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Cited by 326Hallucinations in medical conditionsSchizophrenia research and treatmentVisual perception and processing mechanisms

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Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease

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Waters, Flavie, Collerton, Daniel, ffytche, Dominic H., Jardri, Renaud, Pins, Delphine, Dudley, Robert, Blom, Jan Dirk, Mosimann, Urs Peter, Eperjesi, Frank, Ford, Stephen, Larøi, Frank·2014·Schizophrenia Bulletin
DOI 10.1093/schbul/sbu036PMC PMC4141306
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Abstract

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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Crossref · 10.1093/schbul/sbu036

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Figures

Fig. 1. Visual perceptual symptoms and their clinical contexts.77 A range of clinical conditions (columns) are cross-tabulated with visual hallucination (VH) content and related phenomena (rows). For each condition, the percentage of individuals with VHs reporting a given content is coded red (>20%), pink (10%–20%), or white (not reported or < 10%). The prevalence of each symptom in psychosis is taken from.64 For auditory hallucinations, (+) indicates higher prevalence than VH and (−) indicates lower prevalence than VH (figure adapted from ffytche77). Visual experiences in schizophrenia best match the phenomena reported in the red box derived from PD, AD, DLB, and peduncular lesions—but not the green (eye and visual pathway pathology) and blue (serotonergic syndrome) boxes.
Fig. 1. Visual perceptual symptoms and their clinical contexts.77 A range of clinical conditions (columns) are cross-tabulated with visual hallucination (VH) content and related phenomena (rows). For each condition, the percentage of individuals with VHs reporting a given content is coded red (>20%), pink (10%–20%), or white (not reported or < 10%). The prevalence of each symptom in psychosis is taken from.64 For auditory hallucinations, (+) indicates higher prevalence than VH and (−) indicates lower prevalence than VH (figure adapted from ffytche77). Visual experiences in schizophrenia best match the phenomena reported in the red box derived from PD, AD, DLB, and peduncular lesions—but not the green (eye and visual pathway pathology) and blue (serotonergic syndrome) boxes.CC BY · PubMed Central

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Cites

Research works printed but not linked: 6

  1. Feinberg, 1962, A comparison of the visual hallucinations in schizophrenia with those induced by mescaline and LSD-25, Hallucinations, 64
  2. Malitz, 1962, A comparison of drug-induced hallucinations with those seen in spontaneously occurring psychosis
  3. Eggers, Verlaufsweisen Kindlicher and Praepuberaler Schizophrenien. Monographie aus dem Gesamtgebiet der Psychiatrye V
  4. Huber, 1979, Schizophrenie. Eine verlaufs- und sozialpsychiatrische Langzeitstudie
  5. Owens, 1989, Methods: patient series and quasi-experimental designs, 189
  6. Osis, 1977, At the Hour of Death

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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
DOI
10.1093/schbul/sbu036
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
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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