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Authors: Perminder S. Sachdev
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modality, as adverse reactions to or following intoxication with followed by the tactile, and then auditory and visual medications and nonprescription drugs and alcohol modalities. In a large nonclinical population, Johns and in response to sensory deprivation. Comprehen-and colleagues found auditory and visual hallucina-sive compendia of these causes associated with hallu-tions occurred in approximately 4% of the sample [7].
cinations in different modalities can be found in Brasic Such data support the proposition that just as there is [21] and Cummings [22].
a range of mood and anxiety symptoms in the general population, there is a continuum of psychotic symp-
Prevalence of hallucinations in
toms [8–9] . This is strongly advocated by van Os and colleagues [10]. Evidence from a number of cogni-
organic disorders
tive neuropsychiatric studies suggests that individuals In contrast to the relatively high prevalence of hallu-with hallucination-proneness appear to attribute inter-cinations in populations of psychiatric patients, espe-nal events as external, and to have an external locus cially those with serious psychiatric disorders, sec-of control for internal and interpersonal events [11–
ondary or organic hallucinations are uncommon in 13] . This appears to occur for both auditory and visual general psychiatric practice. Cornelius and colleagues hallucinations [14].
reviewed more than 14,800 patients over a four-year period who had been assessed at the Western Psy-
Prevalence of hallucinations in
chiatric Clinic, Pittsburgh, Pennsylvania, USA, where retrospective analyses revealed only 11 patients with psychiatric disorders
organic hallucinosis [23]. These patients were distin-The disorder in which hallucinations are most com-guished from those with schizophrenia in that visual mon is schizophrenia. It is generally well accepted that hallucinations were the only symptom that was present 60% to 70% of individuals with this disorder experi-to a significantly greater degree in the organic group.
ence hallucinations [15]. Auditory hallucinations are Other distinguishing symptoms including flat affect, most common, followed by visual hallucinations fol-thought disorganization, self-neglect, speech pressure, lowed by tactile, olfactory and gustatory hallucina-and bizarre behavior all occurred more frequently in tions: in 117 consecutively admitted patients studied schizophrenia.
by Mueser and colleagues, the lifetime prevalence of Although there is extensive literature on halluci-hallucinations for auditory, visual, tactile, and olfac-nations in individual modalities – as reflected in the tory/gustatory hallucinations was 72%, 16%, 17%, and sections that follow – there are relatively few papers 11%, respectively [6]. Another study by Bracha and that compare the phenomenology of organic halluci-colleagues suggested that the rate of visual hallucinosis and hallucinations due to primary psychiatric nations in chronic schizophrenia might be as high disorders such as schizophrenia and bipolar disorder.
as 32% [16]. Rates described for auditory hallucina-The best information on the distinction between these tions range from 47% to 98% of schizophrenia patients two broad classes of hallucinations comes from older [6, 16–19], visual hallucinations from 14% to 69% [6,
studies that contrast the presenting features of organic 16–18], and tactile hallucinations from 4% to 25% of and nonorganic psychosis. One of the most quoted patients [6, 16].
studies in this regard is the investigation by Cutting of Hallucinations also occur in mood disorders. One 74 patients who suffered from acute organic psychosis study of 4,972 hospitalized patients [20] showed that and 74 patients with acute schizophrenia [24]. The the prevalence of hallucinations in mood disorder causes of the organic psychosis included stroke, patients was considerably greater for bipolar patients epilepsy, carcinoma, respiratory failure, and alcohol than
cinations in different modalities can be found in Brasic Such data support the proposition that just as there is [21] and Cummings [22].
a range of mood and anxiety symptoms in the general population, there is a continuum of psychotic symp-
Prevalence of hallucinations in
toms [8–9] . This is strongly advocated by van Os and colleagues [10]. Evidence from a number of cogni-
organic disorders
tive neuropsychiatric studies suggests that individuals In contrast to the relatively high prevalence of hallu-with hallucination-proneness appear to attribute inter-cinations in populations of psychiatric patients, espe-nal events as external, and to have an external locus cially those with serious psychiatric disorders, sec-of control for internal and interpersonal events [11–
ondary or organic hallucinations are uncommon in 13] . This appears to occur for both auditory and visual general psychiatric practice. Cornelius and colleagues hallucinations [14].
reviewed more than 14,800 patients over a four-year period who had been assessed at the Western Psy-
Prevalence of hallucinations in
chiatric Clinic, Pittsburgh, Pennsylvania, USA, where retrospective analyses revealed only 11 patients with psychiatric disorders
organic hallucinosis [23]. These patients were distin-The disorder in which hallucinations are most com-guished from those with schizophrenia in that visual mon is schizophrenia. It is generally well accepted that hallucinations were the only symptom that was present 60% to 70% of individuals with this disorder experi-to a significantly greater degree in the organic group.
ence hallucinations [15]. Auditory hallucinations are Other distinguishing symptoms including flat affect, most common, followed by visual hallucinations fol-thought disorganization, self-neglect, speech pressure, lowed by tactile, olfactory and gustatory hallucina-and bizarre behavior all occurred more frequently in tions: in 117 consecutively admitted patients studied schizophrenia.
by Mueser and colleagues, the lifetime prevalence of Although there is extensive literature on halluci-hallucinations for auditory, visual, tactile, and olfac-nations in individual modalities – as reflected in the tory/gustatory hallucinations was 72%, 16%, 17%, and sections that follow – there are relatively few papers 11%, respectively [6]. Another study by Bracha and that compare the phenomenology of organic halluci-colleagues suggested that the rate of visual hallucinosis and hallucinations due to primary psychiatric nations in chronic schizophrenia might be as high disorders such as schizophrenia and bipolar disorder.
as 32% [16]. Rates described for auditory hallucina-The best information on the distinction between these tions range from 47% to 98% of schizophrenia patients two broad classes of hallucinations comes from older [6, 16–19], visual hallucinations from 14% to 69% [6,
studies that contrast the presenting features of organic 16–18], and tactile hallucinations from 4% to 25% of and nonorganic psychosis. One of the most quoted patients [6, 16].
studies in this regard is the investigation by Cutting of Hallucinations also occur in mood disorders. One 74 patients who suffered from acute organic psychosis study of 4,972 hospitalized patients [20] showed that and 74 patients with acute schizophrenia [24]. The the prevalence of hallucinations in mood disorder causes of the organic psychosis included stroke, patients was considerably greater for bipolar patients epilepsy, carcinoma, respiratory failure, and alcohol than
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