Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-24T10:50:11.326Z Has data issue: false hasContentIssue false
  • English
  • Français

On the Interconnectedness and Prognostic Value of Visual and Auditory Hallucinations in First-Episode Psychosis

Published online by Cambridge University Press:  28 January 2017

M.L. Clark ,
F. Waters ,
T.M. Vatskalis  and
A. Jablensky
M.L. Clark
Affiliation:
Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Rear 50 Murray Street, 6000Perth, Australia Cooperative Research Centre for Mental Health, Level 2/161 Barry Street, 3053Carlton South, Australia
F. Waters*
Affiliation:
Clinical Research Centre, North Metropolitan Health Service-Mental Health, John XXIII Avenue, 6010Mount Claremont, Australia
T.M. Vatskalis
Affiliation:
Clinical Research Centre, North Metropolitan Health Service-Mental Health, John XXIII Avenue, 6010Mount Claremont, Australia
A. Jablensky
Affiliation:
Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Rear 50 Murray Street, 6000Perth, Australia
*
⁎Corresponding author. Clinical Research Centre, North Metro Health Service, Graylands Hospital; Perth, Western Australia; and The School of Psychiatry and Clinical Neurosciences, The University of Western Australia (M708), 35, Stirling Highway, 6009 Crawley, WA, Australia. Tel.: +61 8 9347 6650. E-mail addresses:flavie.waters@uwa.edu.au, Flavie.Waters@health.wa.gov.au (F. Waters).
Get access

Abstract

Background

Visual 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.

Objective

This 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.

Method

The 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.

Results

VH 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.

Conclusions

The 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.

Keywords

Schizophrenia and psychosisEpidemiologyPsychotherapy
Type
Original article
Information
European Psychiatry , Volume 41 , Issue 1 , March 2017 , pp. 122 - 128
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Joint first authors: these authors contributed equally to this work.

References

Wing, J.K.C.J.Sartorius, N.Measurement and Classification of Psychiatric Symptoms. Cambridge, UK: Cambridge University Press; 1974.Google Scholar
Fenton, W.S.McGlashan, T.H.Natural history of schizophrenia subtypes: II. Positive and negative symptoms and long-term course. Arch Gen Psychiat 1991;48:978–986.CrossRefGoogle ScholarPubMed
Goodwin, D.W.Rosenthal, R.Clinical significance of hallucinations in psychiatric disorders: a study of 116 hallucinatory patients. Arch Gen Psychiat 1971;24:76–80.CrossRefGoogle ScholarPubMed
Waters, F.Collerton, D.Ffytche, D., et al.Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophr Bull 2014;40:S233–S245.CrossRefGoogle ScholarPubMed
Oorschot, M.Lataster, T.Thewissen, V.Wichers, M.Myin-Germeys, I.Mobile assessment in schizophrenia: a data-driven momentary approach. Schizophr Bull 2012;38:405–413.CrossRefGoogle ScholarPubMed
Ford, J.M.Palzes, V.A.Roach, B.J., et al.Visual hallucinations are associated with hyperconnectivity between the amygdala and visual cortex in people with a diagnosis of schizophrenia. Schizophr Bull 2014;41:223–232.CrossRefGoogle ScholarPubMed
Jardri, R.Thomas, P.Delmaire, C.Delion, P.Pins, D.The neurodynamic organization of modality-dependent hallucinations. Cereb Cortex 2013;23:1108–1117.CrossRefGoogle ScholarPubMed
Rolland, B.Amad, A.Poulet, E., et al.Resting-state functional connectivity in the neucleus accumbens in auditory and visual hallucinations in schizophrenia. Schizophr Bull 2015;42:318–326.Google Scholar
Frieske, D.A.Wilson, W.P. In: Formal qualities of hallucinations: a comparative study of the visual hallucinations in patients with schizophrenic, organic and affective psychoses; 1965.Google Scholar
Jablensky, A.Schwarz, R.Tomov, T.WHO collaborative study on impairments and disabilities associated with schizophrenic disorders. Acta Psychiat Scand 1980;62:152–163.CrossRefGoogle Scholar
Hallmayer, J.F.Kalaydjieva, L.Badcock, J., et al.Genetic evidence for a distinct subtype of schizophrenia characterized by pervasive cognitive deficit. Am J Hum Genet 2005;77:468–476.CrossRefGoogle ScholarPubMed
Hopper, K.Harrison, G.Janca, A.Sartorius, N., editors. Recovery from schizophrenia: an international perspective. A report from the WHO Collaborative Project, the International Study of Schizophrenia. Oxford, United Kingdom: Oxford University Press; 2007.Google Scholar
Jablensky, A.Sartorius, N.Ernberg, G., et al.Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 1992;20:1–97.CrossRefGoogle ScholarPubMed
Sartorius, N.Jablensky, A.Korten, A., et al.Early manifestations and first-contact incidence of schizophrenia in different cultures: a preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders. Psychol Med 1986;16:909–928.CrossRefGoogle Scholar
Wing, J.K.Cooper, J.E.Sartorius, N.Present state examination. Medical Research Council: Cambridge University Press; 1974.Google Scholar
Sartorius, N.Jablensky, A.Shapiro, R.Two-year follow-up of the patients included in the WHO International pilot study of schizophrenia. Psychol Med 1977;7:529–541.CrossRefGoogle ScholarPubMed
Hallmayer, J.Jablensky, A.Michie, P., et al.Linkage analysis of candidate regions using a composite neurocognitive phenotype correlated with schizophrenia. Mol Psychiat 2003;8:511–523.CrossRefGoogle ScholarPubMed
Jablensky, A.Researching psychiatry in Western Australia. Aust NZ J Psychiat 2004;38:306–315.CrossRefGoogle ScholarPubMed
Castle, D.Jablensky, A.McGrath, J., et al.The diagnostic interview for psychoses (DIP): development, reliability and applications. Psychol Med 2006;36:69–80.CrossRefGoogle ScholarPubMed
Jones, S.H.Thornicroft, G.Coffey, M.Dunn, G.A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Brit J Psychiat 1995;166:654–659.CrossRefGoogle Scholar
IBM Corp. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp; 2010.Google Scholar
IBM Corp. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp; 2013.Google Scholar
Bauer, S.M.Schanda, H.Karakula, H., et al.Culture and the prevalence of hallucinations in schizophrenia. Compr Psychiat 2011;52:319–325.CrossRefGoogle Scholar
Mueser, K.Bellack, A.Brady, E.Hallucinations in schizophrenia. Acta Psychiat Scand 1990;82:26–29.CrossRefGoogle Scholar
Baethge, C.Baldessarini, R.J.Freudenthal, K.Streeruwitz, A.Bauer, M.Bschor, T.Hallucinations in bipolar disorder: characteristics and comparison to unipolar depression and schizophrenia. Bipolar Disord 2005;7:136–145.CrossRefGoogle Scholar
Líndal, E.Stefánsson, J.G.Stefánsson, S.B.The qualitative difference of visions and visual hallucinations: a comparison of a general-population and clinical sample. Compr Psychiat 1994;35:405–408.CrossRefGoogle ScholarPubMed
Lowe, G.R.The phenomenology of hallucinations as an aid to differential diagnosis. Brit J Psychiat 1973;123:621–633.CrossRefGoogle ScholarPubMed
A1-IssA, I.Social and cultural aspects of hallucinations. Psychol Bull 1977;84:167–176.Google Scholar
Al-Issa, I.The illusion of reality or the reality of illusion: hallucinations and culture. Brit J Psychiat 1995;166:368–373.CrossRefGoogle ScholarPubMed
Stefan, H.Bracha, M.Wolkowitz, O.M.High prevalence of visual hallucinations in research subjects with chronic schizophrenia. Am J Psychiatry 1989;146(4):526–528.Google Scholar
Lim, A.Hoek, H.W.Deen, M., et al.Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders. Schizophr Res 2016;176:493–499.CrossRefGoogle ScholarPubMed
Amad, A.Cachia, A.Gorwood, P., et al.The multimodal connectivity of the hippocampal cortex in auditory and visual hallucinations. Mol Psychiat 2014;19:184–191.CrossRefGoogle ScholarPubMed
Aguayo, J.Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia. Am J Psychiatry 1990;147:1457–1462.Google Scholar
Suddath, R.L.Casanova, M.F.Goldberg, T.E.Daniel, D.G.Kelsoe, J.R.Weinberger, D.R.Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study. Am J Psychiat 1989;146:464–472.Google ScholarPubMed
Szeszko, P.R.Robinson, D.G.Ashtari, M., et al.Clinical and neuropsychological correlates of white matter abnormalities in recent onset schizophrenia. Neuropsychopharmacol 2008;33:976–984.CrossRefGoogle ScholarPubMed
Jardri, R.Bartels-Velthius, A.A.Debbane, M., et al.From phenomenology to neurophysiological understanding of hallucinations in children and adolescents. Schizophr Bull 2014;40:S221–S232.CrossRefGoogle ScholarPubMed
Hoffman, D.M.Girshick, A.R.Akeley, K.Banks, M.S.Vergence–accommodation conflicts hinder visual performance and cause visual fatigue. J Vision 2008;8:33.CrossRefGoogle ScholarPubMed
Ibarretxe-Bilbao, N.Ramirez-Ruiz, B.Tolosa, E., et al.Hippocampal head atrophy predominance in Parkinson's disease with hallucinations and with dementia. J Neurol 2008;255:1324–1331.CrossRefGoogle ScholarPubMed
Ballard, C.G.Jacoby, R.Del Ser, T., et al.Neuropathological substrates of psychiatric symptoms in prospectively studied patients with autopsy-confirmed dementia with Lewy bodies. Am J Psychiat 2004;161:843–849.CrossRefGoogle ScholarPubMed
Harding, A.Broe, G.Halliday, G.Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe. Brain 2002;125:391–403.CrossRefGoogle ScholarPubMed
Tsuang, D.Larson, E.B.Bolen, E., et al.Visual hallucinations in dementia: a prospective community-based study with autopsy. Am J Geriat Psychiat 2009;17:317–323.CrossRefGoogle ScholarPubMed
Williams, D.R.Lees, A.J.Visual hallucinations in the diagnosis of idiopathic Parkinson's disease: a retrospective autopsy study. Lancet Neurol 2005;4:605–610.CrossRefGoogle Scholar
Catani, M.Jones, D.K.Donato, R.Occipito-temporal connections in the human brain. Brain 2003;126:2093–2107.CrossRefGoogle ScholarPubMed
Cachia, A.Amad, A.Brunelin, J.Deviations in cortex sulcation associated with visual hallucinations in schizophrenia. Mol Psychiat 2015;20:1101–1107.CrossRefGoogle Scholar
David, C.N.Greenstein, D.Clasen, L.Childhood onset shcizophrenia: high rate of visual hallucinations. J Am Acad Child Psy 2011;50:681–686.CrossRefGoogle Scholar
Forsell, Y.Predictors for depression, anxiety and psychotic symptoms in a very elderly population: data from a 3-year follow-up study. Soc Psych Psych Epid 2000;35:259–263.CrossRefGoogle Scholar
Supplementary material: File

Clark et al. supplementary material

Supplementary material

Download Clark et al. supplementary material(File)
File 35.1 KB
Submit a response

Comments

No Comments have been published for this article.