51
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Blom JD, Nanuashvili N, Waters F. Time Distortions: A Systematic Review of Cases Characteristic of Alice in Wonderland Syndrome. Front Psychiatry 2021; 12:668633. [PMID: 34025485 PMCID: PMC8138562 DOI: 10.3389/fpsyt.2021.668633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Of the perceptual distortions characteristic of Alice in Wonderland syndrome, substantial alterations in the immediate experience of time are probably the least known and the most fascinating. We reviewed original case reports to examine the phenomenology and associated pathology of these time distortions in this syndrome. A systematic search in PubMed, Ovid Medline, and the historical literature yielded 59 publications that described 168 people experiencing time distortions, including 84 detailed individual case reports. We distinguished five different types of time distortion. The most common category comprises slow-motion and quick-motion phenomena. In 39% of all cases, time distortions were unimodal in nature, while in 61% there was additional involvement of the visual (49%), kinaesthetic (18%), and auditory modalities (14%). In all, 40% of all time distortions described were bimodal in nature and 19% trimodal, with 1% involving four modalities. Underlying neurological mechanisms are varied and may be triggered by intoxications, infectious diseases, metabolic disorders, CNS lesions, paroxysmal neurological disorders, and psychiatric disorders. Bizarre sensations of time alteration-such as time going backwards or moving in circles-were mostly associated with psychosis. Pathophysiologically, mainly occipital areas appear to be involved, although the temporal network is widely disseminated, with separate component timing mechanisms not always functioning synchronously, thus occasionally creating temporal mismatches within and across sensory modalities (desynchronization). Based on our findings, we propose a classification of time distortions and formulate implications for research and clinical practice.
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Affiliation(s)
- Jan Dirk Blom
- Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, Netherlands.,Faculty of Social Sciences, Leiden University, Leiden, Netherlands.,Department of Psychiatry, University of Groningen, Groningen, Netherlands
| | - Nutsa Nanuashvili
- Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, Netherlands
| | - Flavie Waters
- Clinical Research Centre, Graylands Hospital, North Metro Health Service Mental Health, Perth, WA, Australia.,School of Psychological Sciences, University of Western Australia, Perth, WA, Australia
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52
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Leptourgos P, Fortier-Davy M, Carhart-Harris R, Corlett PR, Dupuis D, Halberstadt AL, Kometer M, Kozakova E, LarØi F, Noorani TN, Preller KH, Waters F, Zaytseva Y, Jardri R. Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison. Schizophr Bull 2020; 46:1396-1408. [PMID: 32944778 PMCID: PMC7707069 DOI: 10.1093/schbul/sbaa117] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - Martin Fortier-Davy
- Institut Jean Nicod, École des Hautes Études en Sciences Sociales, École Normale Supérieure, PSL Research University, Paris France
| | | | - Philip R Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - David Dupuis
- Department of Anthropology, University of Durham, Durham, UK
| | - Adam L Halberstadt
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Research Service, VA San Diego Healthcare System, San Diego, CA
| | - Michael Kometer
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Eva Kozakova
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Frank LarØi
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
- Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | | | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Flavie Waters
- School of Psychological Sciences, The University of Western Australia, Perth, Western Australia
| | - Yuliya Zaytseva
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Renaud Jardri
- Univ. Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
- Laboratoire de Neurosciences Cognitives et Computationnelles, ENS, INSERM U960, PSL Research University, Paris, France
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53
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Muller AM, Dalal TC, Stevenson RA. Schizotypal traits are not related to multisensory integration or audiovisual speech perception. Conscious Cogn 2020; 86:103030. [PMID: 33120291 DOI: 10.1016/j.concog.2020.103030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/02/2020] [Accepted: 10/04/2020] [Indexed: 12/01/2022]
Abstract
Multisensory integration, the binding of sensory information from different sensory modalities, may contribute to perceptual symptomatology in schizophrenia, including hallucinations and aberrant speech perception. Differences in multisensory integration and temporal processing, an important component of multisensory integration, are consistently found in schizophrenia. Evidence is emerging that these differences extend across the schizophrenia spectrum, including individuals in the general population with higher schizotypal traits. In the current study, we investigated the relationship between schizotypal traits and perceptual functioning, using audiovisual speech-in-noise, McGurk, and ternary synchrony judgment tasks. We measured schizotypal traits using the Schizotypal Personality Questionnaire (SPQ), hypothesizing that higher scores on Unusual Perceptual Experiences and Odd Speech subscales would be associated with decreased multisensory integration, increased susceptibility to distracting auditory speech, and less precise temporal processing. Surprisingly, these measures were not associated with the predicted subscales, suggesting that these perceptual differences may not be present across the schizophrenia spectrum.
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Affiliation(s)
- Anne-Marie Muller
- Department of Psychology, University of Western Ontario, London, ON, Canada; Brain and Mind Institute, University of Western Ontario, London, ON, Canada
| | - Tyler C Dalal
- Department of Psychology, University of Western Ontario, London, ON, Canada; Brain and Mind Institute, University of Western Ontario, London, ON, Canada
| | - Ryan A Stevenson
- Department of Psychology, University of Western Ontario, London, ON, Canada; Brain and Mind Institute, University of Western Ontario, London, ON, Canada.
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54
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Wengler K, Goldberg AT, Chahine G, Horga G. Distinct hierarchical alterations of intrinsic neural timescales account for different manifestations of psychosis. eLife 2020; 9:e56151. [PMID: 33107431 PMCID: PMC7591251 DOI: 10.7554/elife.56151] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022] Open
Abstract
Hierarchical perceptual-inference models of psychosis may provide a holistic framework for understanding psychosis in schizophrenia including heterogeneity in clinical presentations. Particularly, hypothesized alterations at distinct levels of the perceptual-inference hierarchy may explain why hallucinations and delusions tend to cluster together yet sometimes manifest in isolation. To test this, we used a recently developed resting-state fMRI measure of intrinsic neural timescale (INT), which reflects the time window of neural integration and captures hierarchical brain gradients. In analyses examining extended sensory hierarchies that we first validated, we found distinct hierarchical INT alterations for hallucinations versus delusions in the auditory and somatosensory systems, thus providing support for hierarchical perceptual-inference models of psychosis. Simulations using a large-scale biophysical model suggested local elevations of excitation-inhibition ratio at different hierarchical levels as a potential mechanism. More generally, our work highlights the robustness and utility of INT for studying hierarchical processes relevant to basic and clinical neuroscience.
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Affiliation(s)
- Kenneth Wengler
- Department of Psychiatry, Columbia UniversityNew YorkUnited States
- New York State Psychiatric InstituteNew YorkUnited States
| | | | - George Chahine
- Department of Psychiatry, Yale UniversityNew HavenUnited States
| | - Guillermo Horga
- Department of Psychiatry, Columbia UniversityNew YorkUnited States
- New York State Psychiatric InstituteNew YorkUnited States
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55
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Moreau CA, Urchs SGW, Kuldeep K, Orban P, Schramm C, Dumas G, Labbe A, Huguet G, Douard E, Quirion PO, Lin A, Kushan L, Grot S, Luck D, Mendrek A, Potvin S, Stip E, Bourgeron T, Evans AC, Bearden CE, Bellec P, Jacquemont S. Mutations associated with neuropsychiatric conditions delineate functional brain connectivity dimensions contributing to autism and schizophrenia. Nat Commun 2020; 11:5272. [PMID: 33077750 PMCID: PMC7573583 DOI: 10.1038/s41467-020-18997-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
16p11.2 and 22q11.2 Copy Number Variants (CNVs) confer high risk for Autism Spectrum Disorder (ASD), schizophrenia (SZ), and Attention-Deficit-Hyperactivity-Disorder (ADHD), but their impact on functional connectivity (FC) remains unclear. Here we report an analysis of resting-state FC using magnetic resonance imaging data from 101 CNV carriers, 755 individuals with idiopathic ASD, SZ, or ADHD and 1,072 controls. We characterize CNV FC-signatures and use them to identify dimensions contributing to complex idiopathic conditions. CNVs have large mirror effects on FC at the global and regional level. Thalamus, somatomotor, and posterior insula regions play a critical role in dysconnectivity shared across deletions, duplications, idiopathic ASD, SZ but not ADHD. Individuals with higher similarity to deletion FC-signatures exhibit worse cognitive and behavioral symptoms. Deletion similarities identified at the connectivity level could be related to the redundant associations observed genome-wide between gene expression spatial patterns and FC-signatures. Results may explain why many CNVs affect a similar range of neuropsychiatric symptoms.
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Affiliation(s)
- Clara A Moreau
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, QC, H3W 1W5, Canada.
| | - Sebastian G W Urchs
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, QC, H3W 1W5, Canada.
- Montreal Neurological Institute and Hospital, McGill University, 3801 Rue de l'Université, Montreal, QC, H3A 2B4, Canada.
| | - Kumar Kuldeep
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Pierre Orban
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Montreal, QC, H1N 3M5, Canada
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Pavillon Roger-Gaudry, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Catherine Schramm
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada
| | - Guillaume Dumas
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Human Genetics and Cognitive Functions, Institut Pasteur, Université de Paris, UMR3571 CNRS, Paris, France
| | - Aurélie Labbe
- Département des Sciences de la Décision, HEC, 3000, chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 2A7, Canada
| | - Guillaume Huguet
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Elise Douard
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Pierre-Olivier Quirion
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, QC, H3W 1W5, Canada
- Canadian Center for Computational Genomics, McGill University and Genome Quebec Innovation Center 740, Dr. Penfield Avenue, H3A 0G1, Montreal, Canada
| | - Amy Lin
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Semel Institute/NPI, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Leila Kushan
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Semel Institute/NPI, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Stephanie Grot
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Montreal, QC, H1N 3M5, Canada
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Pavillon Roger-Gaudry, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada
| | - David Luck
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Adrianna Mendrek
- Department of Psychology, Bishop's University, 2600 College Street, Sherbrooke, QC, J1M IZ7, Canada
| | - Stephane Potvin
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Pavillon Roger-Gaudry, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Emmanuel Stip
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Pavillon Roger-Gaudry, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada
- United Arab Emirates University, College of Medicine and health Sciences, PO 17666, Al Ain, QC, UAE
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, Université de Paris, UMR3571 CNRS, Paris, France
| | - Alan C Evans
- Montreal Neurological Institute and Hospital, McGill University, 3801 Rue de l'Université, Montreal, QC, H3A 2B4, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Semel Institute/NPI, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Pierre Bellec
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, QC, H3W 1W5, Canada
| | - Sebastien Jacquemont
- Sainte Justine Hospital Research Center, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
- Department of Pediatrics, University of Montreal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
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56
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Religious Hallucinations and Religious Delusions among Older Adults in Treatment for Psychoses in the Netherlands. RELIGIONS 2020. [DOI: 10.3390/rel11100522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background. Although religious delusions (RDs) are common in geriatric psychiatry, we know little about their frequency and content. Our study examines the prevalence and content of religious hallucinations (RHs) and RDs and how they relate to the diagnosis and the patients’ denominational background and other aspects of religiousness. Methods. Semi-structured diagnostic interviews were conducted with inpatients and outpatients (N = 155, mean age 76.5) at a geriatric psychiatry department in the Netherlands. We used the Schedules for Clinical Assessment in Neuropsychiatry 2.1. Results. The prevalences of RHs and RDs were 19% and 32%, respectively. RHs were mostly auditory. There was no statistically significant difference between the prevalence of RHs in schizophrenia (17.5%) and in psychotic depression (9.4%). Compared to non-affiliated patients and mainline Protestants, RDs were significantly more prevalent in raised and current strict Protestants, especially in those with psychotic depression. RHs were more prevalent in Evangelical (e.g., Pentecostal) and strict Protestant patients. The presence of RDs was associated with several measures of religiousness (e.g., dogmatism, religious coping). Conclusions. Religion is likely to act as a symptom-formation factor for psychotic symptoms in strict Protestant older adults. More detailed research might lead to a fuller understanding of how strict religious beliefs may affect the content of psychotic symptoms and unintentionally add a component of existential suffering. It is important for mental health professionals, especially the predominantly secular professionals in the Netherlands, to recognize and address religious themes.
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Montagnese M, Leptourgos P, Fernyhough C, Waters F, Larøi F, Jardri R, McCarthy-Jones S, Thomas N, Dudley R, Taylor JP, Collerton D, Urwyler P. A Review of Multimodal Hallucinations: Categorization, Assessment, Theoretical Perspectives, and Clinical Recommendations. Schizophr Bull 2020; 47:237-248. [PMID: 32772114 PMCID: PMC7825001 DOI: 10.1093/schbul/sbaa101] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hallucinations can occur in different sensory modalities, both simultaneously and serially in time. They have typically been studied in clinical populations as phenomena occurring in a single sensory modality. Hallucinatory experiences occurring in multiple sensory systems-multimodal hallucinations (MMHs)-are more prevalent than previously thought and may have greater adverse impact than unimodal ones, but they remain relatively underresearched. Here, we review and discuss: (1) the definition and categorization of both serial and simultaneous MMHs, (2) available assessment tools and how they can be improved, and (3) the explanatory power that current hallucination theories have for MMHs. Overall, we suggest that current models need to be updated or developed to account for MMHs and to inform research into the underlying processes of such hallucinatory phenomena. We make recommendations for future research and for clinical practice, including the need for service user involvement and for better assessment tools that can reliably measure MMHs and distinguish them from other related phenomena.
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Affiliation(s)
- Marcella Montagnese
- Neuroimaging Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | | | - Flavie Waters
- School of Psychological Sciences, The University of Western Australia, Perth, Australia
| | - Frank Larøi
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium,Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | - Renaud Jardri
- University of Lille, INSERM U1172, CHU Lille, Centre Lille Neuroscience and Cognition, Lille, France,Laboratoire de Neurosciences Cognitives et Computationnelles, ENS, INSERM U960, PSL Research University, Paris, France
| | | | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia,The Alfred Hospital, Melbourne, Australia
| | - Rob Dudley
- Gateshead Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS, Newcastle upon Tyne, UK,School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Prabitha Urwyler
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK,Gerontechnology and Rehabilitation, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland,Department of Neurology, University Neurorehabilitation Unit, University Hospital Bern—Inselspital, Bern, Switzerland,To whom correspondence should be addressed; tel: +41 31 632 76 07, fax: +41 31 632 75 76, e-mail:
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58
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Cachia A, Cury C, Brunelin J, Plaze M, Delmaire C, Oppenheim C, Medjkane F, Thomas P, Jardri R. Deviations in early hippocampus development contribute to visual hallucinations in schizophrenia. Transl Psychiatry 2020; 10:102. [PMID: 32214096 PMCID: PMC7096500 DOI: 10.1038/s41398-020-0779-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/17/2020] [Accepted: 02/26/2020] [Indexed: 01/06/2023] Open
Abstract
Auditory hallucinations (AHs) are certainly the most emblematic experiences in schizophrenia, but visual hallucinations (VHs) are also commonly observed in this developmental psychiatric disorder. Notably, several studies have suggested a possible relationship between the clinical variability in hallucinations' phenomenology and differences in brain development/maturation. In schizophrenia, impairments of the hippocampus, a medial temporal structure involved in mnesic and neuroplastic processes, have been repeatedly associated with hallucinations, particularly in the visual modality. However, the possible neurodevelopmental origin of hippocampal impairments in VHs has never been directly investigated. A classic marker of early atypical hippocampal development is incomplete hippocampal inversion (IHI). In this study, we compared IHI patterns in healthy volunteers, and two subgroups of carefully selected schizophrenia patients experiencing frequent hallucinations: (a) those with pure AHs and (b) those with audio-visual hallucinations (A+VH). We found that VHs were associated with a specific IHI pattern. Schizophrenia patients with A+VH exhibited flatter left hippocampi than patients with pure AHs or healthy controls. This result first confirms that the greater clinical impairment observed in A+VH patients may relate to an increased neurodevelopmental weight in this subpopulation. More importantly, these findings bring crucial hints to better specify the sensitivity period of A+VH-related IHI during early brain development.
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Affiliation(s)
- Arnaud Cachia
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005, Paris, France. .,Université de Paris, Laboratoire de Psychologie du développement et de l'Education de l'Enfant, CNRS, F-75005, Paris, France. .,Institut Universitaire de France, Paris, France.
| | - Claire Cury
- grid.83440.3b0000000121901201Department of Medical Physics and Biomedical Engineering, University College, London, UK ,grid.410368.80000 0001 2191 9284Univ Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, EMPENN — ERL U 1228, F-35000 Rennes, France
| | - Jérôme Brunelin
- grid.25697.3f0000 0001 2172 4233INSERM U 1028, CNRS UMR-5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, CH le Vinatier, Lyon, France
| | - Marion Plaze
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005 Paris, France
| | - Christine Delmaire
- grid.410463.40000 0004 0471 8845CHU Lille, Salengro Hospital, Neuroradiology dpt, 59000 Lille, France
| | - Catherine Oppenheim
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005 Paris, France
| | - François Medjkane
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
| | - Pierre Thomas
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
| | - Renaud Jardri
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
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59
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Abstract
Perceptual disturbances in psychosis, such as auditory verbal hallucinations, are associated with increased baseline activity in the associative auditory cortex and increased dopamine transmission in the associative striatum. Perceptual disturbances are also associated with perceptual biases that suggest increased reliance on prior expectations. We review theoretical models of perceptual inference and key supporting physiological evidence, as well as the anatomy of associative cortico-striatal loops that may be relevant to auditory perceptual inference. Integrating recent findings, we outline a working framework that bridges neurobiology and the phenomenology of perceptual disturbances via theoretical models of perceptual inference.
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60
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Francis AM, Knott VJ, Labelle A, Fisher DJ. Interaction of Background Noise and Auditory Hallucinations on Phonemic Mismatch Negativity (MMN) and P3a Processing in Schizophrenia. Front Psychiatry 2020; 11:540738. [PMID: 33093834 PMCID: PMC7523538 DOI: 10.3389/fpsyt.2020.540738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Auditory hallucinations (AHs) are among the cardinal symptoms of schizophrenia (SZ). During the presence of AHs aberrant activity of auditory cortices have been observed, including hyperactivation during AHs alone and hypoactivation when AHs are accompanied by a concurrent external auditory competitor. Mismatch negativity (MMN) and P3a are common ERPs of interest within the study of SZ as they are robustly reduced in the chronic phase of the illness. The present study aimed to explore whether background noise altered the auditory MMN and P3a in those with SZ and treatment-resistant AHs. METHODS MMN and P3a were assessed in 12 hallucinating patients (HPs), 11 non-hallucinating patients (NPs) and 9 healthy controls (HCs) within an auditory oddball paradigm. Standard (P = 0.85) and deviant (P = 0.15) stimuli were presented during three noise conditions: silence (SL), traffic noise (TN), and wide-band white noise (WN). RESULTS HPs showed significantly greater deficits in MMN amplitude relative to NPs in all background noise conditions, though predominantly at central electrodes. Conversely, both NPs and HPs exhibited significant deficits in P3a amplitude relative to HCs under the SL condition only. SIGNIFICANCE These findings suggest that the presence of AHs may specifically impair the MMN, while the P3a appears to be more generally impaired in SZ. That MMN amplitudes are specifically reduced for HPs during background noise conditions suggests HPs may have a harder time detecting changes in phonemic sounds during situations with external traffic or "real-world" noise compared to NPs.
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Affiliation(s)
- Ashley M Francis
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada
| | - Verner J Knott
- Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.,Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Alain Labelle
- Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Derek J Fisher
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada.,Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.,Department of Psychology, Carleton University, Ottawa, ON, Canada.,Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
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61
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Wang TT, Beckstead JW, Yang CY. Social interaction skills and depressive symptoms in people diagnosed with schizophrenia: The mediating role of auditory hallucinations. Int J Ment Health Nurs 2019; 28:1318-1327. [PMID: 31433115 DOI: 10.1111/inm.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022]
Abstract
Past studies have presented evidence that depressive symptoms are affected in different ways by social interaction skills and auditory hallucinatory symptoms in people with schizophrenia. However, few studies have focused on examining the relationship among auditory hallucinatory severity, social interaction skills, and depressive symptoms. This study aimed to explore the mediating effect of auditory hallucinatory severity on social interaction skills and depressive symptoms in people with long-term schizophrenia. We propose that auditory hallucination severity functions as a mechanism through which impaired social interaction skills increase depressive symptoms. In this study, a convenience sample of 186 people with schizophrenia was obtained from hospital-based rehabilitation wards. Four instruments were used: A demographic data questionnaire, the Assessment of Communication and Interaction Skills-Chinese version, the Characteristics of Auditory Hallucinations Questionnaire, and the Beck Depression Inventory II. To investigate the mediating effect of auditory hallucinatory severity after controlling for six covariates, we tested an indirect effect in a simple mediation model using the SPSS macro PROCESS, which is a regression-based approach. The indirect effect and the results of Sobel's test were significant (Z = -2.824, P = 0.005), which confirms that auditory hallucination severity mediates social interaction skills and depressive symptoms. This finding suggests that psychiatric nurses must teach people with schizophrenia to use auditory hallucination management strategies to prevent them from becoming immersed in auditory hallucinations and reducing their social interaction with the real world, so that depressive symptoms can be improved.
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Affiliation(s)
- Tzu-Ting Wang
- School of Nursing National Yang-Ming University, Taipei, Taiwan.,Cardinal Tien Junior College of Healthcare & Management, New Taipei City, Taiwan
| | - Jason W Beckstead
- College of Public Health, Epidemiology and Biostatistics, University of South Florida, Tampa, Florida, USA
| | - Chiu-Yueh Yang
- School of Nursing, National Yang Ming University, Taipei, Taiwan.,Department of Nursing, National Yang-Ming University Hospital, Yilan, Taiwan
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62
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Fernyhough C. Modality-general and modality-specific processes in hallucinations. Psychol Med 2019; 49:2639-2645. [PMID: 31530334 PMCID: PMC6877466 DOI: 10.1017/s0033291719002496] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/12/2019] [Accepted: 08/27/2019] [Indexed: 02/07/2023]
Abstract
There is a growing recognition in psychosis research of the importance of hallucinations in modalities other than the auditory. This has focused attention on cognitive and neural processes that might be shared by, and which might contribute distinctly to, hallucinations in different modalities. In this article, I address some issues around the modality-generality of cognitive and neural processes in hallucinations, including the role of perceptual and reality-monitoring systems, top-down and bottom-up processes in relation to the psychological and neural substrates of hallucinations, and the phenomenon of simultaneous multimodal hallucinations of the same entity. I suggest that a functional systems approach, inspired by some neglected aspects of the writings of A. R. Luria, can help us to understand patterns of hallucinatory experience across modalities and across clinical and non-clinical groups. Understanding the interplay between modality-general and modality-specific processes may bear fruit for improved diagnosis and therapeutic approaches to dealing with distressing hallucinations.
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63
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Gonçalves PDB, Sampaio FMC, da Cruz Sequeira CA, Paiva E Silva MATDC. Nursing Process Addressing the Nursing Focus "Hallucination": A Scoping Review. Clin Nurs Res 2019; 30:392-400. [PMID: 31595769 DOI: 10.1177/1054773819877534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although hallucinations are prevalent in psychiatric disorders, such as psychosis or dementia, no studies were to be found in literature about the nursing process addressing the focus "Hallucination". This literature review, which is integrated with a scoping study framework, was performed to determine a clinical data model addressing the focus "Hallucination". PRISMA checklist for scoping reviews was followed. From the total of 328 papers found, 32 were selected. The findings of this review were summarized according to the nursing process addressing the focus "Hallucination". These findings led to determine a clinical data model addressing the focus "Hallucination", comprising the elements of the nursing process. This clinical data model may contribute toward improving nursing decision-making and nursing care quality in relation to a client suffering from hallucination, as well as contribute toward producing more reliable nursing-sensitive indicators.
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Affiliation(s)
- Patrícia Daniela Barata Gonçalves
- University of Oporto, Abel Salazar Institute of Biomedical Sciences.,Registered Mental Health Nurse, Hospital de Magalhães Lemos, Porto, Portugal.,Escola Superior de Enfermagem do Porto (Oporto Nursing School).,Non-Doctorate Integrated Member, CINTESIS
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64
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Toh WL, McCarthy-Jones S, Copolov D, Rossell SL. Have we overlooked the significance of multinodal hallucinations in schizophrenia? Psychiatry Res 2019; 279:358-360. [PMID: 31227320 DOI: 10.1016/j.psychres.2019.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 11/16/2022]
Abstract
Scant research attention has been devoted to the phenomenon of multimodal hallucinations, with majority of studies focusing on auditory hallucinations (AH) in psychosis. The current study aimed to explore the frequency and characteristics of these multisensory hallucinations in a primary AH cohort. It was concluded more than half of our sample reported comorbid hallucinations in one or more sensory modes. This conveys significant research and clinical implications, in terms of steps taken for adequate assessment and intervention.
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Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health, Swinburne University, John St, Hawthorn, Victoria 3122, Australia.
| | | | - David Copolov
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University, John St, Hawthorn, Victoria 3122, Australia; Department of Psychiatry, St. Vincent's Hospital, Fitzroy, Victoria, Australia
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65
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Laloyaux J, Bless JJ, Hugdahl K, Kråkvik B, Vedul-Kjelsås E, Kalhovde AM, Larøi F. Multimodal hallucinations are associated with poor mental health and negatively impact auditory hallucinations in the general population: Results from an epidemiological study. Schizophr Res 2019; 210:319-322. [PMID: 31277976 DOI: 10.1016/j.schres.2019.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Julien Laloyaux
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium.
| | - Josef J Bless
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Bodil Kråkvik
- St. Olavs University Hospital, Division of Psychiatry, Nidaros District Psychiatric Center, Trondheim, Norway
| | - Einar Vedul-Kjelsås
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway; Department of Research and Development, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | | | - Frank Larøi
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
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66
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Karrer TM, Bassett DS, Derntl B, Gruber O, Aleman A, Jardri R, Laird AR, Fox PT, Eickhoff SB, Grisel O, Varoquaux G, Thirion B, Bzdok D. Brain-based ranking of cognitive domains to predict schizophrenia. Hum Brain Mapp 2019; 40:4487-4507. [PMID: 31313451 DOI: 10.1002/hbm.24716] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/10/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022] Open
Abstract
Schizophrenia is a devastating brain disorder that disturbs sensory perception, motor action, and abstract thought. Its clinical phenotype implies dysfunction of various mental domains, which has motivated a series of theories regarding the underlying pathophysiology. Aiming at a predictive benchmark of a catalog of cognitive functions, we developed a data-driven machine-learning strategy and provide a proof of principle in a multisite clinical dataset (n = 324). Existing neuroscientific knowledge on diverse cognitive domains was first condensed into neurotopographical maps. We then examined how the ensuing meta-analytic cognitive priors can distinguish patients and controls using brain morphology and intrinsic functional connectivity. Some affected cognitive domains supported well-studied directions of research on auditory evaluation and social cognition. However, rarely suspected cognitive domains also emerged as disease relevant, including self-oriented processing of bodily sensations in gustation and pain. Such algorithmic charting of the cognitive landscape can be used to make targeted recommendations for future mental health research.
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Affiliation(s)
- Teresa M Karrer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Birgit Derntl
- Translational Brain Medicine, Jülich Aachen Research Alliance (JARA), Aachen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Gruber
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - André Aleman
- BCN Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Renaud Jardri
- Division of Psychiatry, University of Lille, CNRS UMR 9193, SCALab and CHU Lille, Fontan Hospital, Lille, France
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, Florida
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas.,South Texas Veterans Health Care System, San Antonio, Texas.,State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-7), Research Centre Jülich, Jülich, Germany
| | - Olivier Grisel
- Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
| | - Gaël Varoquaux
- Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
| | | | - Danilo Bzdok
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Translational Brain Medicine, Jülich Aachen Research Alliance (JARA), Aachen, Germany.,Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
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67
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Visual hallucinations associated with multimodal hallucinations, suicide attempts and morbidity of illness in psychotic disorders. Schizophr Res 2019; 208:196-201. [PMID: 30842029 PMCID: PMC6664439 DOI: 10.1016/j.schres.2019.02.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/02/2019] [Accepted: 02/25/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Visual hallucinations (VH) are a common, but understudied symptom of psychosis, experienced by individuals across diagnostic categories of psychotic and neuropsychiatric conditions. There are limited data on VH and associated clinical phenotypes in adult idiopathic psychotic disorders, which are needed to elucidate their relevance to psychotic illness paradigms. METHOD In this cross-sectional study, we examined clinical risk factors for VH in a well-characterized sample of 766 patients with adult psychotic disorders across diagnostic categories of schizophrenia (n = 227), schizoaffective disorder (n = 210), and bipolar I disorder (n = 329). The Structured Clinical Interview for DSM-IV-TR was used for diagnosis and symptom measurements. RESULTS The prevalence of VH was 26.1% (200/766). Multivariate logistic regression showed that VH were independently associated with the presence of hallucinations in other modalities, including auditory, tactile, olfactory, and gustatory hallucinations. History of a suicide attempt and catatonic behavior were also associated with VH. In addition, specific delusions were associated with VH, in particular, delusions of control, and religious, erotomanic and jealousy delusions. Diagnosis, negative symptoms, and family history of psychosis were not independent predictors of VH. CONCLUSIONS Results showed the clinical and disease relevance of VH as they were associated with severe morbidity of illness, including suicide attempts and catatonic behavior. Findings also suggest a phenotype associated with hallucinations in other modalities and specific types of delusions. Based on our findings, VH may be a significant factor in assessing for suicidality and illness severity, warranting clinical attention and further study of underlying mechanisms.
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68
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Allé MC, Berna F, Berntsen D. Individuals with psychotic-like experiences exhibit enhanced involuntary autobiographical memories. Psychiatry Res 2019; 273:281-287. [PMID: 30677715 DOI: 10.1016/j.psychres.2019.01.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/21/2018] [Accepted: 01/12/2019] [Indexed: 10/27/2022]
Abstract
The relationship between hallucinations and stressful life events in psychosis is recognised, and has recently been supported by findings showing that the frequency of involuntary autobiographical memory and future projection predicts hallucination-proneness in the general population. To better understand the nature of this relationship, an online survey was conducted in 44 individuals with high Psychotic Like Experiences (PLE) and 44 matched controls, assessing the quantitative, qualitative and content characteristics of their involuntary autobiographical memories and future thoughts. Individuals with high PLE displayed a higher frequency of both involuntary autobiographical memory and future thought compared to controls. Moreover, the associated emotional intensity, feeling of reliving and intrusiveness were increased. Contrary to controls' memories, involuntary memories of individuals with high PLE more frequently referred to traumatic events and were associated with negative mood impact at retrieval. Taken together, these results can be seen as consistent with a relationship between involuntary memory and hallucination, by suggesting phenomenological and content related similarities between the two processes.
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Affiliation(s)
- Mélissa C Allé
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Bartholins Allé 11, Aarhus University, Aarhus C 8000, Denmark.
| | - Fabrice Berna
- Inserm U1114, Strasbourg University, University Hospital of Strasbourg, France
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Bartholins Allé 11, Aarhus University, Aarhus C 8000, Denmark
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69
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Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
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Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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70
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Dudley R, Aynsworth C, Mosimann U, Taylor JP, Smailes D, Collerton D, McCarthy-Jones S, Urwyler P. A comparison of visual hallucinations across disorders. Psychiatry Res 2019; 272:86-92. [PMID: 30579187 DOI: 10.1016/j.psychres.2018.12.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 11/17/2022]
Abstract
Research into hallucinations typically regards them as single sensory or unimodal experiences leading to a comparative neglect of co-occurring multi-sensory hallucinations (MSH). People with psychosis who have visual hallucinations (VH) report high rates of hallucinations in other senses (auditory, olfactory, tactile). However, it is not known if this is similar to other groups who report VH. Consequently, this study explored MSH in four different patient groups who all had current VH. Archival data from standardised assessments of visual hallucinations in people with psychosis (n = 22), eye disease (ED) (n = 82), Lewy body Dementia (LBD) (n = 41), and Parkinson's disease (PD) (n = 41) determined the presence of MSH. People with psychosis and visual hallucinations reported significantly higher rates of MSH (auditory, 73%; tactile, 82%; olfactory/gustatory hallucinations, 27%) than the LBD group (auditory, 21%; tactile, 28%; olfactory/gustatory, 6%), ED (auditory, 1%; tactile, 11%; olfactory/gustatory, 0%) and PD patients (auditory, 3%; tactile, 8%; olfactory/gustatory, 3%). Regardless of diagnostic grouping, participants with MSH reported greater conviction that the VH were real, and reported greater distress. People with psychosis with VH report high rates of MSH unlike groups of older adults with VH. These between group differences in MSH prevalence have implications for clinical practice and theory.
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Affiliation(s)
- R Dudley
- Gateshead Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS, UK; School of Psychology, Newcastle University, Newcastle upon Tyne, UK.
| | - C Aynsworth
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - U Mosimann
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical engineering, University of Bern, Bern, Switzerland
| | - J-P Taylor
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - D Smailes
- Department of Psychology, Northumbria University, Newcastle upon Tyne, NE1 8ST UK
| | - D Collerton
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK; Older People's Psychology Service, Northumberland, Tyne and Wear NHS Foundation Trust, Bensham Hospital Gateshead, UK
| | | | - P Urwyler
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical engineering, University of Bern, Bern, Switzerland; Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
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71
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Ertekin Pinar S, Tel H. The Effect of Music on Auditory Hallucination and Quality of Life in Schizophrenic Patients: A Randomised Controlled Trial. Issues Ment Health Nurs 2019; 40:50-57. [PMID: 30111213 DOI: 10.1080/01612840.2018.1463324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The study was conducted to determine the effects of music on auditory hallucination and quality of life in schizophrenic patients. The sample of this randomised controlled study consisted of 28 patients (14 experimental and 14 control groups) hospitalised with a diagnosis of schizophrenia (DSM-IV) and auditory hallucination. The study data were collected with the Information Form, The Scale for the Assessment of Positive Symptoms (SAPS), Characteristics of Auditory Hallucinations Questionnaire, and The World Health Organization Quality of Life Scale (WHOQOL-BREF). The hallucination, positive formal thought, and total SAPS scores of the patients in the experimental group obtained during their hospitalisation were determined to be higher than those obtained at discharge and at follow-ups after discharge. The characteristics of auditory hallucination questionnaire scores of the patients in the experimental and control groups decreased. The physical, mental, environmental, and national environmental domain scores of the quality of life in the experimental group increased at sixth month after discharge. Listening to music had positive effects on positive symptoms and the quality of life of patients with auditory hallucination. In line with these results, listening to music may be recommended to cope with auditory hallucinations and to provide positive quality of life.
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Affiliation(s)
| | - Havva Tel
- a Faculty of Health Sciences, Cumhuriyet University , Sivas , Turkey
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72
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Dudley R, Aynsworth C, Cheetham R, McCarthy-Jones S, Collerton D. Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations. Psychiatry Res 2018; 269:25-30. [PMID: 30145297 DOI: 10.1016/j.psychres.2018.08.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/25/2018] [Accepted: 08/12/2018] [Indexed: 12/12/2022]
Abstract
Hallucinations can occur in single or multiple sensory modalities. Historically, greater attention has been paid to single sensory modality experiences with a comparative neglect of hallucinations that occur across two or more sensory modalities (multi-modal hallucinations). With growing evidence suggesting that visual hallucinations may be experienced along with other hallucinations, this study aimed to explore multi-modal hallucinations in a sample of people with psychotic disorders who reported visual hallucinations (n = 22). No participants reported just visual hallucinations i.e. all reported related or unrelated auditory hallucinations. Twenty-one participants reported multi-modal hallucinations that were serial in nature, whereby they saw visual hallucinations and heard unrelated auditory hallucinations at other times. Nineteen people out of the twenty two also reported simultaneous multi-modal hallucinations, with the most common being an image that talked to and touched them. Multi-modal related and simultaneous hallucinations appeared to be associated with greater conviction that the experiences were real, and greater distress. Theoretical and clinical implications of multi-modal hallucinations are discussed.
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Affiliation(s)
- Robert Dudley
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, United Kingdom.
| | - Charlotte Aynsworth
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, United Kingdom
| | - Rea Cheetham
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Sunderland, United Kingdom
| | | | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Older People's Psychology Service, Northumberland, Tyne and Wear NHS Foundation Trust, Bensham Hospital, Gateshead, United Kingdom
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73
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Lim A, Hoek HW, Ghane S, Deen M, Blom JD. The Attribution of Mental Health Problems to Jinn: An Explorative Study in a Transcultural Psychiatric Outpatient Clinic. Front Psychiatry 2018; 9:89. [PMID: 29643820 PMCID: PMC5882841 DOI: 10.3389/fpsyt.2018.00089] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/05/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Among Muslim patients, a common cultural concept of distress is the notion that jinn may be the cause of mental health problems, especially in the presence of hallucinations. OBJECTIVE This study examines the frequency with which this attribution style is manifest in a specific psychiatric outpatient population with a Muslim background. METHODS Of all patients registered at an outpatient clinic specialized in transcultural psychiatry, data were collected on folk belief, religion, hallucinations (if present), and medical diagnosis. Through a search in the electronic medical files, the notes made during the first contact and first psychiatric examination were screened for the keywords "evil eye," "magic," "voodoo," and "jinn." In addition, new eligible cases were accepted. RESULTS From all 551 patients thus screened, 118 were eligible for participation. Of these, 49 (41.5%) were interviewed using a semi-structured questionnaire. Among them, 21 (43%) were positive that their psychiatric symptoms were caused by jinn, whereas 13 (27%) thought not, and 15 (31%) were in doubt. No less than 87.2% had experienced hallucinations during their lives. Among the relatively large proportion of eligible patients who did not participate (58.5%), many expressed a fear for stigmatization or metaphysical repercussions if they spoke about jinn. CONCLUSION The phenomenon of attributing mental health symptoms to jinn was much more common in this population of Muslim patients than previously assumed. This underscores the need for proper knowledge of Muslim explanatory models of disease and for the use of culturally sensitive interviewing techniques in this population.
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Affiliation(s)
- Anastasia Lim
- i-psy Intercultural Psychiatry, Parnassia Psychiatric Institute, Utrecht, Netherlands.,Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Dutch Institute of Forensic Psychiatry and Psychology, Utrecht, Netherlands
| | - Hans W Hoek
- i-psy Intercultural Psychiatry, Parnassia Psychiatric Institute, Utrecht, Netherlands.,Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Department of Psychiatry, University of Groningen, Groningen, Netherlands.,Department of Psychiatric Epidemiology, Columbia University, New York, NY, United States
| | - Samrad Ghane
- i-psy Intercultural Psychiatry, Parnassia Psychiatric Institute, Utrecht, Netherlands.,Arq Psychotrauma Expert Group, Equator Foundation, Diemen, Netherlands
| | - Mathijs Deen
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands
| | - Jan Dirk Blom
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Department of Psychiatry, University of Groningen, Groningen, Netherlands
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74
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Blom JD, Mangoenkarso E. Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma. Front Psychiatry 2018; 9:193. [PMID: 29867612 PMCID: PMC5954108 DOI: 10.3389/fpsyt.2018.00193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/23/2018] [Indexed: 12/03/2022] Open
Abstract
Background: Sexual hallucinations are probably the most neglected types of hallucination, even in psychiatric settings. They are often multimodal in nature, and their prevalence rate is unknown. For other types of hallucination, notably auditory hallucinations, childhood trauma is an important risk factor. However, whether this also applies to sexual hallucinations is unexplored. Objective: To establish the prevalence rate of sexual hallucinations in a clinical sample of patients diagnosed with a schizophrenia spectrum disorder, to describe their phenomenological characteristics, and to estimate their relationship with childhood trauma. Methods: After screening 778 patients diagnosed with a schizophrenia spectrum disorder, 42 were considered eligible for inclusion by their treating physician or psychiatrist. Thirty of these patients were interviewed to assess the presence of sexual hallucinations, using a tailor-made questionnaire and the short form of the Childhood Trauma Questionnaire. Results: Of the 30 patients interviewed, 13 reported sexual hallucinations, yielding a 1-year prevalence rate of 0.017 in this clinical sample. Of the hallucinating patients, 46.2% reported multimodal hallucinations, with involvement of up to five sensory modalities. All patients who experienced sexual hallucinations reported a history of childhood trauma, of which 76.9% involved sexual trauma (OR 8.7). In addition, 61.5% of the patients reported high levels of distress. Conclusion: In patients diagnosed with a schizophrenia spectrum disorder, sexual hallucinations warrant appropriate medical attention. They are not as rare as traditionally thought, and their relationship with childhood trauma is overwhelming. Therefore, we recommend that clinical attention be paid to the psychotic and traumatic symptoms of these patients, as well as to the somatic conditions that may underlie them. For clinical and research purposes, we propose a classification of sexual hallucinations in accordance with the sensory modalities involved. As sexual hallucinations are also experienced in the context of temporal lobe epilepsy, narcolepsy, persistent genital arousal disorder, intoxications and other somatic conditions, further research in transdiagnostic populations seems warranted. In line with the current practice of providing trauma-focused treatment for trauma-related auditory hallucinations, we recommend that future studies explore the effectiveness of this type of treatment for sexual hallucinations.
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Affiliation(s)
- Jan Dirk Blom
- Parnassia Psychiatric Institute, The Hague, Netherlands.,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Department of Psychiatry, University of Groningen, Groningen, Netherlands
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75
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Mitchell CAA, Maybery MT, Russell-Smith SN, Collerton D, Gignac GE, Waters F. The Structure and Measurement of Unusual Sensory Experiences in Different Modalities: The Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ). Front Psychol 2017; 8:1363. [PMID: 28848477 PMCID: PMC5554527 DOI: 10.3389/fpsyg.2017.01363] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/27/2017] [Indexed: 12/11/2022] Open
Abstract
Hallucinations and other unusual sensory experiences (USE) can occur in all modalities in the general population. Yet, the existing literature is dominated by investigations into auditory hallucinations (“voices”), while other modalities remain under-researched. Furthermore, there is a paucity of measures which can systematically assess different modalities, which limits our ability to detect individual and group differences across modalities. The current study explored such differences using a new scale, the Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ). The MUSEQ is a 43-item self-report measure which assesses USE in six modalities: auditory, visual, olfactory, gustatory, bodily sensations, and sensed presence. Scale development and validation involved a total of 1,300 participants, which included: 513 students and community members for initial development, 32 individuals with schizophrenia spectrum disorder or bipolar disorder for validation, 659 students for factor replication, and 96 students for test-retest reliability. Confirmatory factor analyses showed that a correlated-factors model and bifactor model yielded acceptable model fit, while a unidimensional model fitted poorly. These findings were confirmed in the replication sample. Results showed contributions from a general common factor, as well as modality-specific factors. The latter accounted for less variance than the general factor, but could still detect theoretically meaningful group differences. The MUSEQ showed good reliability, construct validity, and could discriminate non-clinical and clinical groups. The MUSEQ offers a reliable means of measuring hallucinations and other USE in six different modalities.
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Affiliation(s)
- Claire A A Mitchell
- School of Psychological Science, The University of Western AustraliaCrawley, WA, Australia
| | - Murray T Maybery
- School of Psychological Science, The University of Western AustraliaCrawley, WA, Australia
| | | | - Daniel Collerton
- Northumberland, Tyne and Wear NHS Foundation Trust, Bensham HospitalGateshead, United Kingdom.,Institute of Neuroscience, Newcastle UniversityNewcastle upon Tyne, United Kingdom
| | - Gilles E Gignac
- School of Psychological Science, The University of Western AustraliaCrawley, WA, Australia
| | - Flavie Waters
- School of Psychological Science, The University of Western AustraliaCrawley, WA, Australia.,Clinical Research Centre, Graylands Hospital, North Metro Health Service Mental HealthMount Claremont, WA, Australia
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76
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Schwippel T, Wasserka B, Fallgatter AJ, Plewnia C. Safety and efficacy of long-term home treatment with transcranial direct current stimulation (tDCS) in a case of multimodal hallucinations. Brain Stimul 2017; 10:873-874. [DOI: 10.1016/j.brs.2017.04.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022] Open
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77
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Schlier B, Hennig T, Lincoln TM. Measuring fluctuations across the Continuum of Auditory Hallucinations. Development and validation of a state inventory. Psychiatry Res 2017; 253:325-332. [PMID: 28412616 DOI: 10.1016/j.psychres.2017.03.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 02/21/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
In order to identify causes and triggers of hallucinations that can inform therapy, reliable, valid, and change-sensitive instruments to assess hallucinatory experiences in the subclinical and clinical range are needed. We developed and validated a novel scale, the Continuum of Auditory Hallucinations - State Assessment (CAHSA), to be used for repeated assessment of the subclinical factors vivid imagination, intrusive thoughts, and perceptual sensitivity as well as auditory hallucinations. After selecting items for the four factors in a first test sample (n=84), we tested factorial validity using CFA and criterion validity with self-reported psychosis-like experiences (n=534). Finally, within-subject variation of CAHSA scores over 14 days and time-lagged associations between its factors were explored (n=85). A 9-item CAHSA was selected that showed good factorial validity, criterion validity, and substantial, valid within-subject variation. Time-lagged regression showed that vivid imagination, perceptual sensitivity, and intrusive thought precede auditory hallucinations. In sum, the CAHSA validly measures fluctuation along the continuum of auditory hallucinations, is sensitive to change, and well suited for experimental studies, repeated measurement, and longitudinal research.
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Affiliation(s)
- Björn Schlier
- University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, D-20146, Hamburg, Germany.
| | - Timo Hennig
- University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, D-20146, Hamburg, Germany
| | - Tania M Lincoln
- University of Hamburg, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, D-20146, Hamburg, Germany
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78
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Aynsworth C, Collerton D, Dudley R. Measures of visual hallucinations: Review and recommendations. Clin Psychol Rev 2017; 57:164-182. [PMID: 28844297 DOI: 10.1016/j.cpr.2017.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/11/2017] [Accepted: 05/03/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies designed to investigate visual hallucinations (VH) require reliable and valid measures that can appropriately capture peoples' experiences. This review aimed to assess the psychometric rigour and usefulness of VH measures. METHOD A systematic literature search was carried out against inclusion criteria (e.g. more than one specific question on VH, measures for adults in clinical and non-clinical populations). Eighteen measures were identified and rated against an adapted evaluation grid, which included essential criteria such as clear purpose and definition, psychometric properties including reliability and validity, and appropriate exploration of visual hallucinations. RESULTS Measures could be categorised into 3 groups; those for general psychotic symptoms, those for all hallucinations, or those specifically for visual hallucinations. With one exception (the North East Visual Hallucinations Inventory), the measures were considered to be limited as they often targeted one population and hence lacked generalisability, or were limited in the characteristics of the visions that were described, or that psychometric properties were not adequately evaluated. CONCLUSIONS Measures of VH require further development. The need to establish a clearer definition of VH is essential to provide clarity and consistency within research and practice. Measures need to demonstrate good psychometric properties to indicate robustness whilst being sensitive to change to help in the evaluation of treatments. Other recommendations include developing cross-cultural measures and involving service users in item development.
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Affiliation(s)
- Charlotte Aynsworth
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Daniel Collerton
- Northumberland, Tyne and Wear NHS Foundation Trust, Bensham Hospital Gateshead, UK
| | - Robert Dudley
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
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79
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On the Interconnectedness and Prognostic Value of Visual and Auditory Hallucinations in First-Episode Psychosis. Eur Psychiatry 2017; 41:122-128. [DOI: 10.1016/j.eurpsy.2016.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 01/29/2023] Open
Abstract
AbstractBackgroundVisual hallucinations (VH) are common symptoms in schizophrenia and other psychoses. An understanding of their cross-sectional and longitudinal patterns of association with auditory hallucinations (AH) is essential for developing accurate models of hallucinatory phenomena.ObjectiveThis study presents the most comprehensive examination of the association between VH and AH, and its change over time, in 1303 individuals with first-episode psychosis (FEP) and 469 individuals with chronic schizophrenia.MethodThe samples included data from the WHO multicentre study on the Determinants of Outcome of Severe Mental Disorders and the Western Australian Family Study of Schizophrenia (WAFSS). Standardized assessment of symptoms and functioning were used to examine the clinical profile and symptom co-occurrence of hallucinations over time.ResultsVH were approximately half as frequent as AH, almost always co-occurred with AH, and tended to be linked to a more severe psychopathological profile. AH and VH at baseline also predicted higher disability, risk of relapse and duration of psychosis after 1 and 2 years, especially when occurring in combination.ConclusionsThe findings point to three hallucination ‘subtypes’ with different symptom profile. The VH + AH combination signals greater psychopathology and a less favourable prognosis, than hallucinations occurring in isolation, and no hallucinations. This conclusion points to one common mechanism for all hallucinations, which can separate into distinct pathways and modalities. For a more complete clinical picture, clinicians should carefully probe for both auditory and VHs in presenting patients.
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80
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Mørch-Johnsen L, Nesvåg R, Jørgensen KN, Lange EH, Hartberg CB, Haukvik UK, Kompus K, Westerhausen R, Osnes K, Andreassen OA, Melle I, Hugdahl K, Agartz I. Auditory Cortex Characteristics in Schizophrenia: Associations With Auditory Hallucinations. Schizophr Bull 2017; 43:75-83. [PMID: 27605526 PMCID: PMC5216858 DOI: 10.1093/schbul/sbw130] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Neuroimaging studies have demonstrated associations between smaller auditory cortex volume and auditory hallucinations (AH) in schizophrenia. Reduced cortical volume can result from a reduction of either cortical thickness or cortical surface area, which may reflect different neuropathology. We investigate for the first time how thickness and surface area of the auditory cortex relate to AH in a large sample of schizophrenia spectrum patients. METHODS Schizophrenia spectrum (n = 194) patients underwent magnetic resonance imaging. Mean cortical thickness and surface area in auditory cortex regions (Heschl's gyrus [HG], planum temporale [PT], and superior temporal gyrus [STG]) were compared between patients with (AH+, n = 145) and without (AH-, n = 49) a lifetime history of AH and 279 healthy controls. RESULTS AH+ patients showed significantly thinner cortex in the left HG compared to AH- patients (d = 0.43, P = .0096). There were no significant differences between AH+ and AH- patients in cortical thickness in the PT or STG, or in auditory cortex surface area in any of the regions investigated. Group differences in cortical thickness in the left HG was not affected by duration of illness or current antipsychotic medication. CONCLUSIONS AH in schizophrenia patients were related to thinner cortex, but not smaller surface area of the left HG, a region which includes the primary auditory cortex. The results support that structural abnormalities of the auditory cortex underlie AH in schizophrenia.
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Affiliation(s)
- Lynn Mørch-Johnsen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; .,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway;,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Kjetil N. Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway;,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth H. Lange
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway;,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cecilie B. Hartberg
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Unn K. Haukvik
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristiina Kompus
- NORMENT, Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | | | - Kåre Osnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ole A. Andreassen
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kenneth Hugdahl
- NORMENT, Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway;,Division of Psychiatry and Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway;,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Combs BL, Cox AG. Update on the treatment of Parkinson's disease psychosis: role of pimavanserin. Neuropsychiatr Dis Treat 2017; 13:737-744. [PMID: 28331324 PMCID: PMC5352252 DOI: 10.2147/ndt.s108948] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) has a prevalence of nearly 1 million people in the USA, with increasing incidence in the elderly population. Generally, the age of presentation is between 55 and 65 years, with the likelihood of diagnosis increasing as patients reach the age of 80 years or above. Some of the common treatments for PD increase dopamine levels in the brain. Dopaminergic therapy helps to improve motor and non-motor symptoms, but it is not without risks. Dopaminergic therapy can cause confusion, delirium, and psychotic-like behavior. It is recommended that these agents are used cautiously in patients with a history of psychosis due to the risk of exacerbation. It is unclear whether Parkinson's disease psychosis (PDP) is due to the disease itself, the treatment, or a combination of both, but it is clear that a safe, effective treatment is necessary. Second-generation (atypical) antipsychotics are the current choice of therapy for PDP. All of these agents have a black box warning from the US Food and Drug Administration (FDA) for elevated risk of mortality in elderly patients with dementia-related psychosis. Pimavanserin (Nuplazid®) received its novel drug approval by the FDA on April 29, 2016, to treat hallucinations and delusions associated with psychosis experienced by some people with PD. We review in this article the new research that led to this approval as well as its potential place in therapy.
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Affiliation(s)
- Brianna L Combs
- Department of Pharmaceutical Sciences, Sullivan University College of Pharmacy, Louisville, KY, USA
| | - Arthur G Cox
- Department of Pharmaceutical Sciences, Sullivan University College of Pharmacy, Louisville, KY, USA
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Abstract
Hearing voices that are not present is a prominent symptom of serious mental illness. However, these experiences may be common in the non-help-seeking population, leading some to propose the existence of a continuum of psychosis from health to disease. Thus far, research on this continuum has focused on what is impaired in help-seeking groups. Here we focus on protective factors in non-help-seeking voice-hearers. We introduce a new study population: clairaudient psychics who receive daily auditory messages. We conducted phenomenological interviews with these subjects, as well as with patients diagnosed with a psychotic disorder who hear voices, people with a diagnosis of a psychotic disorder who do not hear voices, and matched control subjects (without voices or a diagnosis). We found the hallucinatory experiences of psychic voice-hearers to be very similar to those of patients who were diagnosed. We employed techniques from forensic psychiatry to conclude that the psychics were not malingering. Critically, we found that this sample of non-help-seeking voice hearers were able to control the onset and offset of their voices, that they were less distressed by their voice-hearing experiences and that, the first time they admitted to voice-hearing, the reception by others was much more likely to be positive. Patients had much more negative voice-hearing experiences, were more likely to receive a negative reaction when sharing their voices with others for the first time, and this was subsequently more disruptive to their social relationships. We predict that this sub-population of healthy voice-hearers may have much to teach us about the neurobiology, cognitive psychology and ultimately the treatment of voices that are distressing.
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Affiliation(s)
| | - Megan S Kelley
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT
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