa

    2011-11-01

    Few studies have investigated the relation between dream features and cognition in Parkinson's disease (PD), although vivid dreams, hallucinations and cognitive decline have been proposed as successive steps of a pathological continuum. Our objectives were therefore to characterize the dreams of early stage PD and to study the relation between dream characteristics, cognitive function, motor status, depression, dopaminergic treatment, and the presence of REM sleep behaviour disorder (RBD) and hallucinations. Dreams of 19 male PD patients and 21 matched control subjects were classified according to Hall and van de Castle system. h statistics was used to compare the dream content between patients and controls. We tested the relation between patients' dreams characteristics and cognitive function (Frontal assessment battery (FAB) and Mini-Mental State Examination tests) depression (Beck depression inventory), motor function (UPDRS), dopaminergic treatment, the presence of RBD (according to clinical criteria) and hallucinations, using general linear model statistics. Patients and controls differed only on FAB scores. Relevant differences in the Hall and van de Castle scale were found between patient's dreams and those of the control group, regarding animals, aggression/friendliness, physical aggression, befriender (higher in the patient group) and aggressor and bodily misfortunes (lower in the patient group) features. Cognitive and particularly frontal dysfunction had a significant influence on the frequency of physical aggression and animal related features, while dopaminergic doses, depressive symptoms, hallucinations and RBD did not. We found a pattern of dream alteration characterized by heightened aggressiveness and the presence of animals. These were related to more severe frontal dysfunction, which could be the origin of such changes.

  18. Cerebral correlates of psychotic syndromes in neurodegenerative diseases

    OpenAIRE

    Jellinger, Kurt A

    2012-01-01

    Abstract Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer?s disease, synucleinopathies (Parkinson?s disease, dementia with Lewy bodies), Huntington?s disease, frontotemporal degenerations, motoneuron and prion...

  19. Posttraumatic stress disorder caused by the misattribution of seizure-related experiential responses

    OpenAIRE

    Cohen, Matthew L.; Rozensky, Ronald H.; Zlatar, Zvinka Z.; Averbuch, Robert N.; Cibula, Jean E.

    2010-01-01

    Patients with temporal lobe seizures sometimes experience what John Hughlings Jackson described as “dreamy states” during seizure onset. These phenomena may be characterized by a re-experiencing of past events, feelings of familiarity (déjà vu), and hallucinations. In previous reports, patients have been aware of the illusory nature of their experiences. Here, however, the case of a patient with a documented 37-year history of temporal lobe epilepsy who is not aware is described. Fifteen year...

  20. Towards a geography of schizophrenia

    International Nuclear Information System (INIS)

    Frith, Ch.

    1996-01-01

    The schizophrenia is one of the more severe and the more frequent mental diseases. It cannot be explained by a structural anomaly of the brain but by a cerebral functioning disorder. With the imagery (NMR imaging, positron computed tomography) the searchers have particularly studied two sorts of schizophrenia: the lack of will and the pseudo hallucinations. In these two cases, an alteration of the affected cerebral areas activity compared with healthy persons is observed. (O.M.)

  1. A Dementia Case Presenting with Psychotic Symptoms

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir

    2013-06-01

    Full Text Available Dementia is a progressive clinical syndrome in which affected areas of brain function may be affected, such as memory, language, abstract thinking, problem solving and attention. Psychotic symptoms include auditory and visual hallucinations and delusions, which usually occur in the dementia. In this paper, a dementia case presenting with psychotic symptoms is presented. [Cukurova Med J 2013; 38(3.000: 482-486

  2. Designer Drugs: A Synthetic Catastrophe

    OpenAIRE

    Fratantonio, James; Andrade, Lawrence; Febo, Marcelo

    2015-01-01

    Synthetic stimulants can cause hallucinations, aggressive behaviors, death and are sometimes legal. These substances are sold as plant food and bath salts that are "Not for Human Consumption", therefore skirting the 1986 Federal Analogue Act and giving a false pretense of safety. Studies have proved that these substances are toxic, have a high abuse potential, and are becoming extremely prevalent in the United States. This creates a dilemma for law enforcement agents, hospitals, and substance...

  3. Content of atropine and scopolamine in poisonous solanaceae plants from Slovenia

    OpenAIRE

    Javor Kac; Uroš Klančar; Aleš Mlinarič; Aleš Krbavčič

    2006-01-01

    Background: Some species from the Solanaceae family are still the cause of serious poisoning among youth in Slovenia. Usually intoxication is due to abuse of these plants to provoke hallucinations. There is still not enough data about the alkaloid content of these plants growing in Slovenia.Methods: Different plant samples were analyzed for the content of atropine and scopolamine with capillary electrophoresis after solid phase extraction of alkaloids. Plants were gathered from different area...

  4. Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

    OpenAIRE

    Romm, Lie K; Ivar Rossberg, Jan; Fredslund Hansen, Charlotte; Haug, Elisabeth; Andreassen, Ole A; Melle, Ingrid

    2011-01-01

    Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis...

  5. Sensory deprivation leading to late onset psychosis

    Directory of Open Access Journals (Sweden)

    Swapnajeet Sahoo

    2016-01-01

    Full Text Available Sensory deprivation is understood as diminution or absence of perceptual experiences to the usual external stimuli. Sensory deprivation in elderly is reported to be associated with depression, anxiety, psychosis, dementia, etc. In this report, we present the case of an 84-year- elderly man who developed auditory hallucination and after 1 year of onset of hearing difficulties. He was managed with quetiapine, with which he showed significant improvement.

  6. Unusual Phenotype of the Brownell-Oppenheimer Variant of Sporadic Creutzfeldt-Jakob Disease

    Directory of Open Access Journals (Sweden)

    Dronacharya Lamichhane

    2016-03-01

    Full Text Available Creutzfeldt-Jakob disease is a rare, transmissible, neurodegenerative disease caused by conformationally changed abnormal prion protein. Most patients present with cognitive impairment, myoclonus, ataxia, visual impairment alone or in combination. Patients who present with ataxia only at the onset are said to have Brownell-Oppenheimer variant of the disease. However, here we present a case where visual symptoms preceded the clinical presentation and hallucinations accompanied the ataxia at the onset of the disease.

  7. Correlates of self-harm behaviour in acutely ill patients with schizophrenia.

    Science.gov (United States)

    Simms, Jane; McCormack, Vinny; Anderson, Richard; Mulholland, Ciaran

    2007-03-01

    This study compared acutely ill patients with schizophrenia with a history of self-harm (N=17) to those without a history of self-harm (N=16) on measures of depression, hopelessness, suicidal ideation, and demographic and psychiatric variables. A subgroup of these patients who experience auditory hallucinations, with and without a history of self-harm, were selected and compared on measures of depression, hopelessness, suicidal ideation and beliefs about voices. Employing a cross-sectional design, in-patients of two local psychiatric hospital, who met DSM-IV-TR criteria for schizophrenia and who were in an acute phase of the illness, were selected. Each patient was assessed using the Beck Depressions Inventory (BDI), Beck Hopelessness Scale (BHS) and the Beck Suicide Scale (BSS). Patients who experienced auditory verbal hallucinations completed the Beliefs About Voices Questionnaire Revised (BAVQ-R). Patients with a history of self-harm completed the Beck Suicide Intent Scale (BSI). Patients with a history of self-harm (N=17) had significantly greater symptoms of depression, greater suicidal thoughts, increased number of hospital admissions, greater duration of illness and were more likely to be married, compared to patients without a history of self-harm (N=16). Among the subgroup of patients who experience auditory hallucinations, those with a history of self-harm (N=9), believed their voice to be more malevolent, had a tendency to resist their voice and experienced significantly greater symptoms of depression and hopelessness compared to those without a history of self-harm (N=6). These findings highlight the importance for screening by clinicians during inpatient hospital stays and for monitoring to be ongoing following discharge. For the subgroup of patients who experience auditory hallucinations, future research should seek to explore the relationship between self-harm and beliefs about voices.

  8. Interaction between Harmane and Nicotinic in the Passive Avoidance Test

    OpenAIRE

    M Piri; M Nasehi; MS Shahin; MR Zarrindast

    2011-01-01

    Introduction & Objective: A number of β-carboline alkaloids such as harmane are naturally present in the human food chain. Furthermore, some plants which contain β-carboline have behavioral effects such as hallucination. In the present study, the effect of intra-dorsal hippocampus injection of nicotinic receptor agonist on memory impairment induced by harmane was examined in mice. Materials & Methods: This study was conducted at Shahid Beheshti University in 2009. Two hundred and forty mi...

  9. Decline in cerebral glucose utilisation and cognitive function with aging in Down's syndrome.

    OpenAIRE

    Schapiro, M B; Haxby, J V; Grady, C L; Duara, R; Schlageter, N L; White, B; Moore, A; Sundaram, M; Larson, S M; Rapoport, S I

    1987-01-01

    The cerebral metabolic rate for glucose (CMRglc) was measured with positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose in 14 healthy subjects with Down's syndrome, 19 to 33 years old, and in six healthy Down's syndrome subjects over 35 years, two of whom were demented. Dementia was diagnosed from a history of mental deterioration, disorientation and hallucinations. All Down's syndrome subjects were trisomy 21 karyotype. CMRglc also was examined in 15 healthy men aged 20-35 years ...

  10. Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2012-02-01

    Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.

  11. Kafka, paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states

    OpenAIRE

    Mishara Aaron L

    2010-01-01

    Abstract Kafka's writings are frequently interpreted as representing the historical period of modernism in which he was writing. Little attention has been paid, however, to the possibility that his writings may reflect neural mechanisms in the processing of self during hypnagogic (i.e., between waking and sleep) states. Kafka suffered from dream-like, hypnagogic hallucinations during a sleep-deprived state while writing. This paper discusses reasons (phenomenological and neurobiological) why ...

  12. Recovery from Gz-induced Loss of Consciousness: Psychophysiologic Considerations

    Science.gov (United States)

    1988-06-01

    hypnagogic hallucinations). REM activity been considered to occur during REM sleep, non-REM during narcoleptic episodes is usually present at the on...is difficult to ascertain whether the sidered adequate for our purposes. Fig. 3 depicts an "dreams" reported were either " hypnagogic " (as the...necessary. Currently, it is difficult to obtain EEG data in the ac- HYPNAGOGIC HYPNOPOMPIC celeration environment. However, current studies are PERIOD

  13. Disremembering the holocaust.

    Science.gov (United States)

    Kannai, Ruth

    2012-11-01

    The essay describes an elderly Holocaust survivor, who re-experiences the horrors of the Holocaust through his senile hallucinations. Although he is demented, telling and re-telling the story to a therapist helps him regain a sense of control and feel less frightened. He is finally able to revise the nightmarish story into a narrative that enables him to find strength and meaning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Neuropsychological and psychopathological differentiation of delirium

    OpenAIRE

    Gabriel, Alexander

    2010-01-01

    ICD-10 and DSM-IV differ in their definitions of delirium. The DSM-IV definition centers around a disorder of attention and cognitive functions, whereas ICD-10 describes delirium as a broader neuropsychological and psychopathological syndrome, e.g. hallucinations, emotional and psychomotor disorder. When neuropsychological and psychopathological symptoms of delirium are assessed simultaneously, our question was, if there are core symptoms of delirium, i.e. neuropsychological and psychopat...

  15. Cerebral blood flow during delirium tremens and related clinical states studied with xenon-133 inhalation tomography

    International Nuclear Information System (INIS)

    Hemmingsen, R.; Vorstrup, S.; Clemmesen, L.; Holm, S.; Tfelt-Hansen, P.; Sorensen, A.S.; Hansen, C.; Sommer, W.; Bolwig, T.G.

    1988-01-01

    The regional cerebral blood flow of 12 patients with severe alcohol withdrawal reactions (delirium tremens or impending delirium tremens) was measured during the acute state before treatment and after recovery. Greater cerebral blood flow was significantly correlated with visual hallucinations and agitation during the acute withdrawal reaction. The results suggest that delirium tremens and related clinical states represent a type of acute brain syndrome mainly characterized by CNS hyperexcitability

  16. A Rare Cause of Confusion: Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis

    Directory of Open Access Journals (Sweden)

    Laura Virginia Gonzalez

    2015-02-01

    Full Text Available An 81-year-old female patient required numerous admissions for symptoms of confusion, visual hallucinations, myoclonus and seizures, which were treated as stroke, infections and viral encephalitis with some improvement after treatment but with recurrence that caused her to be readmitted to hospital. On the last admission, she was found to have very high antithyroid antibodies and a diagnosis of Hashimoto’s encephalopathy was made, with an overwhelming response to steroids.

  17. French version validation of the psychotic symptom rating scales (PSYRATS for outpatients with persistent psychotic symptoms

    Directory of Open Access Journals (Sweden)

    Favrod Jerome

    2012-09-01

    Full Text Available Abstract Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS. Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.

  18. SYNDROME DE GELINEAU. A PROPOS D\\'UN CAS NIGERIAN ET ...

    African Journals Online (AJOL)

    Au Nigéria, le syndrome de Gélineau est un trouble rare avec une prévalence hospitalière de 0.026%. Nous étudions ici le cas d'un patient nigérien âgé de 14 ans atteint de narcolepsie, de cataplexie, d'hallucinations hypnagogiques visuelles et de paralysie du sommeil hypnopompique. Il a été effectué un test de latence ...

  19. THE ‘MALACOPTERÍGIO’ AND THE MADONNA: OVERLAPPING AND CONFLICTING "TRANSFERLIKES"

    Directory of Open Access Journals (Sweden)

    Mario Cesar Newman de Queiroz

    2014-12-01

    Full Text Available The article focuses on the analysis of the poem “Alucinação à beira-mar” (Hallucination by the sea-side. It aims at demonstrating how two antagonistic fields of discourse, i.e., scientific and folk-religious, shift meaning territories in an exemplary way so as to give us a glimpse of the “transferlike” poetics of Augusto dos Anjos, which anticipates the bricolage usage.

  20. Clinical Report of a 17q12 Microdeletion with Additionally Unreported Clinical Features

    OpenAIRE

    Roberts, Jennifer L.; Gandomi, Stephanie K.; Parra, Melissa; Lu, Ira; Gau, Chia-Ling; Dasouki, Majed; Butler, Merlin G.

    2014-01-01

    Copy number variations involving the 17q12 region have been associated with developmental and speech delay, autism, aggression, self-injury, biting and hitting, oppositional defiance, inappropriate language, and auditory hallucinations. We present a tall-appearing 17-year-old boy with marfanoid habitus, hypermobile joints, mild scoliosis, pectus deformity, widely spaced nipples, pes cavus, autism spectrum disorder, intellectual disability, and psychiatric manifestations including physical and...

  1. Impact of antipsychotic medication on transcranial direct current stimulation (tDCS) effects in schizophrenia patients.

    Science.gov (United States)

    Agarwal, Sri Mahavir; Bose, Anushree; Shivakumar, Venkataram; Narayanaswamy, Janardhanan C; Chhabra, Harleen; Kalmady, Sunil V; Varambally, Shivarama; Nitsche, Michael A; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2016-01-30

    Transcranial direct current stimulation (tDCS) has generated interest as a treatment modality for schizophrenia. Dopamine, a critical pathogenetic link in schizophrenia, is also known to influence tDCS effects. We evaluated the influence of antipsychotic drug type (as defined by dopamine D2 receptor affinity) on the impact of tDCS in schizophrenia. DSM-IV-TR-diagnosed schizophrenia patients [N=36] with persistent auditory hallucinations despite adequate antipsychotic treatment were administered add-on tDCS. Patients were divided into three groups based on the antipsychotic's affinity to D2 receptors. An auditory hallucinations score (AHS) was measured using the auditory hallucinations subscale of the Psychotic Symptom Rating Scales (PSYRATS). Add-on tDCS resulted in a significant reduction inAHS. Antipsychotic drug type had a significant effect on AHS reduction. Patients treated with high affinity antipsychotics showed significantly lesser improvement compared to patients on low affinity antipsychotics or a mixture of the two. Furthermore, a significant sex-by-group interaction occurred; type of medication had an impact on tDCS effects only in women. Improvement differences could be due to the larger availability of the dopamine receptor system in patients taking antipsychotics with low D2 affinity. Sex-specific differences suggest potential estrogen-mediated effects. This study reports a first-time observation on the clinical utility of antipsychotic drug type in predicting tDCS effects in schizophrenia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Comparing schizophrenia symptoms in the Iban of Sarawak with other populations to elucidate clinical heterogeneity.

    Science.gov (United States)

    McLean, Duncan; Barrett, Robert; Loa, Peter; Thara, Rangaswamy; John, Sujit; McGrath, John; Gratten, Jake; Mowry, Bryan

    2015-03-01

    The symptom profile of schizophrenia can vary between ethnic groups. We explored selected symptom variables previously reported to be characteristic of schizophrenia in the Iban of Sarawak in transethnic populations from Australia, India, and Sarawak, Malaysia. We tested site differences to confirm previous research, and to explore implications of differences across populations for future investigations. We recruited schizophrenia samples in Australia (n = 609), India (n = 310) and Sarawak (n = 205) primarily for the purposes of genetic studies. We analyzed seven identified variables and their relationship to site using logistic regression, including: global delusions, bizarre delusions, thought broadcast/insertion/withdrawal delusions, global hallucinations, auditory hallucinations, disorganized behavior, and prodromal duration. We identified a distinct symptom profile in our Sarawak sample. Specifically, the Iban exhibit: low frequency of thought broadcast/insertion/withdrawal delusions, high frequency of auditory hallucinations and disorganized behavior, with a comparatively short prodrome when compared with Australian and Indian populations. Understanding between-site variation in symptom profile may complement future transethnic genetic studies, and provide important clues as to the nature of differing schizophrenia expression across ethnically distinct groups. A comprehensive approach to subtyping schizophrenia is warranted, utilizing comprehensively ascertained transethnic samples to inform both schizophrenia genetics and nosology. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  3. How psychotic-like are paranormal beliefs?

    Science.gov (United States)

    Cella, Matteo; Vellante, Marcello; Preti, Antonio

    2012-09-01

    Paranormal beliefs and Psychotic-like Experiences (PLE) are phenotypically similar and can occur in individuals with psychosis but also in the general population; however the relationship of these experiences for psychosis risk is largely unclear. This study investigates the association of PLE and paranormal beliefs with psychological distress. Five hundred and three young adults completed measures of paranormal beliefs (Beliefs in the Paranormal Scale), psychological distress (General Health Questionnaire), delusion (Peters et al. Delusions Inventory), and hallucination (Launay-Slade Hallucination Scale) proneness. The frequency and intensity of PLE was higher in believers in the paranormal compared to non-believers, however psychological distress levels were comparable. Regression findings confirmed that paranormal beliefs were predicted by delusion and hallucination-proneness but not psychological distress. The use of a cross-sectional design in a specific young adult population makes the findings exploratory and in need of replication with longitudinal studies. The predictive value of paranormal beliefs and experiences for psychosis may be limited; appraisal or the belief emotional salience rather than the belief per se may be more relevant risk factors to predict psychotic risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. The Structure of The Extended Psychosis Phenotype in Early Adolescence—A Cross-sample Replication

    Science.gov (United States)

    Wigman, Johanna T. W.; Vollebergh, Wilma A. M.; Raaijmakers, Quinten A. W.; Iedema, Jurjen; van Dorsselaer, Saskia; Ormel, Johan; Verhulst, Frank C.; van Os, Jim

    2011-01-01

    The extended psychosis phenotype, or the expression of nonclinical positive psychotic experiences, is already prevalent in adolescence and has a dose-response risk relationship with later psychotic disorder. In 2 large adolescent general population samples (n = 5422 and n = 2230), prevalence and structure of the extended psychosis phenotype was investigated. Positive psychotic experiences, broadly defined, were reported by the majority of adolescents. Exploratory analysis with Structural Equation Modelling (Exploratory Factor Analysis followed by Confirmatory Factor Analysis [CFA]) in sample 1 suggested that psychotic experiences were best represented by 5 underlying dimensions; CFA in sample 2 provided a replication of this model. Dimensions were labeled Hallucinations, Delusions, Paranoia, Grandiosity, and Paranormal beliefs. Prevalences differed strongly, Hallucinations having the lowest and Paranoia having the highest rates. Girls reported more experiences on all dimensions, except Grandiosity, and from age 12 to 16 years rates increased. Hallucinations, Delusions, and Paranoia, but not Grandiosity and Paranormal beliefs, were associated with distress and general measures of psychopathology. Thus, only some of the dimensions of the extended psychosis phenotype in young people may represent a continuum with more severe psychopathology and predict later psychiatric disorder. PMID:20044595

  5. Ertapenem-associated neurotoxicity in the Spinal Cord Injury (SCI) population: a case series.

    Science.gov (United States)

    Patel, Ursula C; Fowler, Mallory A

    2017-09-06

    Context Ertapenem, a broad spectrum carbapenem antibiotic, is used often in Spinal Cord Injury (SCI) patients due to increased risk factors for multi-drug resistant (MDR) infections in this population. Neurotoxicity, specifically seizures, due to ertapenem is a known adverse effect and has been described previously. Other manifestations such as delirium and visual hallucinations have rarely been reported, and no literature, to the best of our knowledge, specifically describes these effects solely in the SCI population. Findings Four cases of mental status changes and hallucinations in SCI patients attributed to ertapenem therapy are described. Onset of symptoms began between one and six days following initiation of ertapenem and resolved between two to 42 days following discontinuation. Based on the Naranjo probability scale, a probable relationship exists between the adverse events and ertapenem for three out of the four cases. Possible overestimation of renal function and hypoalbuminemia may be contributing factors to the noted adverse reactions. Conclusion/Clinical Relevance The cases described highlight the importance of recognizing ertapenem-associated hallucinations in SCI patients. The population is particularly vulnerable due to risk factors for MDR infections necessitating ertapenem use, possible overestimation of renal function, and a high prevalence of hypoalbuminemia.

  6. The stuff that dreams aren't made of: why wake-state and dream-state sensory experiences differ.

    Science.gov (United States)

    Symons, D

    1993-06-01

    It is adaptive for individuals to be continuously alert and responsive to external stimuli (such as the sound and odor of an approaching predator or the cry of an infant), even during sleep. Natural selection thus has disfavored the occurrence during sleep of hallucinations that compromise external vigilance. In the great majority of mammalian species, including Homo sapiens, closed eyes and immobility are basic aspects of sleep. Therefore, (a) visual and movement sensory modalities (except kinesthesis) do not provide the sleeper with accurate information about the external environment or the sleeper's relationship to that environment; (b) the sleeper's forebrain "vigilance mechanism" does not monitor these modalities; hence (c) visual and movement hallucinations--similar or identical to percepts--can occur during sleep without compromising vigilance. In contrast, the other sensory modalities do provide the sleeper with a continuous flow of information about the external environment or the sleeper's relationship to that environment, and these modalities are monitored by the vigilance mechanism. Hallucinations of kinesthesis, pain, touch, warmth, cold, odor, and sound thus would compromise vigilance, and their occurrence during sleep has been disfavored by natural selection. This vigilance hypothesis generates novel predictions about dream phenomenology and REM-state neurophysiology and has implications for the general study of imagery.

  7. Adult attention deficit hyperactivity symptoms and psychosis: Epidemiological evidence from a population survey in England.

    Science.gov (United States)

    Marwaha, Steven; Thompson, Andrew; Bebbington, Paul; Singh, Swaran P; Freeman, Daniel; Winsper, Catherine; Broome, Matthew R

    2015-09-30

    Despite both having some shared features, evidence linking psychosis and adult attention deficit hyperactivity disorder (ADHD) is sparse and inconsistent. Hypotheses tested were (1) adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis (2) links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Dopamine agonists and delusional jealousy in Parkinson's disease: a cross-sectional prevalence study.

    Science.gov (United States)

    Poletti, Michele; Perugi, Giulio; Logi, Chiara; Romano, Anna; Del Dotto, Paolo; Ceravolo, Roberto; Rossi, Giuseppe; Pepe, Pasquale; Dell'Osso, Liliana; Bonuccelli, Ubaldo

    2012-11-01

    Delusional jealousy (DJ) has been described in patients with Parkinson's disease (PD) on dopaminergic therapy, but a role for dopaminergic therapy in DJ has not been established. The current cross-sectional study on DJ investigated its association with dopaminergic therapies compared with their associations with hallucinations and its prevalence in PD patients. Eight hundred five consecutive patients with PD were enrolled between January 2009 and June 2010. DJ was identified in 20 patients (2.48%) and hallucinations in 193 patients (23.98%). In the multivariate logistic regression analyses, dopamine agonists were significantly associated with DJ (odds ratio, 18.1; 95% CI, 3.0-infinity; P = .0002) but not with hallucinations (odds ratio, 0.73; 95% CI, 0.49-1.10; P = .133). These findings suggest that dopamine agonist treatment represents a risk factor for DJ in PD independent of the presence of a dementing disorder, and the presence of this additional nonmotor side effect should be investigated in this clinical population. Copyright © 2012 Movement Disorder Society.

  9. Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis.

    Science.gov (United States)

    Romm, Kristin Lie; Rossberg, Jan Ivar; Hansen, Charlotte Fredslund; Haug, Elisabeth; Andreassen, Ole A; Melle, Ingrid

    2011-08-19

    Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. A total of 113 patients from the Thematically Organized Psychosis research study (TOP) were included at first treatment. The Positive and Negative Syndrome Scale (PANSS) was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS) and self-esteem by the Rosenberg Self-Esteem Scale (RSES). Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

  10. What Behavioral and Psychological Symptoms of Dementia Affect Caregiver Burnout?

    Science.gov (United States)

    Hiyoshi-Taniguchi, Kazuko; Becker, Carl B; Kinoshita, Ayae

    2018-01-01

    Patients' irritability and aggression have been linked to caregiver depression, but the behaviors that most burden caregivers are not yet definitively identified. This study examines the connection between behavioral and psychological symptoms of dementia (BPSD) and the burnout of caregivers caring for home-dwelling elders with dementia symptoms in Japan. 80 Japanese rural and urban family caregivers completed detailed questionnaires about their experiences in caring for demented family members. We statistically analyzed the results for correlations between types of dementia, Pines Burnout, and Caregiver Distress. BPSD symptom severity significantly correlated with caregiver distress. The dementia symptoms most strongly correlated with caregiver burnout were: aggression, irritability, abnormal motor behavior, and hallucinations. Among the commonest symptoms, apathy, anxiety, and depression did not seriously aggravate caregiver burnout. Caregivers displayed higher burnout facing agitation/aggression, irritability, aberrant motor behavior, and hallucinations. Caregivers' reported distress was surprisingly dissimilar to their burnout scores; patients' delusions and anxiety led to higher distress reporting but not to burnout. Advance diagnosis of BPSD symptoms should be helpful to support nurses and caregivers of dementia patients. Particular support should be considered for caregivers and nurses of patients expressing aggression, irritability, abnormal motor behavior, and hallucination.

  11. Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia.

    Science.gov (United States)

    Maung, K; Ohnmar, H; Than, W; Ramli, M; Najwa Hanim, M R; Ali Sabri, R; Ahmad Zafri, A B

    The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia. This study involved a retrospective review and analysis of data from case notes. Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05. There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.

  12. Increased frequency of involuntary semantic memories or mind-pops in schizophrenia: a diary study.

    Science.gov (United States)

    Elua, Ia; Laws, Keith R; Kvavilashvili, Lia

    2015-01-01

    Hallucinations constitute a prominent symptom of schizophrenia and may take a variety of forms (verbal, visual, musical, or environmental noises). Interesting similarities exist between hallucinations and so-called mind-pops which refer to isolated fragments of one's semantic knowledge (e.g., a word/sentence, visual image, or a song/melody) that come to mind unexpectedly, often without any obvious triggers, and are difficult to control. The aim of the present study was to evaluate whether mind-pops may constitute the raw cognitive material from which hallucinations are constructed by studying the nature and frequency of mind-pops in the everyday life of people with schizophrenia and non-clinical controls. Eleven participants with schizophrenia and 14 non-clinical controls kept a diary of their mind-pops for seven days and completed a brief questionnaire every time they had a mind-pop. Schizophrenia participants reported significantly more verbal and image mind-pops than controls and their content was negative more often than in controls. No group differences were obtained in terms of reported triggers or ongoing activities. Data from both groups also supported the priming hypothesis by showing that stimuli encountered in one's environment or thoughts could later re-appear in the form of a mind-pop. The findings have implications for models of schizophrenia that emphasise the role of intrusive thoughts and memories in the aetiology and development of key psychotic symptoms.

  13. The misdiagnosis of bipolar disorder as a psychotic disorder: some of its causes and their influence on therapy.

    Science.gov (United States)

    Meyer, Friederike; Meyer, Thomas D

    2009-01-01

    Looking at chart records bipolar disorder is often misdiagnosed as a psychotic disorder but no study has ever systematically looked into the reasons. One reason for misdiagnoses could be that clinicians use heuristics like the prototype approach in routine practice instead of strictly adhering to the diagnostic criteria. Using an experimental approach we investigated if the use of heuristics can explain when a diagnosis of psychotic disorder is given instead of bipolar disorder. We systematically varied information about the presence or absence of specific symptoms, i.e. hallucinations and decreased need for sleep during a manic episode. Experimentally varied case vignettes were randomly sent to psychiatrists in Southern Germany. The four versions of the case vignette all described the same person in a manic state and differed only in two aspects: the presence or absence of auditory hallucinations and of decreased need for sleep. The psychiatrists were asked to make a diagnosis, to rate their confidence in their diagnosis, and to recommend treatments. Almost half of the 142 psychiatrists (45%) did not diagnose bipolar disorder. Mentioning hallucinations decreased the likelihood of diagnosing bipolar disorder. The information about decreased need for sleep only affected the diagnosis significantly, if schizoaffective disorder was considered a bipolar disorder. Our results suggest that clinicians indeed use heuristics when making diagnostic decisions instead of strictly adhering to diagnostic criteria. More research is needed to better understand diagnostic decision making, especially under real life settings, and this might also be of interest when revising diagnostic manuals such as DSM.

  14. Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia

    Science.gov (United States)

    Bornheimer, Lindsay A.

    2018-01-01

    Background Suicide is among the leading causes of death for adults diagnosed with schizophrenia, with risk estimates being over eight folds greater than the general population. While the majority of research to date focuses on the role of symptoms of depression in suicide risk, there is a lack of consensus and understanding of the relationship between positive symptoms of psychosis and both suicidal ideation and attempt. The current study examined pathways of influence between symptoms of depression, positive symptoms of psychosis (i.e. hallucinations and delusions), hopelessness, and suicidal ideation among a population of adults diagnosed with schizophrenia. Methods Data were obtained from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE; n = 1460) at baseline. Suicidal ideation, hopelessness, and symptoms of depression were measured by the Calgary Depression Scale (CDRS) and hallucinations and delusions by the Positive and Negative Syndrome Scale (PANSS). Data were analyzed with Structural Equation Modeling (SEM) using Mplus 7. Results Symptoms of depression, positive symptoms of psychosis, and hopelessness independently predicted suicidal ideation. Hopelessness significantly mediated the relationship between symptoms of depression and suicidal ideation. Lastly, positive symptoms of psychosis were found to moderate the relationship between symptoms of depression and suicidal ideation. Conclusions The current study provides evidence for the role that positive symptoms of psychosis (specifically hallucinations and delusions) play in suicidal ideation, pointing towards the implication that beyond symptoms of depression, positive symptoms must be evaluated for and treated. PMID:27450776

  15. Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

    Directory of Open Access Journals (Sweden)

    Haug Elisabeth

    2011-08-01

    Full Text Available Abstract Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis research study (TOP were included at first treatment. The Positive and Negative Syndrome Scale (PANSS was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS and self-esteem by the Rosenberg Self-Esteem Scale (RSES. Results Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. Conclusion There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

  16. AWARENESS UNDER GENERAL ANAESTHESIA IN PATIENTS UNDERGOING ELECTIVE CAESAREAN SECTION USING THIOPENTONE AND KETAMINE AS INDUCTION AGENTS- A RANDOMISED PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Somashekharappa Basavanneppa Kadur

    2016-12-01

    Full Text Available BACKGROUND Awareness during general anaesthesia for caesarean section is a big concern because of its serious adverse consequences. It has been reported that ketamine used as induction agent reduces awareness. This study was conducted to compare awareness under general anaesthesia when thiopentone and ketamine are used as induction agents for caesarean section. MATERIALS AND METHODS Fifty healthy mothers scheduled for elective caesarean section were randomly divided into two groups to receive thiopentone (4 mg/kg -1 or ketamine (1.5 mg/kg -1 for induction of anaesthesia. Mothers were examined for intraoperative awareness using isolated forearm technique until the delivery of the baby. Postoperatively, they were spoken about recall and any hallucination by using a set of questionnaire. RESULTS 15% patients who received thiopentone were able to follow the commands compared to 8% patients who received ketamine. 65% patients who received thiopentone made reaching movements of the isolated forearm towards the stimulus compared to 20% patients of ketamine group. None of the patients in thiopentone group experienced any hallucinations compared to 1 patient (4% in ketamine group who exhibited hallucinations. None of fifty patients could recall the intraoperative events like squeezing of hands or the pain of operation. CONCLUSION Ketamine can be used as substitute for thiopentone as an induction agent in a dose equal to 1.5 mg/kg -1 . Having profound analgesic effect, property to maintain foetoplacental exchange better than any other induction agents, ketamine can be used routinely as an induction agent for mothers undergoing caesarean section under general anaesthesia.

  17. Spontaneous Adverse Event Reports Associated with Zolpidem in the United States 2003–2012

    Science.gov (United States)

    Wong, Carmen K.; Marshall, Nathaniel S.; Grunstein, Ronald R.; Ho, Samuel S.; Fois, Romano A.; Hibbs, David E.; Hanrahan, Jane R.; Saini, Bandana

    2017-01-01

    Study Objectives: Stimulated reporting occurs when patients and healthcare professionals are influenced or “stimulated” by media publicity to report specific drug-related adverse reactions, significantly biasing pharmacovigilance analyses. Among countries where the non-benzodiazepine hypnotic drug zolpidem is marketed, the United States experienced a comparable surge of media reporting during 2006–2009 linking the above drug with the development of complex neuropsychiatric sleep-related behaviors. However, the effect of this stimulated reporting in the United States Food and Drug Administration Adverse Event Reporting System has not been explored. Methods: Using disproportionality analyses, reporting odds ratios for zolpidem exposure and the following adverse events; parasomnia, movement-based parasomnia, nonmovement-based parasomnia, amnesia, hallucination, and suicidality were determined and compared to all other medications in the database, followed by specific comparison to the benzodiazepine hypnotic class, year-by-year from 2003 to 2012. Results: Odds ratios were increased significantly during and after the period of media publicity for parasomnias, movement-based parasomnias, amnesias and hallucinations. We also observed that zolpidem adverse drug reaction (ADR) reports have higher odds for parasomnias, movement-based parasomnias, amnesias, hallucinations, and suicidality compared to all other drugs, even before the media publicity cluster. Conclusions: Although our results indicate that zolpidem reports have higher odds for the ADR of interest even before the media publicity cluster, negative media coverage greatly exacerbated the reporting of these adverse reactions. The effect of such reporting must be borne in mind when decisions around drugs which have been the subject of intense media publicity are made by health professionals or regulatory bodies. Citation: Wong CK, Marshall NS, Grunstein RR, Ho SS, Fois RA, Hibbs DE, Hanrahan JR, Saini B

  18. Spontaneous Adverse Event Reports Associated with Zolpidem in the United States 2003-2012.

    Science.gov (United States)

    Wong, Carmen K; Marshall, Nathaniel S; Grunstein, Ronald R; Ho, Samuel S; Fois, Romano A; Hibbs, David E; Hanrahan, Jane R; Saini, Bandana

    2017-02-15

    Stimulated reporting occurs when patients and healthcare professionals are influenced or "stimulated" by media publicity to report specific drug-related adverse reactions, significantly biasing pharmacovigilance analyses. Among countries where the non-benzodiazepine hypnotic drug zolpidem is marketed, the United States experienced a comparable surge of media reporting during 2006-2009 linking the above drug with the development of complex neuropsychiatric sleep-related behaviors. However, the effect of this stimulated reporting in the United States Food and Drug Administration Adverse Event Reporting System has not been explored. Using disproportionality analyses, reporting odds ratios for zolpidem exposure and the following adverse events; parasomnia, movement-based parasomnia, nonmovement-based parasomnia, amnesia, hallucination, and suicidality were determined and compared to all other medications in the database, followed by specific comparison to the benzodiazepine hypnotic class, year-by-year from 2003 to 2012. Odds ratios were increased significantly during and after the period of media publicity for parasomnias, movement-based parasomnias, amnesias and hallucinations. We also observed that zolpidem adverse drug reaction (ADR) reports have higher odds for parasomnias, movement-based parasomnias, amnesias, hallucinations, and suicidality compared to all other drugs, even before the media publicity cluster. Although our results indicate that zolpidem reports have higher odds for the ADR of interest even before the media publicity cluster, negative media coverage greatly exacerbated the reporting of these adverse reactions. The effect of such reporting must be borne in mind when decisions around drugs which have been the subject of intense media publicity are made by health professionals or regulatory bodies. © 2017 American Academy of Sleep Medicine

  19. Shared Psychotic Disorder (Folie à Deux in Turkey

    Directory of Open Access Journals (Sweden)

    Buket Cinemre

    2009-09-01

    Full Text Available Shared psychotic disorder or folie à deux is a rare and relatively unknown syndrome. Large case series are needed to find out and clarify the etiological factors and the phenomenology of shared psychotic disorder by comparing the cases from different society and cultures. In this study, we reviewed all reported cases of shared psychotic disorder that had been published or presented in Turkey since 1962. To reach this aim, we have searched Pubmed/Medline, ScienceDirect, Google Scholar, Ulakbim Turkish Medical Index, Turkish Psychiatric Index databases for published records originating from Turkey. We have also manually searched poster abstract books of congresses held in Turkey between 1962 and 2009. All cases eligible for inclusion into this study have been evaluated one by one and grouped as primary or secondary cases. The features of these cases were investigated for a number of variables including age, sex, educational level, occupation, the presence of shared delusion and hallucinations, diagnosis, management, onset of illness, family history, IQ, social isolation, the nature of the relationship and classification system used for diagnosis. The results have showed that the syndrome is more frequently observed among women, within same family members and between sisters. Social isolation was the most common risk factor in these patients and most patients shared hallucinations with their partners along with their delusions. Several secondary cases required antipsychotic drugs for the treatment of their symptoms. Though these features were inline with literature findings, the present findings from Turkish population were different from previous studies with regards to the presence of olfactory hallucinations, absence of grandiose delusions and the number of affected family members. The results mostly supported the challenges and discussions in western countries. To understand this most pathological form of interpersonal relationships

  20. Disturbed neural circuits in a subtype of chronic catatonic schizophrenia demonstrated by F-18-FDG-PET and F-18-DOPA-PET

    International Nuclear Information System (INIS)

    Lauer, M.; Beckmann, H.; Stoeber, G.; Schirrmeister, H.; Gerhard, A.; Ellitok, E.; Reske, S.N.

    2001-01-01

    Permanent verbal, visual scenic and coenaestetic hallucinations are the most prominent psychopathological symptoms aside from psychomotor disorders in speech-sluggish catatonia, a subtype of chronic catatonic schizophrenia according to Karl Leonhard. These continuous hallucinations serve as an excellent paradigm for the investigation of the assumed functional disturbances of cortical circuits in schizophrenia. Data from positron emission tomography (F-18-FDG-PET and F-18-DOPA-PET) from three patients with this rare phenotype were available (two cases of simple speech-sluggish catatonia, one case of a combined speech-prompt/speech-sluggish subtype) and were compared with a control collective. During their permanent hallucinations, all catatonic patients showed a clear bitemporal hypometabolism in the F-18-FDG-PET. Both patients with the simple speech-sluggish catatonia showed an additional bilateral thalamic hypermetabolism and an additional bilateral hypometabolism of the frontal cortex, especially on the left side. In contrast, the patient with the combined speech-prompt/speech-sluggish catatonia showed a bilateral thalamic hypo-metabolism combined with a bifrontal cortical hypermetabolism. However, the left/right ratio of the frontal cortex also showed a lateralization effect with a clear relative hypometabolism of the left frontal cortex. The F-18-DOPA-PET of both schizophrenic patients with simple speech-sluggish catatonia showed a normal F-18-DOPA storage in the striatum, whereas in the right putamen of the patient with the combined form a higher right/left ratio in F-DOPA storage was discernible, indicating an additional lateralized influence of the dopaminergic system in this subtype of chronic catatonic schizophrenia. (author)

  1. Capgras syndrome in Dementia with Lewy Bodies.

    Science.gov (United States)

    Thaipisuttikul, Papan; Lobach, Iryna; Zweig, Yael; Gurnani, Ashita; Galvin, James E

    2013-05-01

    Capgras syndrome is characterized by the recurrent, transient belief that a person has been replaced by an identical imposter. We reviewed clinical characteristics of Dementia with Lewy Bodies (DLB) patients with Capgras syndrome compared to those without Capgras. We identified 55 consecutive DLB patients (11 cases with Capgras syndrome (DLB-C) and 44 cases without evidence of Capgras (DLB). Semi-structured interviews with the patient and an informant, neurological exams, and neuropsychological testing were performed. Caregivers were assessed for caregiver burden and depression. Primary comparisons were made between DLB-C and DLB. Exploratory analyses using stepwise logistic regression and bootstrap analyses were performed to determine clinical features associated with Capgras. DLB-C patients experienced more visual hallucinations and self-reported anxiety, had higher scores on the Neuropsychiatric Inventory, and were less likely to be treated with cholinesterase inhibitors at time of initial evaluation. Extrapyramidal symptoms and depression were not associated with Capgras. Caregivers of DLB-C patients had higher caregiver burden. DLB-C was associated with self-reported anxiety (OR = 10.9; 95% CI = 2.6-47.6). In a bootstrap analysis, clinical findings that were predictors of Capgras included visual hallucinations (log(OR) = 18.3; 95% CI = 17.9-19.3) and anxiety (log(OR) = 2.9; 95% CI = 0.31-20.2). Our study suggests that Capgras syndrome is common in DLB and usually occurs in the presence of anxiety and visual hallucinations, suggesting related etiopathogenesis. Early appreciation of Capgras syndrome may afford the opportunity to alleviate caregiver burden and improve patient and caregiver outcomes.

  2. Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Kamoya, Masatoshi

    2001-01-01

    For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

  3. Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions.

    Science.gov (United States)

    Ruffell, Tamatha; Azis, Matilda; Hassanali, Nedah; Ames, Catherine; Browning, Sophie; Bracegirdle, Karen; Corrigall, Richard; Laurens, Kristin R; Hirsch, Colette; Kuipers, Elizabeth; Maddox, Lucy; Jolley, Suzanne

    2016-03-01

    The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of 'targeted' cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8-14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning; of frequency, and hallucinations and paranoia, with negative life events; and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.

  4. Source retrieval is not properly differentiated from object retrieval in early schizophrenia: An fMRI study using virtual reality

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    Colin Hawco

    2015-01-01

    Full Text Available Source memory, the ability to identify the context in which a memory occurred, is impaired in schizophrenia and has been related to clinical symptoms such as hallucinations. The neurobiological underpinnings of this deficit are not well understood. Twenty-five patients with recent onset schizophrenia (within the first 4.5 years of treatment and twenty-four healthy controls completed a source memory task. Participants navigated through a 3D virtual city, and had 20 encounters of an object with a person at a place. Functional magnetic resonance imaging was performed during a subsequent forced-choice recognition test. Two objects were presented and participants were asked to either identify which object was seen (new vs. old object recognition, or identify which of the two old objects was associated with either the person or the place being presented (source memory recognition. Source memory was examined by contrasting person or place with object. Both patients and controls demonstrated significant neural activity to source memory relative to object memory, though activity in controls was much more widespread. Group differences were observed in several regions, including the medial parietal and cingulate cortex, lateral frontal lobes and right superior temporal gyrus. Patients with schizophrenia did not differentiate between source and object memory in these regions. Positive correlations with hallucination proneness were observed in the left frontal and right middle temporal cortices and cerebellum. Patients with schizophrenia have a deficit in the neural circuits which facilitate source memory, which may underlie both the deficits in this domain and be related to auditory hallucinations.

  5. Sleep paralysis in Brazilian folklore and other cultures: a brief review

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    José Felipe Rodriguez de Sá

    2016-09-01

    Full Text Available Sleep paralysis (SP is a dissociative state that occurs mainly during awakening. SP is characterized by altered motor, perceptual, emotional and cognitive functions, such as inability to perform voluntary movements, visual hallucinations, feelings of chest pressure, delusions about a frightening presence and, in some cases, fear of impending death. Most people experience SP rarely, but typically when sleeping in supine position; however, SP is considered a disease (parasomnia when recurrent and/or associated to emotional burden. Interestingly, throughout human history, different peoples interpreted SP under a supernatural view. For example, Canadian Eskimos attribute SP to spells of shamans, who hinder the ability to move, and provoke hallucinations of a shapeless presence. In the Japanese tradition, SP is due to a vengeful spirit who suffocates his enemies while sleeping. In Nigerian culture, a female demon attacks during dreaming and provokes paralysis. A modern manifestation of SP is the report of alien abductions, experienced as inability to move during awakening associated with visual hallucinations of aliens. Furthermore, SP is a significant example of how a specific biological phenomenon can be interpreted and shaped by different cultural contexts. In order to further explore the ethnopsychology of SP, the Pisadeira, a character of Brazilian folklore originated in the country’s Southeast, but also found in other regions with variant names, has been reviewed. Pisadeira is described as a crone with long fingernails who lurks on roofs at night and tramples on the chest of those who sleep on a full stomach with the belly up. This legend is mentioned in many anthropological accounts; however, we found no comprehensive reference on the Pisadeira from the perspective of sleep science. Here we aim to fill this gap. We first review the neuropsychological aspects of SP, and then present the folk tale of the Pisadeira. Finally, we summarize the

  6. Les psychoses de l’épileptique: approche clinique à propos d'un cas

    Science.gov (United States)

    Charfi, Nada; Trigui, Dorsaf; Ben Thabet, Jihène; Zouari, Nasreddine; Zouari, Lobna; Maalej, Mohamed

    2014-01-01

    Pour discuter les liens entre épilepsie et psychose, les auteurs rapportent l'observation d'une fille âgée de 22 ans, traitée pour épilepsie fronto-temporale, adressée en psychiatrie pour des hallucinations sensorielles et cénesthésiques et un délire mystique et d'influence, apparus secondairement et non améliorés par le traitement antiépileptique. Les symptômes psychotiques, chez l’épileptique, peuvent entrer dans le cadre de psychoses intercritiques, post-critiques ou alternatives. Pour le cas rapporté, les symptômes psychotiques étaient intercritiques et chroniques. Il s'agissait vraisemblablement d'une psychose schizophréniforme. Dans ce type de psychose, une indifférence affective et une restriction des activités sont rarement rencontrés, alors que les fluctuations rapides de l'humeur sont fréquentes. Les thématiques délirantes sont assez souvent mystiques, alimentées par des hallucinations auditives et par des hallucinations visuelles inhabituelles. Les troubles négatifs sont rares. Les psychoses épileptiques n'ont pas été identifiées comme des entités nosographiques dans les systèmes de classification psychiatrique (DSM-IV et CIM-10), ce qui pose un problème de reconnaissance de ces troubles. Une collaboration entre psychiatre et neurologue devient ainsi nécessaire pour mieux comprendre cette comorbidité complexe, éviter les erreurs diagnostiques et optimiser la prise en charge. PMID:25309665

  7. Experience-dependent induction of hypnagogic images during daytime naps: a combined behavioural and EEG study.

    Science.gov (United States)

    Kusse, Caroline; Shaffii-LE Bourdiec, Anahita; Schrouff, Jessica; Matarazzo, Luca; Maquet, Pierre

    2012-02-01

    This study characterizes hypnagogic hallucinations reported during a polygraphically recorded 90-min daytime nap following or preceding practice of the computer game Tetris. In the experimental group (N = 16), participants played Tetris in the morning for 2 h during three consecutive days, while in a first control group (N = 13, controlling the effect of experience) participants did not play any game, and in a second control group (N = 14, controlling the effect of anticipation) participants played Tetris after the nap. During afternoon naps, participants were repetitively awakened 15, 45, 75, 120 or 180 s after the onset of S1, and were asked to report their mental content. Reports content was scored by three judges (inter-rater reliability 85%). In the experimental group, 48 out of 485 (10%) sleep-onset reports were Tetris-related. They mostly consisted of images and sounds with very little emotional content. They exactly reproduced Tetris elements or mixed them with other mnemonic components. By contrast, in the first control group, only one report out of 107 was scored as Tetris-related (1%), and in the second control group only three reports out of 112 were scored as Tetris-related (3%; between-groups comparison; P = 0.006). Hypnagogic hallucinations were more consistently induced by experience than by anticipation (P = 0.039), and they were predominantly observed during the transition of wakefulness to sleep. The observed attributes of experience-related hypnagogic hallucinations are consistent with the particular organization of regional brain activity at sleep onset, characterized by high activity in sensory cortices and in the default-mode network. © 2011 European Sleep Research Society.

  8. Frequencies and Associations of Narcolepsy-Related Symptoms: A Cross-Sectional Study.

    Science.gov (United States)

    Kim, Lenise Jihe; Coelho, Fernando Morgadinho; Hirotsu, Camila; Araujo, Paula; Bittencourt, Lia; Tufik, Sergio; Andersen, Monica Levy

    2015-12-15

    Narcolepsy is a disabling disease with a delayed diagnosis. At least 3 years before the disorder identification, several comorbidities can be observed in patients with narcolepsy. The early recognition of narcolepsy symptoms may improve long-term prognosis of the patients. Thus, we aimed to investigate the prevalence of the symptoms associated with narcolepsy and its social and psychological association in a sample of Sao Paulo city inhabitants. We performed a cross-sectional evaluation with 1,008 individuals from the Sao Paulo Epidemiologic Sleep Study (EPISONO). Excessive daytime sleepiness (EDS) was assessed by the Epworth Sleepiness Scale. Volunteers were also asked about the occurrence of cataplectic-like, hypnagogic or hypnopompic hallucinations, and sleep paralysis symptoms. The participants underwent a full-night polysomnography and completed questionnaires about psychological, demographic, and quality of life parameters. We observed a prevalence of 39.2% of EDS, 15.0% of cataplectic-like symptom, 9.2% of hypnagogic or hypnopompic hallucinations, and 14.9% of sleep paralysis in Sao Paulo city inhabitants. A frequency of 6.9% was observed when EDS and cataplectic-like symptoms were grouped. The other associations were EDS + hallucinations (4.7%) and EDS + sleep paralysis (7.5%). Symptomatic participants were predominantly women and younger compared with patients without any narcolepsy symptom (n = 451). Narcolepsy symptomatology was also associated with a poor quality of life and symptoms of depression, anxiety, and fatigue. Narcolepsy-related symptoms are associated with poor quality of life and worse psychological parameters. © 2015 American Academy of Sleep Medicine.

  9. Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam--a pilot study.

    Science.gov (United States)

    Sackey, Peter V; Martling, Claes-Roland; Carlswärd, Christine; Sundin, Orjan; Radell, Peter J

    2008-03-01

    To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. Prospective long-term follow-up after randomized controlled trial. General ICU at Karolinska University Hospital, Solna, Stockholm. Forty patients in need of sedation during ventilator treatment. Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress

  10. Value of 99mTc-ECD SPET for the diagnosis of dementia with Lewy bodies

    International Nuclear Information System (INIS)

    Pasquier, Jacques; Brenot-Rossi, Isabelle; Hassan-Sebbag, Nathalie; Sauvan, Richard; Michel, Bernard F.; Gastaut, Jean Louis

    2002-01-01

    Despite improved diagnostic accuracy, differentiation of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) on the basis of clinical findings remains problematic. The purpose of this retrospective study was to evaluate the utility of technetium-99m ethyl cysteinate dimer (ECD) single-photon emission tomography (SPET) as a potential tool for the diagnosis of DLB and discrimination from AD. Cerebral perfusion patterns detected by 99m Tc-ECD SPET were compared in patients presenting with a probable diagnosis of DLB (n=34) or AD (n=28). Tracer distribution was quantified using the region of interest technique in eight symmetrical paired zones and expressed as a perfusion index (ratio of mean uptake in a brain region to that in the cerebellum). Comparison of findings in the DLB and AD groups demonstrated significant differences in mean perfusion indexes in the right occipital region (P=0.004), left occipital region (P=0.005) and left medial temporal region (P=0.013). Mean perfusion indexes in the right and left occipital regions were lower in DLB than in AD patients. Conversely, the mean perfusion index in the left medial temporal region was lower in AD than in DLB patients. DLB was correctly identified in 22 patients (sensitivity, 65%) while AD was correctly identified in 20 patients (specificity, 71%). In the DLB group, right and left occipital perfusion indexes were 0.95 or more in all eight non-hallucinating patients, and bilateral occipital hypoperfusion was observed in 15 of the 26 patients with visual hallucinations (57.7%). To our knowledge, this is the first study in which 99m Tc-ECD SPET has been used exclusively for the diagnosis of DLB. The results suggest that brain perfusion scintigraphy could be helpful in distinguishing DLB from AD if diagnosis based on clinical criteria alone is difficult. The findings also support a link between visual hallucinations and structural/functional changes in the occipital region in DLB patients. (orig.)

  11. Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kamoya, Masatoshi [Kanazawa Medical Univ., Ishikawa (Japan)

    2001-03-01

    For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

  12. Comparison of efficacy of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort

    Directory of Open Access Journals (Sweden)

    Başak Akça

    2016-01-01

    Full Text Available Objectives: To compare the effects of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort/pain in patients undergoing cystoscopy. Methods: This prospective study was conducted on 75 American Society of Anesthesiologists (ASA I-II patients between 18-75 years of age and undergoing cystoscopy between November 2011 and June 2012 at Hacettepe University Hospital, Ankara, Turkey. Patients were randomly assigned to one of the 3 groups to receive 1 μ/kg dexmedetomidine, 250 μ/kg intravenous ketamine, or normal saline. All patients were questioned regarding probe-related discomfort, patient satisfaction, and pain at the end of the operation 0 (t0 and 15 (t1, 60 (t2, 120 (t3, and 360 (t4 minutes postoperatively. Evaluations were performed in person at the post-anesthesia care unit, or in ambulatory surgery rooms, or by phone calls. Results: Pain incidence in the dexmedetomidine and ketamine groups (p=0.042 was significantly lower than that in the control group (p=0.044.The sedation scores recorded at t0 in the dexmedetomidine and ketamine groups (p=0.004 were significantly higher than that of the control group (p=0.017. Patient groups were similar regarding the rate of hallucinations experienced at t1, no patients experienced hallucinations at t2, t3, or t4. Significantly more patients experienced hallucinations at t0 in the ketamine group than in the dexmedetomidine group (p=0.034 and the control group (p=0.005. Conclusion: Dexmedetomidine and ketamine had similar analgesic effects in preventing catheter-related pain; however, dexmedetomidine had a more acceptable side effect profile. To identify the optimal doses of dexmedetomidine and ketamine, more large-scale interventional studies are needed.

  13. Ketamine in the treatment of acute pain.

    Science.gov (United States)

    Brinck, Elina; Kontinen, Vesa

    2017-01-01

    Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management. The significance of these effects at low doses is probably less than expected, particularly if benzodiazepines or an alpha-2 agonist, such as dexmedetomidine, are administered in addition to ketamine.

  14. Parkinson Disease and Dementia.

    Science.gov (United States)

    Garcia-Ptacek, Sara; Kramberger, Milica G

    2016-09-01

    Dementia is a frequent complication of Parkinson disease (PD) with a yearly incidence of around 10% of patients with PD. Lewy body pathology is the most important factor in the development of Parkinson disease dementia (PDD) and there is evidence for a synergistic effect with β-amyloid. The clinical phenotype in PDD extends beyond the dysexecutive syndrome that is often present in early PD and encompasses deficits in recognition memory, attention, and visual perception. Sleep disturbances, hallucinations, neuroleptic sensitivity, and fluctuations are often present. This review provides an update on current knowledge of PDD including aspects of epidemiology, pathology, clinical presentation, management, and prognosis. © The Author(s) 2016.

  15. Hitler: a neurohistorical formulation.

    Science.gov (United States)

    Martindale, C; Hasenfus, N; Hines, D

    1976-01-01

    It is hypothesized that Adolf Hitler suffered from a constitutional left-side weakness that allowed his cerebral hemisphere to exert a strong influence on his thought and behavior. Physical characteristics such as trembling of the left extremities, lack of a left testicle, and tendency to exhibit leftward eye movements are interpreted as supportive of the hypothesis. Right hemisphere dominance is consistent with a number of Hitler's personal traits such as praise of the irrational, automatic speech, auditory hallucinations, hypochondriasis, uncontrolled rages, and spatial and musical interests. Right hemisphere dominated thought may also have formed a basis for his two basic political policies: Lebensraum and anti-Semitism.

  16. Safety Profile of Cough and Cold Medication Use in Pediatrics.

    Science.gov (United States)

    Green, Jody L; Wang, George Sam; Reynolds, Kate M; Banner, William; Bond, G Randall; Kauffman, Ralph E; Palmer, Robert B; Paul, Ian M; Dart, Richard C

    2017-06-01

    The safety of cough and cold medication (CCM) use in children has been questioned. We describe the safety profile of CCMs in children pediatric (75.5%), and single-ingredient (77.5%) formulations were most commonly involved. AEs occurring in >20% of all cases included tachycardia, somnolence, hallucinations, ataxia, mydriasis, and agitation. Twenty cases (0.6%) resulted in death; most were in children pediatric liquid formulations were the most commonly reported products. These characteristics present an opportunity for targeted prevention efforts. Copyright © 2017 by the American Academy of Pediatrics.

  17. Thought-action fusion and schizotypy in undergraduate students.

    Science.gov (United States)

    Muris, Peter; Merckelbach, Harald

    2003-06-01

    To examine the relationship between thought-action fusion (TAF) and schizotypy. In two separate samples of undergraduate students (Ns = 77 and 64), correlations were computed between a measure of TAF and indices of schizotypy and fantasy proneness. Positive correlations were found between TAF and various aspects of schizotypy (i.e. perceptual aberration, magical ideation, schizotypal personality characteristics, disposition to hallucinate). However, correlations between TAF and schizotypy no longer attained significance when controlling for fantasy proneness. At least in the non-clinical population, the connection between TAF and schizotypy seems to be a by-product of fantasy-prone individuals' tendency to report unusual experiences.

  18. Anton's Syndrome due to Bilateral Ischemic Occipital Lobe Strokes.

    Science.gov (United States)

    Zukić, Sanela; Sinanović, Osman; Zonić, Lejla; Hodžić, Renata; Mujagić, Svjetlana; Smajlović, Edina

    2014-01-01

    We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

  19. Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark

    DEFF Research Database (Denmark)

    Palic, Sabina; Carlsson, Jessica; Armour, Cherie

    2015-01-01

    systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). Results: The SIDES-D indicated twice as high prevalence...... reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon...

  20. [The representation of madness in William Shakespeare's characters].

    Science.gov (United States)

    Stompe, Thomas; Ritter, Kristina; Friedmann, Alexander

    2006-08-01

    Shakespeare is one of the great creators of human characters of the 16(th) century. Like for many of his contemporaries madness was a central topic of his work. The first part of this paper discusses the sociocultural environment and the semantic field of madness in the Elizabethan age, which forms the background for Shakespeare's characters. In the second part we try to analyze the clinical pictures of the fictive characters of Othello, Hamlet, Lear and Macbeth. While we find melancholy, delusions and hallucinations, other diseases such as schizophrenia are missing entirely. Schizophrenia only appears in the literature more than two hundred years later, in the beginning of modern age.