Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease
Open accessAbstract
Much of the research on visual hallucinations (VHs) has been conducted in the context of eye disease and neurodegenerative conditions, but little is known about these phenomena in psychiatric and nonclinical populations. The purpose of this article is to bring together current knowledge regarding VHs in the psychosis phenotype and contrast this data with the literature drawn from neurodegenerative disorders and eye disease. The evidence challenges the traditional views that VHs are atypical or uncommon in psychosis. The weighted mean for VHs is 27% in schizophrenia, 15% in affective psychosis, and 7.3% in the general community. VHs are linked to a more severe psychopathological profile and less favorable outcome in psychosis and neurodegenerative conditions. VHs typically co-occur with auditory hallucinations, suggesting a common etiological cause. VHs in psychosis are also remarkably complex, negative in content, and are interpreted to have personal relevance. The cognitive mechanisms of VHs in psychosis have rarely been investigated, but existing studies point to source-monitoring deficits and distortions in top-down mechanisms, although evidence for visual processing deficits, which feature strongly in the organic literature, is lacking. Brain imaging studies point to the activation of visual cortex during hallucinations on a background of structural and connectivity changes within wider brain networks. The relationship between VHs in psychosis, eye disease, and neurodegeneration remains unclear, although the pattern of similarities and differences described in this review suggests that comparative studies may have potentially important clinical and theoretical implications.
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Hallucinations in the visual domain are very common in schizophrenia.
“Although the conventional view focuses preferentially on auditory hallucinations in psychosis, epidemiological evidence indicates that hallucinations in the visual domain are very common in, for example, schizophrenia (13).”
From Shift toward prior knowledge confers a perceptual advantage in early psychosis and psychosis-prone healthy individuals (2015) · cites this paper as [13]
Visual hallucinations in schizophrenia have a substantial point prevalence of 27%.
“The authors reported visual hallucinations with a substantial point prevalence of 27% (Waters et al., 2014).”
From What visual illusions teach us about schizophrenia (2014) · cites this paper as Waters et al., 2014
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Self-citationVisual hallucinations in psychiatric conditions: Appraisals and their relationship to distress
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Self-citationA cross‐cultural study of the frequencies of Schneider's first rank symptoms of schizophrenia
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Charles Bonnet syndrome improves when treatment is effective in age-related macular degeneration
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A Graded Exposure Intervention for Distressing Visual Hallucinations in Schizophrenia
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DO PATIENTS SEE VISIONS THAT TALK?
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Self-citationHallucinations in Parkinson's disease
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Visual hallucinations in Charles Bonnet syndrome
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Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes
Waters, F., & Fernyhough, C. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw132 · Cited by 315 · see citing works
Self-citationTeufel, C., Subramaniam, N., Dobler, V., Perez, J., Finnemann, J., Mehta, P. R., Goodyer, I. M., & Fletcher, P. C. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1503916112 · Cited by 308 · see citing works
The neural mechanisms of hallucinations: A quantitative meta-analysis of neuroimaging studies
Zmigrod, L., Garrison, J. R., Carr, J., & Simons, J. S. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.05.037 · Cited by 226 · see citing works
Brain mechanisms of reality monitoring
Simons, J. S., Garrison, J. R., & Johnson, M. K. (2017) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2017.03.012 · Cited by 202 · see citing works
What visual illusions teach us about schizophrenia
Notredame, C.-E., Pins, D., Deneve, S., & Jardri, R. (2014) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2014.00063 · Cited by 177 · see citing works
“The authors reported visual hallucinations with a substantial point prevalence of 27% (Waters et al., 2014).”
BackgroundSelf-citationStudying Hallucinations Within the NIMH RDoC Framework
Ford, J. M., Morris, S. E., Hoffman, R. E., Sommer, I. E., Waters, F., McCarthy‐Jones, S., Thoma, R. J., Turner, J. A., Keedy, S., Badcock, J. C., et al. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu011 · Cited by 170 · see citing works
Self-citationPredictions penetrate perception: Converging insights from brain, behaviour and disorder
O’Callaghan, C., Kveraga, K., Shine, J. M., Adams, R. B., & Bar, M. (2016) · Consciousness and Cognition · doi:10.1016/j.concog.2016.05.003 · Cited by 162 · see citing works
“…has been linked to mood and physiological states (e.g., stress, depression and fatigue), with mood also playing an important role in determining the content of hallucinations (e.g., when the image of a deceased spouse is perceived during a period of bereavement) (Waters et al., 2014).”
BackgroundLim, A. S. M., Hoek, H. W., Deen, M. L., Blom, J. D., Bruggeman, R., Cahn, W., de Haan, L., Kahn, R. S., Meijer, C. J., Myin‐Germeys, I., et al. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.06.010 · Cited by 155 · see citing works
“Although this situation is not unique for schizophrenia spectrum disorders (Waters et al., 2014), some studies indicatethat the prevalence ofmultimodalhallucinationsmaybese-verely underestimated inthis group(Goodwinet al.,1971) while others indicate that the presence of MMHs may be indicative of an…”
InfluentialSelf-citationOccurrence and co-occurrence of hallucinations by modality in schizophrenia-spectrum disorders
McCarthy‐Jones, S., Smailes, D., Corvin, A. P., Gill, M., Morris, D. W., Dinan, T. G., Murphy, K. C., O’Neill, F. A., Waddington, J. L., Donohoe, G. J., et al. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.01.102 · Cited by 155 · see citing works
“In terms of gender, women are more likely than men to experience hallucinations (Baethge et al., 2005), but it is not clear if this is true for visual hallucinations specifically (Waters et al., 2014).”
BackgroundSelf-citationWearne, T. A., & Cornish, J. L. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00491 · Cited by 144 · see citing works
“However, visual hallucinations are typically only reported in severe cases in schizophrenia (129), with the prevalence rate ranging from 16 to 27% (129, 130).”
BackgroundVisual Perception Disturbances in Schizophrenia: A Unified Model
Silverstein, S. M. (2016) · Nebraska Symposium on Motivation/The Nebraska symposium on motivation · doi:10.1007/978-3-319-30596-7_4 · Cited by 144 · see citing works
“For example, approximately 25–30 % of individuals with schizophrenia report visual hallucinations (Waters et al., 2014 ), and the rate of patients reporting visual distortions (in the domains of brightness, motion, form, and color) is at least double that (Cutting & Dunne, 1986 ; Phillipson &…”
BackgroundKremláček, J., Kreegipuu, K., Tales, A., Astikainen, P., Põldver, N., Näätänen, R., & Stefanics, G. (2016) · Cortex · doi:10.1016/j.cortex.2016.03.017 · Cited by 138 · see citing works
“Furthermore, visual hallucinations are present in about 27% of schizophrenia patients (Waters et al., 2014).”
BackgroundAlderson‐Day, B., Diederen, K. M. J., Fernyhough, C., Ford, J. M., Horga, G., Margulies, D. S., McCarthy‐Jones, S., Northoff, G., Shine, J. M., Turner, J. A., et al. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw078 · Cited by 129 · see citing works
Self-citationVarieties of Voice-Hearing: Psychics and the Psychosis Continuum
Powers, A. R., Kelley, M. S., & Corlett, P. R. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw133 · Cited by 124 · see citing works
Abraham, A. (2016) · Human Brain Mapping · doi:10.1002/hbm.23300 · Cited by 133 · see citing works
“The issues of personal relevance and social significance have also been highlighted in association with hallucinations in psychosis, especially given the contributions of DMN brain regions [Bell, 2013; Waters et al., 2014].”
BackgroundIncreased risk of psychosis in patients with hearing impairment: Review and meta-analyses.
Linszen, M., Brouwer, R., Heringa, S., & Sommer, I. (2016) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.12.012 · Cited by 122 · see citing works
Refining the psychiatric syndrome of anti‐N‐methyl‐ d ‐aspartate receptor encephalitis
Warren, N., Siskind, D. J., & O’Gorman, C. (2018) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12941 · Cited by 118 · see citing works
“There was a high proportion of cases with visual hallucinations, often in the absence of other psychotic phenomena (23, 24).”
BackgroundA review of abnormalities in the perception of visual illusions in schizophrenia
Griffiths-King, D. J., Hodgekins, J., Chouinard, P. A., Chouinard, V., & Sperandio, I. (2016) · Psychonomic Bulletin & Review · doi:10.3758/s13423-016-1168-5 · Cited by 112 · see citing works
A Deep-Dream Virtual Reality Platform for Studying Altered Perceptual Phenomenology
Suzuki, K., Roseboom, W., Schwartzman, D. J., & Seth, A. K. (2017) · Scientific Reports · doi:10.1038/s41598-017-16316-2 · Cited by 112 · see citing works
“Causes of ASC include psychedelic drugs (e.g., LSD, psilocybin) as well as pathological or psychiatric conditions such as epilepsy or psychosis 8–10 .”
BackgroundPerceptual reality monitoring: Neural mechanisms dissociating imagination from reality
Dijkstra, N., Kok, P., & Fleming, S. M. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104557 · Cited by 107 · see citing works
Hallucinations, loneliness, and social isolation in Alzheimer's disease
Haj, M. E., Jardri, R., Larøi, F., & Antoine, P. (2016) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2015.1121139 · Cited by 99 · see citing works
“…basis of hallucinations, visual hallucinations have been associated with functional and structural changes on several levels of the visual pathway (Waters et al., 2014), notably the visual associative cortices, as previously reported in Parkinson’s disease (Yao et al., 2015), Charles-Bonnet…”
ResultSelf-citationSchizophrenia and the retina: Towards a 2020 perspective
Silverstein, S. M., Fradkin, S. I., & Demmin, D. L. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.09.016 · Cited by 99 · see citing works
“, 2018; Phillipson and Harris, 1985); 2) visual hallucinations, which have been estimated to occur in approximately 1/3 of patients (Waters et al., 2014), with some studies reporting significantly higher rates [e.”
ResultRolland, B., Amad, A., Poulet, E., Bordet, R., Vignaud, A., Bation, R., Delmaire, C., Thomas, P., Cottencin, O., & Jardri, R. (2015) · Schizophrenia bulletin · doi:10.1093/schbul/sbu097 · Cited by 98 · see citing works
“VAH patients exhibited greater functional connectivity of the NAcc with the ventral tegmental area (1), the insulae (2), the superior temporal gyri (3), the parahippocampal gyri (4), and associative visual areas (5).”
BackgroundInfluentialSelf-citationPharmacology of Hallucinations: Several Mechanisms for One Single Symptom?
Rolland, B., Jardri, R., Amad, A., Thomas, P., Cottencin, O., & Bordet, R. (2014) · BioMed Research International · doi:10.1155/2014/307106 · Cited by 93 · see citing works
“However, psilocybin-induced visual hallucinations and synesthesia have been repeatedly associated with occipitoparietal cortex activity [49, 66, 70], which has not been the case either for VH induced either by NDMAR antagonists, or for VH of schizophrenia [71] or first psychosis episode [72].”
BackgroundSelf-citationLlorca, P., Pereira, B., Jardri, R., Chéreau, I., Brousse, G., Misdrahi, D., Fénelon, G., Tronche, A.-M., Schwan, R., Lançon, C., et al. (2016) · Scientific Reports · doi:10.1038/srep38152 · Cited by 88 · see citing works
Self-citationLeptourgos, P., Fortier, M., Carhart-Harris, R. L., Corlett, P. R., Dupuis, D., Halberstadt, A. L., Kometer, M., Kozáková, E., Larøi, F., Noorani, T. N., et al. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa117 · Cited by 87 · see citing works
Self-citationUnderstanding visual hallucinations: A new synthesis
Collerton, D., Barnes, J., Diederich, N. J., Dudley, R., ffytche, D., Friston, K., Goetz, C. G., Goldman, J. G., Jardri, R., Kulisevsky, J., et al. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105208 · Cited by 83 · see citing works
“…with a visual component are found in advanced Lewy body disorders (Goetz, Stebbins, and Ouyang, 2011; Montagnese et al., 2021), in delirium (Webster and Holroyd, 2000), and in psychotic disorders (Dudley et al., 2018; Waters et al., 2014) such as schizophrenia (Chouinard et al., 2019; Fig.”
BackgroundSelf-citationInterdisciplinary Approaches to the Phenomenology of Auditory Verbal Hallucinations
Woods, A., Jones, N., Bernini, M., Callard, F. J., Alderson‐Day, B., Badcock, J. C., Bell, V., Cook, C. C. H., Csordas, T., Humpston, C. S., et al. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu003 · Cited by 83 · see citing works
Self-citationSilverstein, S. M., & Lai, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.684720 · Cited by 85 · see citing works
“(4) include schizophrenia in this group, andwhile schizophrenia does not seem to be primarily a disorder of altered serotonergic transmission, findings from multiple lines of research implicate serotonergic dysfunction in this condition (105, 106).”
BackgroundResultInfluentialClinical and neurocognitive aspects of hallucinations in Alzheimer’s disease
el Haj, M., Roche, J., Jardri, R., Kapogiannis, D., Gallouj, K., & Antoine, P. (2017) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.02.021 · Cited by 70 · see citing works
“, 2012; Cho and Wu, 2013; Wilkinson, 014), or combinations of neurocognitive findings (Allen et al., 008; Laroi et al., 2012; Aleman et al., 2003; Fovet et al., 2016; aters et al., 2014; Allen et al., 2012).”
BackgroundSelf-citationMontagnese, M., Leptourgos, P., Fernyhough, C., Waters, F., Larøi, F., Jardri, R., McCarthy‐Jones, S., Thomas, N., Dudley, R. E. J., Taylor, J., et al. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa101 · Cited by 72 · see citing works
Self-citationOn visual hallucinations and cortical networks: a trans-diagnostic review
Carter, R., & Ffytche, D. H. (2015) · Journal of Neurology · doi:10.1007/s00415-015-7687-6 · Cited by 65 · see citing works
“visions of fires) and frightening [39].”
BackgroundInfluentialSelf-citationMoreau, C. A., Urchs, S. G. W., Kumar, K., Orban, P., Schramm, C., Dumas, G., Labbe, A., Huguet, G., Douard, E. A., Quirion, P.-O., et al. (2020) · Nature Communications · doi:10.1038/s41467-020-18997-2 · Cited by 60 · see citing works
Fischer, C. E., Ismail, Z., Youakim, J. M., Creese, B., Kumar, S., Núñez, N. A., Darby, R. R., Vita, A. D., D’Antonio, F., de Lena, C., et al. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190828 · Cited by 62 · see citing works
“The content, which is frightening, can consist of visions of angels, the devil, and saints [59].”
Disrupted local functional connectivity in schizophrenia: An updated and extended meta-analysis
Cai, M., Wang, R., Liu, M., Du, X., Xue, K., Ji, Y., Wang, Z., Zhang, Y., Guo, L., Qin, W., et al. (2022) · Schizophrenia · doi:10.1038/s41537-022-00311-2 · Cited by 61 · see citing works
Thalamocortical Anatomical Connectivity in Schizophrenia and Psychotic Bipolar Disorder
Sheffield, J. M., Huang, A., Rogers, B. P., Giraldo‐Chica, M., Landman, B. A., Blackford, J. U., Heckers, S., & Woodward, N. D. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa022 · Cited by 62 · see citing works
Stephan‐Otto, C., Siddi, S., Senior, C., Cuevas‐Esteban, J., Cambra-Martí, M. R., Ochoa, S., & Brébion, G. (2017) · Cortex · doi:10.1016/j.cortex.2017.06.009 · Cited by 57 · see citing works
“Introduction Visual hallucinations occur in schizophrenia with a lower prevalence than do auditory hallucinations, and hence they have been th object of much scanter investigation (van Ommen et al., 2016; Waters et al., 2014).”
BackgroundDeviations in cortex sulcation associated with visual hallucinations in schizophrenia
Cachia, A., Amad, A., Brunelin, J., Krebs, M., Plaze, M., Thomas, P., & Jardri, R. (2014) · Molecular Psychiatry · doi:10.1038/mp.2014.140 · Cited by 56 · see citing works
Self-citationMitchell, C. A. A., Maybery, M. T., Russell-Smith, S. N., Collerton, D., Gignac, G. E., & Waters, F. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01363 · Cited by 52 · see citing works
Self-citationDudley, R. E. J., Aynsworth, C., Cheetham, R., McCarthy‐Jones, S., & Collerton, D. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.032 · Cited by 54 · see citing works
Self-citationKeane, B. P., Cruz, L. N., Paterno, D., & Silverstein, S. M. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00069 · Cited by 53 · see citing works
Du, Y., Fu, Z., Xing, Y., Lin, D., Pearlson, G. D., Kochunov, P. V., Hong, L. E., Qi, S., Salman, M. S., Abrol, A., et al. (2021) · Communications Biology · doi:10.1038/s42003-021-02592-2 · Cited by 51 · see citing works
Is the perception of illusions abnormal in schizophrenia?
Grzeczkowski, L., Roinishvili, M., Chkonia, E. D., Brand, A., Mast, F. W., Herzog, M. H., & Shaqiri, A. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.10.063 · Cited by 51 · see citing works
Noort, A., Beekman, A. T. F., & Braam, A. W. (2020) · Religions · doi:10.3390/rel11100522 · Cited by 50 · see citing works
“In an overview study on schizophrenia inpatients and outpatients, Waters et al. (2014) observed a mean prevalence of auditory hallucinations of 59% (range 25–86”
BackgroundModality-Dependent Impact of Hallucinations on Low-Frequency Fluctuations in Schizophrenia
Hare, S., Ford, J. M., Ahmadi, A., Damaraju, E., Belger, A., Bustillo, J., Lee, H. J., Mathalon, D. H., Mueller, B. A., Preda, A., et al. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw093 · Cited by 48 · see citing works
“While approximately 59% of Sz patients report experiencing auditory hallucinations (AH), nearly half of those report visual hallucinations (VH).(1) Despite the prevalence of these symptoms, the underlying mechanisms remain elusive.”
BackgroundLarøi, F., Bless, J. J., Laloyaux, J., Kråkvik, B., Vedul‐Kjelsås, E., Kalhovde, A. M., Hirnstein, M., & Hugdahl, K. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.01.003 · Cited by 46 · see citing works
Self-citationRollins, C. P. E., Garrison, J., Simons, J., Rowe, J., O'Callaghan, C., Murray, G., & Suckling, J. (2018) · bioRxiv · doi:10.1016/j.eclinm.2019.01.012 · Cited by 39 · see citing works
“Abnormalities in the occipital cortex in neurodegenerative diseases suggest that deficits in sensory regions contribute to hallucinations of the associated sensory modality since VH are more common in PD than in schizophrenia [19].”
BackgroundAluh, D. O., Okonta, M. J., & Odili, V. U. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-028913 · Cited by 44 · see citing works
“More than half of the hallucination cases are auditory, and in 27% of those cases, they are accompanied by visual hallucinations.(46) About one-third of the respondents recommended the help of a psychiatrist, while one-fifth of them recommended the help of a psychologist.”
BackgroundClark, M. L., Waters, F., Vatskalis, T., & Jablensky, A. V. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2016.10.011 · Cited by 43 · see citing works
Self-citationChouinard, V., Shinn, A. K., Valeri, L., Chouinard, P. A., Gardner, M. E., Asan, A. E., Cohen, B. M., & Öngür, D. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.02.022 · Cited by 42 · see citing works
“5%, with the presence of VH early in psychotic illness (Clark et al., 2017; McCarthy-Jones et al., 2017; Waters et al., 2014).”
BackgroundPezzoli, S., Sánchez‐Valle, R., Solanes, A., Kempton, M. J., Bandmann, O., Shin, J. I., Cagnin, A., Goldman, J. G., Merkitch, D., Firbank, M., et al. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.06.030 · Cited by 42 · see citing works
“Recurrent and complex visual hallucinations (VH) are involuntary and repetitive visual perceptions experienced in the absence of external sensory inputs (Collerton et al., 2005; Ffytche, 2007; Waters et al., 2014).”
BackgroundVisual-Tactile Spatial Multisensory Interaction in Adults With Autism and Schizophrenia
Noel, J.-P., Failla, M. D., Quinde-Zlibut, J. M., Williams, Z. J., Gerdes, M., Tracy, J. M., Zoltowski, A. R., Foss-Feig, J. H., Nichols, H., Armstrong, K., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.578401 · Cited by 39 · see citing works
“(70)— may explain the contradiction between the two studies, particularly given the much higher prevalence of auditory than visual hallucinations in SZ (71).”
ResultDisrupted network cross talk, hippocampal dysfunction and hallucinations in schizophrenia
Hare, S., Law, A., Ford, J. M., Mathalon, D. H., Ahmadi, A., Damaraju, E., Bustillo, J., Belger, A., Lee, H. J., Mueller, B. A., et al. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.03.004 · Cited by 41 · see citing works
“Introduction An estimated 59% of patients with schizophrenia (Sz) report auditory hallucinations (AH); nearly half of those reporting AHs also report visual hallucinations (VHs) (Waters et al., 2014).”
Visual Hallucinations in First-Episode Psychosis: Association with Childhood Trauma
Solesvik, M., Joa, I., Larsen, T., Langeveld, J., Johannessen, J., Bjørnestad, J., Anda, L., Gisselgård, J., Hegelstad, W. T. V., & Brønnick, K. (2016) · PLoS ONE · doi:10.1371/journal.pone.0153458 · Cited by 31 · see citing works
“Visual hallucinations have often been linked to biological causes, such as organic disease and drug-induced psychosis, and have been considered uncommon in psychiatric samples [6].”
BackgroundResultInfluentialSilverstein, S. M., Demmin, D. L., & Škodlar, B. (2017) · Psychopathology · doi:10.1159/000452493 · Cited by 36 · see citing works
Bernardin, F., Schwan, R., Lalanne, L., Ligier, F., Angioï-Duprez, K., Schwitzer, T., & Laprévote, V. (2017) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2017.03.002 · Cited by 36 · see citing works
“For example, current OCT machines have different measuring protocols for specific ophthalmologic diseases, and so good reproducibility is possible only if the same equipment is used, which makes difficult the comparison of results across studies with different manufacturers (Watson et al., 2011).”
Gender differences in language are small but matter for disorders
Wallentin, M. (2020) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64123-6.00007-2 · Cited by 35 · see citing works
“Auditory hallucinations are experienced by around 60% of all patients diagnosed with a schizophrenia spectrum disorder (Waters et al., 2014).”
BackgroundDellazizzo, L., Giguère, S., Léveillé, N., Potvin, S., & Dumais, A. (2022) · Psychological Medicine · doi:10.1017/s003329172200143x · Cited by 35 · see citing works
Contrast sensitivity deficits in schizophrenia: A psychophysical investigation
Zemon, V. M., Herrera, S. N., Gordon, J., Revheim, N., Silipo, G. S., & Butler, P. D. (2020) · European Journal of Neuroscience · doi:10.1111/ejn.15026 · Cited by 33 · see citing works
“People with schizophrenia self-report visual distortions and anomalies (McGhie & Chapman, 1961; Phillipson & Harris, 1985; Waters et al., 2014) and are well-known to exhibit deficits in visual tasks (Butler & Javitt, 2005; Chen, 2011; Doniger et al., 2002; Feigenson et al., 2014; Green et …”
BackgroundHallucinations on demand: the utility of experimentally induced phenomena in hallucination research
Rogers, S., Keogh, R., & Pearson, J. (2020) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2020.0233 · Cited by 33 · see citing works
“First, current definitions do not establish sharp boundaries between hallucinations and illusions [1,12,17,59].”
BackgroundValidation of a Psycho-Sensory hAllucinations Scale (PSAS) in schizophrenia and Parkinson's disease
de Chazeron, I., Pereira, B., Chéreau, I., Brousse, G., Misdrahi, D., Fénelon, G., Tronche, A.-M., Schwan, R., Lançon, C., Marquès, A., et al. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.11.010 · Cited by 32 · see citing works
“A recent review (Waters et al., 2014) on VH in psychosis emphasizes particularly on key future directions including what is its relationship with hallucinations in other modalities; what are the similarities and differences in the VH profile of individuals with psychosis compared with other psychiatric/neurological co…”
BackgroundDamiani, S., Donadeo, A., Bassetti, N., Salazar‐de‐Pablo, G., Guiot, C., Politi, P., & Fusar‐Poli, P. (2022) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13338 · Cited by 31 · see citing works
Hjelmervik, H., Craven, A., Sinceviciute, I., Johnsen, E., Kompus, K., Bless, J., Kroken, R., Løberg, E., Ersland, L., Grüner, R., et al. (2019) · Schizophrenia bulletin · doi:10.1093/schbul/sbz099 · Cited by 33 · see citing works
Measures of visual hallucinations: Review and recommendations
Aynsworth, C., Collerton, D., & Dudley, R. E. J. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.05.001 · Cited by 30 · see citing works
Self-citationNeuroretinal Alterations in Schizophrenia and Bipolar Disorder: An Updated Meta-analysis
Sheehan, N., Bannai, D., Silverstein, S. M., & Lizano, P. L. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae102 · Cited by 28 · see citing works
Lehembre-Shiah, E., Leong, W., Brucato, G., Abi‐Dargham, A., Lieberman, J. A., Horga, G., & Girgis, R. R. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.3055 · Cited by 29 · see citing works
Modality-general and modality-specific processes in hallucinations
Fernyhough, C. (2019) · Psychological Medicine · doi:10.1017/s0033291719002496 · Cited by 27 · see citing works
“While this is likely due to their lower frequency, it is known that visual hallucinations (VHs) are reasonably common in psychotic disorders, with one recent review putting their incidence at 27% (weighted mean prevalence; Waters et al., 2014).”
InfluentialBlindness, Psychosis, and the Visual Construction of the World
Pollak, T. A., & Corlett, P. R. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sbz098 · Cited by 28 · see citing works
“16 applyparastyle "fig//caption/p[1]" parastyle "FigCapt" applyparastyle "fig" parastyle "Figure"”
BackgroundBrain‐based ranking of cognitive domains to predict schizophrenia
Karrer, T. M., Bassett, D. S., Derntl, B., Gruber, O., Aleman, A., Jardri, R., Laird, A. R., Fox, P. T., Eickhoff, S. B., Grisel, O., et al. (2019) · Human Brain Mapping · doi:10.1002/hbm.24716 · Cited by 25 · see citing works
“The maintenance of controlled cognitive sets has sometimes been challenging to ascertain in psychiatric patients (Eickhoff and Etkin, 2016; Weinberger and Radulescu, 2016).”
BackgroundSelf-citationPsychiatric manifestations of inborn errors of metabolism: A systematic review
van de Burgt, N., van Doesum, W. B., Grevink, M., van Niele, S., de Koning, T. J., Leibold, N. K., Martínez‐Martínez, P., van Amelsvoort, T., & Cath, D. C. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104970 · Cited by 27 · see citing works
“Generally, it is assumed that visual hallucinations, olfactory, gustatory and somatosensory hallucinations, more than auditory hallucinations, are prominent in organic disease (Lautenschlager and Forstl, 2001; Waters et al., 2014; Lewandowski et al., 2009).”
BackgroundSilverstein, S. M., Demmin, D. L., & Bednar, J. A. (2017) · Computational Psychiatry · doi:10.1162/cpsy_a_00005 · Cited by 26 · see citing works
“In addition, 25%–30% of individuals with schizophrenia report visual hallucinations (Waters et al., 2014), and the rate of patients reporting visual distortions (in the domains of brightness, motion, form, and color) has been estimated to be from 30% to over 60% (Bunney et al., 1999; Cutting &…”
BackgroundDeviations in early hippocampus development contribute to visual hallucinations in schizophrenia
Cachia, A., Cury, C., Brunelin, J., Plaze, M., Delmaire, C., Oppenheim, C., Medjkane, F., Thomas, P., & Jardri, R. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-0779-9 · Cited by 26 · see citing works
“Although visual hallucinations (VHs) have been largely neglected in psychiatric disorders, a systematic review showed evidence of a weighted mean of 27% of VHs in schizophrenia 3 .”
BackgroundSelf-citationSchizophrenia in Translation: Why the Eye?
Silverstein, S. M., Choi, J. J., Green, K. M., Bowles-Johnson, K., & Ramchandran, R. S. (2022) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac050 · Cited by 28 · see citing works
Wilson, R., Collerton, D., Freeston, M. H., Christodoulides, T., & Dudley, R. E. J. (2015) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1962 · Cited by 26 · see citing works
Self-citationEmberson, L. L. (2016) · Behavioral and Brain Sciences · doi:10.1017/s0140525x15002496 · Cited by 25 · see citing works
Waters, F., Barnby, J. M., & Blom, J. D. (2020) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2019.0701 · Cited by 24 · see citing works
“Visual hallucinations (common in older adults and in some psychiatric conditions) [24,25] may range from simple flashes or geometric shapes to static percepts involving people, faces, animals or objects, as well as dynamic scenes unfolding before the eyes [26].”
BackgroundSelf-citationVisual system assessment for predicting a transition to psychosis
Diamond, A., Silverstein, S. M., & Keane, B. P. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02111-9 · Cited by 25 · see citing works
“Visual disturbances—which often do not qualify as hallucinatory because they occur too infrequently or because they merely alter stimulus appearance—are reported by almost two-thirds of people with non-affective psychosis [13–15], which rivals the prevalence of more standard illness features such as auditory hallucina…”
BackgroundChang, X., Zhao, W. D., Kang, J., Xiang, S., Xie, C., Hernández, H. C., Palaniyappan, L. K., & Feng, J. (2022) · Schizophrenia · doi:10.1038/s41537-022-00308-x · Cited by 29 · see citing works
Castiajo, P., & Pinheiro, A. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01138 · Cited by 28 · see citing works
“VHs may also occur in a wide range of clinical conditions, such as ophthalmologic diseases, neurologic disorders, toxic and metabolic disorders, and psychiatric disorders (e.g., schizophrenia, affective psychosis and bipolar disorder; Cummings and Miller, 1987; Waters et al., 2014), as well as in nonclinical individua…”
Backgroundvan Ommen, M. M., van Beilen, M., Cornelissen, F. W., Smid, H. G. O. M., Knegtering, H., Aleman, A., van Laar, T., & GROUP Investigators (2016) · Psychological Medicine · doi:10.1017/s0033291716000246 · Cited by 25 · see citing works
“VH are visual percepts occurring in the absence of external stimuli, experienced while awake (Waters et al. 2014).”
InfluentialAuditory Steady-State Responses in Schizophrenia: An Updated Meta-Analysis
Zouaoui, I., Dumais, A., Lavoie, M. E., & Potvin, S. (2023) · Brain Sciences · doi:10.3390/brainsci13121722 · Cited by 24 · see citing works
“Auditory hallucinations are prevalent symptoms of schizophrenia, reported in 60 to 80% of patients [1].”
BackgroundSuzuki, K., Seth, A. K., & Schwartzman, D. J. (2024) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2023.1159821 · Cited by 25 · see citing works
Schwarzer, J., Meyhöfer, I., Antonucci, L. A., Kambeitz‐Ilankovic, L., Surmann, M., Bienek, O., Romer, G., Dannlowski, U., Hahn, T., Korda, A. I., et al. (2022) · Neuropsychopharmacology · doi:10.1038/s41386-022-01385-3 · Cited by 22 · see citing works
Psychotic experiences and future school performance in childhood: a population‐based cohort study
Steenkamp, L. R., Bolhuis, K., Blanken, L. M. E., Luijk, M. P. C. M., Hillegers, M. H. J., Kushner, S. A., & Tiemeier, H. W. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13281 · Cited by 23 · see citing works
“This is in line with studies in psychosis demonstrating that visual hallucinations are associated with greater clinical impairments and a poorer prognosis (Waters et al., 2014).”
ResultIdentification of Psychosis Risk and Diagnosis of First-Episode Psychosis: Advice for Clinicians
Lundin, N. B., Blouin, A., Cowan, H. R., Moe, A. M., Wastler, H. M., & Breitborde, N. J. K. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s423865 · Cited by 22 · see citing works
“38 Delusions are tenaciously held, false beliefs that are not responsive to contrary information 5 and are inconsistent with the individual’s cultural norms.”
Thomson, C., Wilson, R., Collerton, D., Freeston, M. H., & Dudley, R. E. J. (2017) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x17000174 · Cited by 22 · see citing works
“Visual hallucinations (VH) are relatively common, with around 27% of individuals with a diagnosis of schizophrenia (Waters et al., 2014) reporting VH.”
Self-citationToh, W. L., Thomas, N., Robertson, M., & Rossell, S. L. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112987 · Cited by 22 · see citing works
The Etiology of Auditory Hallucinations in Schizophrenia: From Multidimensional Levels
Shao, X., Liao, Y., Gu, L., Chen, W., & Tang, J. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.755870 · Cited by 21 · see citing works
Using Extended Reality to Study the Experience of Presence
Suzuki, K., Mariola, A., Schwartzman, D. J., & Seth, A. K. (2023) · Current topics in behavioral neurosciences · doi:10.1007/7854_2022_401 · Cited by 22 · see citing works
Mapping psychotic‐like experiences: Results from an online survey
Kusztrits, I., Larøi, F., Laloyaux, J., Marquardt, L., Sinkeviciute, I., Kjelby, E., Johnsen, E., Sommer, I. E., Hugdahl, K., & Hirnstein, M. (2020) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12683 · Cited by 20 · see citing works
Self-citationStein, F., & Kircher, T. T. J. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119464 · Cited by 21 · see citing works
Pareidolia in Schizophrenia and Bipolar Disorder
Hamza, E. A., Kéri, S., Csigó, K., Bedewy, D. A., & Moustafa, A. A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.746734 · Cited by 19 · see citing works
Funayama, M., Koreki, A., Takata, T., Kurose, S., Hisamatsu, T., Ono, A., Yagihashi, T., Mizushima, J., Yagi, Y., Ogino, S., et al. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.05.008 · Cited by 19 · see citing works
Reality-monitoring deficits and visual hallucinations in schizophrenia
Mondino, M., Dondé, C., Lavallé, L., Haesebaert, F., & Brunelin, J. (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2019.08.010 · Cited by 19 · see citing works
“This co-occurrence suggests common hallucinatory mechanisms in addition to specific modality-dependent dysfunctions [4].”
BackgroundZhuo, C., Ji, F., Xiao, B., Lin, X., Chen, C., Jiang, D., Ma, X., Li, R., Liu, S., Xu, Y. J., et al. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112906 · Cited by 19 · see citing works
“Such disturbances in patients with schizophrenia generally include both visual distortions and hallucinations (Cutting and Dunne, 1986; Silverstein, 2016; Waters et al., 2014).”
Increased Entropic Brain Dynamics during DeepDream-Induced Altered Perceptual Phenomenology
Greco, A., Gallitto, G., D’Alessandro, M., & Rastelli, C. (2021) · Entropy · doi:10.3390/e23070839 · Cited by 19 · see citing works
Visual Hallucinations in Psychosis: The Curious Absence of the Primary Visual Cortex
van Ommen, M. M., van Laar, T., Renken, R. J., Cornelissen, F. W., & Bruggeman, R. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac140 · Cited by 18 · see citing works
Zhuo, C., Xiao, B., Chen, C., Jiang, D., Li, G., Ma, X., Li, R., Wang, L., Xu, Y. J., Zhou, C., et al. (2020) · Brain and Behavior · doi:10.1002/brb3.1611 · Cited by 18 · see citing works
“The prevalence of VHs in schizophrenia patients is 25%–30% (Waters et al., 2014).”
BackgroundPsychiatrie en milieu pénitentiaire : une sémiologie à part ?
Fovet, T., Thomas, P., & Amad, A. (2015) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2015.07.033 · Cited by 18 · see citing works
“[28] Waters F, Collerton D, Ffytche DH, Jardri R, Pins D, Dudley R, et al.”
Visual hallucinations in psychosis
van Ommen, M. M., van Laar, T., Cornelissen, F. W., & Bruggeman, R. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112517 · Cited by 17 · see citing works
- Authors
- Waters, F., Collerton, D., ffytche, D. H., Jardri, R., Pins, D., Dudley, R., Blom, J. D., Mosimann, U. P., Eperjesi, F., Ford, S., & Larøi, F.
- Affiliations
- The University of Western Australia (AU)
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust (GB)
- King's College London (GB)
- Centre Hospitalier Universitaire de Lille (FR)
- University of Groningen (NL)
- University of Bern (CH)
- Aston University (GB)
- Sir Charles Gairdner Hospital (AU)
- University of Liège (BE)
- Corresponding author
- Waters, Flavie
- ORCID
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-06-13
- Volume
- 40
- Issue
- Suppl_4
- Pages
- S233-S245
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC4141306
- OpenAlex
- W2146834289
- Cited by
- 325
- References
- 123
- Citations by year
- 2026: 21 · 2025: 33 · 2024: 23 · 2023: 33 · 2022: 33 · 2021: 31 · 2020: 37 · 2019: 29 · 2018: 19 · 2017: 20 · 2016: 26 · 2015: 12 · 2014: 8
- FWCI
- 12.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Schizophrenia Bulletin (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- UWA Profiles and Research Repository (UWA) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- HAL (submittedVersion, other-oa)
- Aston Publications Explorer (Aston University) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- ORBi (University of Liège) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Open Access CRIS of the University of Bern
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Visual perception and processing mechanisms
- Keywords
- visual hallucinations, psychosis spectrum
- MeSH terms
- Affective Disorders, Psychotic, Brain, Eye Diseases, Hallucinations, Humans, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Visual Cortex, Neurodegenerative Diseases
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