MRCPsych Paper A1 Mock Examination 5: Questions
Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri in Get Through, 2016
A 25-year-old man with a history of cocaine misuse feels bugs on his skin. He scratches at the ‘bugs’ trying to remove them, gouging his skin and leaving scars. The psychopathology being described is FormicationFunctional hallucinationGustatory hallucinationReflex hallucinationVisceral hallucination
The Dementia Workup
Marc E. Agronin in Alzheimer's Disease and Other Dementias, 2014
Hallucinations are false sensory perceptions that can be auditory, visual, and, less commonly, tactile or olfactory. Auditory hallucinations are the most common type of hallucination encountered in psychotic states, including psychosis associated with severe depression. Visual hallucinations and delusions are common side effects of medications used to treat Parkinson's disease. They are sometimes associated with visual impairment, such as occurs in the rare Charles Bonnet syndrome, in which an individual with no other psychiatric symptoms experiences vivid visual hallucinations (sometimes of small or Lilliputian people moving about) that typically cause little emotional distress. Tactile hallucinations are suggestive of substance withdrawal, whereas olfactory hallucinations are associated with temporal lobe seizures.
Observed Effects of the Unconscious Mind and the Unknown World. 3: Optical Effects
David E. H. Jones in Why Are We Conscious?, 2017
This discussion has to centre on ghosts, for the overwhelmingly popular theory of ghosts is that each is in some way the animation of the soul of someone dead, which has come back to haunt the physical world as a visual apparition. However, the obvious counter-theory is that such effects are simply a form of hallucination. A hallucination is a malfunction of the sensory system, leading it to report something which is not there. It can disrupt any sensory system. (I myself once answered a telephone, convinced that it had been ringing. It hadn’t: I had had an acoustic hallucination.) A typical medical hallucination is the illusion of feeling the creep of small creatures on the skin, a common sensory delusion is delirium tremens. It is a private feeling and cannot be tested by an external carer, though that carer may note that no small creatures can be seen on the skin. There are, of course, many ways to distinguish a hallucination from a sensory reality. A simple one is permanence, or even just persistence. Instrumental tests are often useful. Some of the ‘phantasms’ recorded by Gurney, Myers and Podmore (Chapter 8) even showed a reflection in a mirror, or cast a visible shadow.
Cannabis for cancer – illusion or the tip of an iceberg: a review of the evidence for the use of Cannabis and synthetic cannabinoids in oncology
Published in Expert Opinion on Investigational Drugs, 2019
Side effects associated with cannabinoids vary largely from patient to patient and are generally mitigated by limiting drug dosage. They are generally short-term and include somnolence, nausea, dizziness, dry mouth, and disorientation, as well as euphoria, anxiety and hallucination. Memory and cognition problems, addiction, and exacerbation or provocation of nascent psychiatric illness, such as depression and anxiety disorders, have also been associated with Cannabis use [84]. A small prospective study did not find cognitive impairment in cancer patients on chemotherapy while on CBMs [85]. adverse events are mostly attributed to Δ9-THC, while the opposing cannabinoid CBD is thought to alleviate its effects, and rather to facilitate learning, prevent psychosis and ease anxiety [9]. Street Cannabis notoriously contains high levels of Δ9-THC and negligible CBD, in contrast to CBMs supplied for research or patient use [9].
Treating hallucinations in Parkinson’s disease
Published in Expert Review of Neurotherapeutics, 2022
Alice Powell, Elie Matar, Simon J. G. Lewis
Visual hallucinations are the most common psychotic symptom in PD [1,11]. Classic minor visual hallucinations include the perception that someone is present nearby, usually over one’s shoulder (presence hallucination) or that something (typically a person or animal) is passing through the periphery of the visual field (passage hallucination) [4,12]. Related phenomena such as illusions are also common and involve the misperception of real visual cues such as seeing a coat on a hanger as a person. They also include pareidolias in which faces or animals may emerge from natural phenomena such as flames or clouds, or from artificial patterns seen, for instance, in a curtain or an upholstered couch [12,13]. These ‘minor hallucinations’ usually precede the onset of well-structured visual hallucinations and can occur very early in the course of disease, sometimes before any drug therapy has been initiated [12,14].
Analytically confirmed 4-Methyl-N-ethylnorpentedrone (4-MEAP), a synthetic cathinone, in cases presenting to an emergency department
Published in Clinical Toxicology, 2020
Te-I Weng, Pei-I Su, Ju-Yu Chen, Pai-Shan Chen, Hsaio-Lin Hwa, Cheng-Chung Fang
The clinical assessment of the effects of 4-MEAP in our patients was unavoidably limited as none was exposed to 4-MEAP alone. Varma et al. reported two cases of 4-MEAP misuse, whose urine were also analyzed positive for numerous other psycho-stimulants, such as mexedrone, cocaine, amphetamine, and methamphetamine [3]. However, 4-MEAP was the only psycho-stimulant confirmed in our three cases (cases 4, 8 and 9). Three to four benzodiazepines were the other substances detected in these three cases. Delirium, agitation, and violent behavior were observed in these three patients, and two cases had hallucination. Our results are in agreement with the findings of previous studies with similar clinical features in cathinone abusers [4]. The patients in our study were younger than those in other cathinone abuse studies [5]. It is noteworthy that no patient declared 4-MEAP use. The immunoassay of drug screen test was unable to detect this substance. All patients tested positive for benzodiazepines. Benzodiazepines are a common substance in the “instant coffee packet” in Taiwan. Benzodiazepines may mitigate the psychostimulant effects of 4-MEAP, but aggravated rhabdomyolysis because of the prolonged immobilization period.
Related Knowledge Centers
- Consciousness
- Delusion
- Rapid Eye Movement Sleep
- Sleep Paralysis
- Visual System
- Wakefulness
- Stimulus
- Pseudohallucination
- Mental Image
- Stimulus Modality