Journal reading

October 3, 2019

A comparison of visual hallucinations across disorders

Rika Anggraini

Consultant:
Dr. Devi Azri Wahyuni, SpM(K), MARS
Source: R.Dudley, et al. J.psychres.2018.

OPHTHALMOLOGY DEPARTMENT SRIWIJAYA UNIVERSITY

MOHAMMAD HOESIN GENERAL HOSPITAL PALEMBANG
2019
 INTRODUCTION
• Visual hallucinations (VH) are defined as visual percepts that are
experienced when fully conscious but in the absence of the
corresponding external stimulus
• Etiology:
 Lewy body dementia (93%)
 Parkinson’s disease (75%)
 Eye disease (60%)
 Psychosis (27%)
 Lim, et al. (2016)
• MMHs are a Mueser et al. (1990)
characteristic
feature of Llorca, et al. (2016) • People with psychosis
schizophrenia the presence of visual
spectrum disorders • MMH with people with hallucinations is
Parkinson’s disease associated with greater
(n=100) and people with distress and disability
schizophrenia (n=100)
 AIM

To determine the prevalence and impact of related multimodal

hallucinations in the context of eye disease, Parkinson’s
disease, Lewy body dementia or psychosis.
 METHOD
PARTICIPANTS MEASURES
• 4 groups with VH: 82 • The North East Visual Hallucination Interview
eye disease, 41 (Emotional impact and people’s appraisal)
Parkinson’s disease, 31 • BCVA in decimals
Lewy body dementia, • MMSE to assess cognition
22 psychosis • Category fluency test (executive and
• Total 176 language skills)
• UPDRS part II & III (severity of motor
features and the impairment in functional
activity)
• ESS (day-time sleepiness)
• Mayo sleepquistionnaire (presence of REM)
 METHOD
DATA ANALYSIS
• Prevalence, emotional
response and the
conviction to VH (Chi ETHICAL CONSIDERATION
square, Fisher exact
test) • All datas approved by NHS Ethics
committees
• Helsinki Declaration
RESULT
RESULT
RESULT
 DISCUSSION

• Related MMH were much more common in psychosis than in

Parkinson’s disease, eye disease with Dementia Lewy Body rates
being intermediate

• Older people with visual perceptual impairments (ED) or those

with intact cognitive processes (PD) were low rates of related
hallucinations

• There were higher level of distress and conviction in those people

with MMH
 Conclusion

• It is possible that people reported unrelated hallucinations

experienced other hallucination that is not related to the
vision
• Previous studies of people with visual hallucinations in the
context of eye disease, Parkinson’s disease and Lewy body
dementia reported that other hallucinations were much less
that visual hallucinations
• Understanding the nature of multisensory experiences
could have important theoretical implication
 CRITICAL
APPRAISAL
 Is the background clearly stated?

Yes, it is. There has no previous study that explored the

prevalences of people with visual hallucinations that
experienced the related hallucination across the diseases of
eye disease, Lewy bodies dementia, Parkinson’s disease and
psychosis
 What is the type of the study?

Semi-structured interview, qualitative study

 What is the main problem of the study?

Hallucinations can occur in more than 1 sensory

domain (MMH). It is important to understand the
origin of the hallucinations and whether the
conditions are related
 What is the objective of the study?

To determine the prevalence and impact of related

multimodal hallucinations in conditions of Eye Disease,
Lewy body dementia, Parkinson’s disease and
psychosis
 What is the conclusion of the study?

Related multimodal hallucinations were much

common in psychosis than in Parkinson’s
disease, eye disease, and Lewy body dementia.
Visual hallucinations
MMSE
UPDRS
ESS Score