HALLUCINATIONS
SOUNDARYA. A . N
Roll no. : 112
OBJECTIVES :
Definition
Classification
Investigations
Treatment
DEFINITION :
False sensory perceptions occurring in the absence of
any relevant external stimulation of the sensory
modality involved.
CLASSIFICATION :
Depending on sensory modality :
1) Auditory hallucinations
2) Visual hallucinations
3) Olfactory hallucinations
4) Gustatory hallucinations
5) Tactile hallucinations
6) Vestibular hallucinations
7) Deep sensations
1) AUDITORY HALLUCINATIONS:
This is the most common form of hallucinations and
refers to the perception of sound without auditory
stimulus.
In this, the patients often hear voices talking to them but
it may also take form of whistling or hissing.
Seen in schizophrenia ,organic states such as delirium
and dementia.
Imperative hallucinations – Here, hallucinatory voices
gives command to the patient, who may or may not
act upon them.
2nd person hallucinations – Here, the voices appears to
address the patient in the second person .
3rd person hallucinations – giving running commentary
about the patient to a second person.
2) VISUAL HALLUCINATIONS:
Here a person sees a person or object
that does not exist.
Several conditions can cause visual
hallucinations which include dementia,
migraine and drug or alcohol addiction.
3) OLFACTORY HALLUCINATIONS:
These hallucinations involve smelling odours that do not
exist.
The odours are usually unpleasant such as vomit, urine,
feces, smoke or rotten flesh.
This condition is also called as phantosmia and can occur
as a result of neurological damage to the olfactory
system.
4) GUSTATORY HALLUCINATIONS:
These hallucinations cause a person to taste
something that is not present.
Seen in schizophrenia as well as in acute organic
states.
5) TACTILE HALLUCINATIONS:
Experiences the feeling of touch in the absence of such
tactile sensory input.
Sensation of bugs crawling over skin.
Associated with substance abuse like cocaine or
amphetamine.
Depending on complexity :
1) Simple – single sensory modality involved
2) Complex – multiple sensory modality involved
Depending on organisation :
1) Unformed – sparks of light,noises
2) Formed – voices accusing the patient
Depending on reality value :
1) False hallucinations – the patient is aware of unreality of his perception
2) True hallucinations – have reality value
SPECIAL TYPES:
Hypnagogic and hypnapompic hallucinations
Functional hallucinations
Reflex hahallucinations
Extracampaign hallucinations
Paranoramic or scenic hallucinations
Treatment :
Treatment of underlying condition such as delirium, schizophrenia,
mania or psychotic depression.
Antipsychotic medication (such as Haloperidol, Risperidone or
Olanzapine), and is often used with other sedating medication (such
as Benzodiazepine).
Reference :
Kaplon and Sadock’s synopsis of psychiatry (11th edition)
Niraj Ahuja’s short textbook of psychiatry (7th edition)
Davidson’s principles and practice of medicine (23rd edition)
