Signs and Symptoms in Psychiatry
Mohamed Ahmed Abd El-Hay in Essentials of Psychiatric Assessment, 2018
Visual hallucination: false perception involving vision, consisting of both formed (complex) images, e.g., people, and ill-defined (elementary) images and colors, e.g., flashes of light. They may appear normal or abnormal in size; if the latter, they are more often smaller than the corresponding real percept (sometimes called Lilliputian). Visual hallucinations occur in many mental disorders, often in conjunction with auditory hallucinations. However, visual and tactile hallucinations are usually linked to organic conditions (Tombini et al., 2012); i.e., they occur more in cases of dementia, delirium, recently developed blindness, drug withdrawal states, drug intoxications (e.g., hallucinogenic, anticholinergic, or dopaminergic substances), temporal lobe epilepsy, migraine, and other organic mental disorders. Ill-defined visual experiences occur in ocular and neurologic diseases, e.g., flashing lights occur with retinal detachment, whereas scintillating lights, a series of undulating jagged lines, blurred areas, or dark spots occur in migraine (scotomas). Seeing a curtain of darkness over the lower visual field is a sign of transient ischemic attack. Small dark specks, called floaters, that drift across the visual field are a common and benign result of senescent changes in the eye.
Reflections of a child and adolescent psychiatrist
Chris Donovan, Heather C Suckling, Zoe Walker, Janet Bell, Tami Kramer, Sheila R Cross in Difficult Consultations with Adolescents, 2018
Acute presentations are easier to identify. These include abnormal thoughts (incoherent, illogical speech), beliefs (false beliefs that are impervious to reason and often paranoid), perceptions (auditory hallucinations are most common) and mobility (abnormal postures or stupor). Remember that the presence of visual hallucinations is more commonly suggestive of an organic pathology such as intoxication or withdrawal from an illicit substance, infection, seizures, etc. Acute presentations should be referred to CAMHS urgently. With a very non-specific insidious presentation, close follow-up over time may be required. If the picture is persistent, with no other obvious cause, refer the adolescent for a specialist opinion.
Psychiatric Misdiagnosis
Mark S. Gold, R. Bruce Lydiard, John S. Carman in Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
This nonspecificity of medical disease causing specific behavioral syndromes applies to other disorders as well. The differential diagnosis of depression is long and involved. Giannini et al.16 list 91 possible disorders which can present as depression. Hall17 lists 24 medical illnesses that frequently induce depression and 77 medical conditions which can present as depression. Giannini lists 28 causes of auditory hallucinations, 26 causes of euphoria, 8 causes for mania, 56 causes of delusions, 21 causes of depersonalization, and 12 causes of hyperventilation. Hall et al.3 found that visual hallucinations were present almost exclusively in medically induced psychiatric disorders. Thus there are a variety of physical disorders which can cause the same symptomatology.
Prevalence of visual hallucinations
Published in Clinical and Experimental Optometry, 2020
Srinivas Marmamula, Rebecca Sumalini, Thirupathi K Reddy, Satya M Brahmanandam, Premnandhini Satgunam
The prevalence of CBS had been reported in the Western population (11 to 63 per cent)2008 and in a few East Asian countries (0.4 to 1.4 per cent).2012 Prevalence of CBS was found to be 6.7 to 8.1 per cent in a tertiary eye‐care centre in India.2019 Not all visual hallucinations can be attributed to CBS. Visual hallucinations can be present even without any visual impairment.2009 Neither the prevalence of CBS nor the presence of visual hallucinations is known from community‐based population studies in India. As part of the survey of a larger epidemiological study2019 conducted during February–June 2017 to determine the prevalence of visual impairment in Khammam and Warangal districts in Telangana, India, we specifically aimed to screen for visual hallucinations and to determine its associations with clinical and demographic parameters.
Bilateral Vision Loss and Visual Hallucinations in Subacute Sclerosing Panencephalitis: A Case Report
Published in Neuro-Ophthalmology, 2023
Ravi Uniyal, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Shweta Pandey, Imran Rizvi, Amita Jain, Nidhi Tejan, Rupesh Singh kirar
This patient also developed visual hallucinations. Simple visual hallucinations occur due to hyperactivity or irritation of the primary visual cortex, while complex visual hallucinations can occur due to the involvement of visual association cortices.5 Visual hallucinations can be associated with various psychiatric, neurologic, and ophthalmologic conditions. In patients with severe vision loss, visual deafferentation may cause cortical release phenomenon, in the form of visual hallucinations, which is typically known as Charles Bonnet syndrome (CBS).5 CBS can be associated with vision loss due to any cause. Visual hallucinations in CBS tend to involve people, animals, faces, and even inanimate objects.5 The appearance of visual hallucinations in this patient can be explained by CBS secondary to vision loss; however, the occurrence of seizures suggests that brain parenchyma per se is also contributory.
Visual hallucination induced by duloxetine use: a male case diagnosed with generalized anxiety disorder
Published in Psychiatry and Clinical Psychopharmacology, 2018
Kemal Utku Yazici, Ipek Percinel Yazici
In our case, we thought the visual hallucinations occurred as a result of increased dopamine, either as a result of inhibition of serotonin reuptake, or inhibition of NET. However, our case did not experience visual hallucinations during his previous treatments including SSRIs (sertraline, fluoxetine, and citalopram) and venlafaxine. This suggests that the possible responsible mechanism was inhibition of NET rather than the inhibition of serotonin reuptake. Additionally, although the case did not develop visual hallucinations with venlafaxine in the past, it is known that venlafaxine shows a primarily serotonergic effect at low doses with increasing noradrenergic effect as the dose is increased, and in a general sense, inhibition of serotonin reuptake is more prominent than inhibition of norepinephrine [17]. This may explain why our case did not develop visual hallucinations during venlafaxine treatment.
Related Knowledge Centers
- Consciousness
- Delusion
- Rapid Eye Movement Sleep
- Sleep Paralysis
- Visual System
- Wakefulness
- Stimulus
- Pseudohallucination
- Mental Image
- Stimulus Modality