Psychopathology, mental Health, Hallucination

2.  The word 'Hallucination' was introduced into
the English language in the seventeenth
century by the physician Sir Thomas
Browne from the derivation of the Latin word
alucinari meaning to wander in the mind.

3.  A perception without an object- Esquirol,1817
 Hallucinations proper are false perceptions which
are not in any way distortions of real perceptions
but spring up on their own as something quite
new and occur simultaneously with and alongside
real perception-Jaspers,1962
 An hallucination is an exteroceptive or
interoceptive percept which does not correspond
to an actual object- Smythies,1956

4.  According to Slade three criteria are essential
for the operational definition :a)percept like
experience in the absence of an external
stimulus; b)percept like experience which has
the full force and impact of a real perception;
c)percept like experience which is unwilled,
occur spontaneously and cannot be readily
controlled by the percipient.
 A hallucination is a perception without an
object or the appearance of an individual
thing- Cutting 1997

5. Auditory Hallucinations
Visual Hallucinations
Olfactory Hallucinations
Gustatory Hallucinations
Hallucinations of Bodily sensation

6.  Hallucinatory voices were called as phonemes –
Wernicke ,1900
 Hallucinatory voices vary in quality , from clear to
vague
 Auditory hallucinations in the form of
unstructured sounds – elementary hallucinations.
It is seen in organic state and in schizophrenia.
 Auditory hallucinations are characteristic of
schizopheria.
 Auditory hallucinations occur when there is a
combination of vivid mental imagery and poor
reality testing in the auditory modality(Slade).

7.  The voices give instructions to some patients, who
may or may not feel obliged to carry them out-
imperative hallucination
 In some cases the voices talk about the person in the
third person and may give running commentary.
 Hearing one’s own thought being spoken aloud-
thought echo.
 Hearing their thoughts being spoken as they think
and the voices which speaks their thoughts may come
from inside or outside the head- thought
sonorization.
 Normal people occasionally vocalize their thoughts –
sotto voce.

8.  May be elementary in the form of flashes of
light, partly organized as patterns or
completely organized as visions of people,
animals or objects.
 All varieties of visual hallucinations are found
in acute organic states, but small animals are
most often hallucinated in delirium.
 Usually these hallucinations are associated
with fear or even terror.

9.  Scenic hallucinations are more common in
psychiatric disorders associated with
epilepsy, eg: visions of fire crucifixation
 Often visual hallucinations are isolated and
do not have any accompanying noises or
voices. But patients with temporal lobe
epilepsy can have both.
 Micropsia affects visual hallucinations, patient
sees tiny people accompanied by pleasure-
Lilliputian hallucinations

10.  Visual hallucinations are more common in acute
organic state than in the functional psychoses.
 Disturbance of consciousness makes it difficult
for the patient to distinguish between mental
images and perceptions
 Visual hallucinations are extremely rare in
schizophrenia.
 Some schizophrenics describe visions but they
are pseudo hallucinations
 Visual hallucinations are produced by drugs of
abuse- LSD, mescaline etc..

11.  In this patient has hallucination of smell
 Can occur in schizophrenics, organic states,
epilepsy and uncommonly in depression.
 The smell may be pleasant or unpleasant ,
but it usually has a special and personal
significance.
 Eg: ‘people are pumping poisonous gas into
the room, which only the patient can smell’

12.  Can be seen in schizophrenia and acute
organic states
 There may be a persistent taste or some
bizarre type of taste, ‘metallic taste’
 Changes in gustatory perception may occur
with temporal lobe epilepsy and also with
some psychotropic drugs- lithium carbonate,
disulfiram.

13.  It may be Superficial, Kinaesthetic or Visceral.
 Superficial hallucinations-
1) Thermic – an abnormal perception of heat or
cold; ‘my feet on fire’
2) Haptic –of touch: ‘a dead hand touched me’;
or pain : ‘knives stabbing my neck’
3) Hygric ,Perception of fluid- ‘all my blood has
dropped into my legs’
4) Paraesthesiae- sensation of tingling or ‘pins
and needles’

14.  Kinasthetic- muscle and joint sense, feeling
of his limb are being bent or twisted,or his
muscle squeezed.eg: ‘a feeling of being
rocked about’
 It can be seen in people with schizopheria,
organic pathology, withdrawal state from
benzodiazepine or alcohol intoxication.
 Visceral hallucinations:false perception of the
inner organs eg: pain, heaviness, distension

15.  A form of haptic hallucination is formication
 Usually takes the form of a feeling that
animals crawling over the body
 In cocaine psychosis- cocaine bug
 Sexual hallucination is also a form of haptic
hallucination. Male patients c/o erections
and orgasms are forced on them. Female
patients say that they are being raped or
sexually abused.

16.  Patient complains that his organs are torn
out, the flesh ripped away from his body
 An interesting unusual variety of somatic
hallucinosis is delusional zoopathy.
 Patient is convinced that there is an animal
crawling about his body,but he does not see
this animal- external delusional zoopathy.
 Patient believes that there is an animal inside
the body. Eg wasp wandering inside body-
internal delusional zoopathy

17.  A ) FUNCTIONAL HALLUCINATIONS- an
external stimuli is necessary to provoke
hallucinations. The normal perception of the
stimulus and hallucination are experienced
simultaneously.
 ‘Clock ticking and the voice of god’.
 Mistaken for illusion but both the provoking
noise and the voices are heard.

18.  B )REFLUX HALLUCINATION- A stimulus in
one sensory field produces a hallucination in
another.
 ‘Pain in head when others sneeze and
convinced that the pain is caused by
sneezing’.

19.  C )EXTRACAMPINE
HALLUCINATION(CONCRETE AWARENESS)
 Hallucinations which are outside the limits of
the sensory field.
 “I know that there is someone behind me on
the right all the time; he moves when I move”.

20.  D )AUTOSCOPY OR THE PHANTOM MIRROR
IMAGE- Seeing oneself and knowing that it is
onself.
 Can be seen in normal subject who are
emotionally disturbed, schizopherics,organic
states like epilepsy, focal lesions, toxic
infective state,drug addictions etc.
 Negative autoscopy- patient looks in the
mirror and sees no image at all.
 Internal autoscopy- subject sees their own
internal organ.

21.  Confusional hallucinosis- consciousness is
clouded and visual hallucinations are
prominent.
 Self-Reference hallucinosis-patient hears
voices talking about him.but unable to
reproduce them word by word. It is difficult
to decide if the patient is really experiencing
hallucinations or is mishearing real
conversations

22.  Verbal hallucinosis- hears clear voices, which
talk about him and he can reproduce their
content. Voices may be real/imaginery.
 Fantastic hallucinosis- hallucinations of all
kinds seem to occur. Sometimes it appears
that the patient is describing dream
experiences as if real. In this they have mass
hallucinations in which they see and hear
large number of people being murdered or
tortured.

23.  It is a condition in which individuals
experience complex visual hallucinations in
association with impaired vision without
demonstrable psychopathology
 Elderly person with normal consciousness
 No delirium,dementia,psychosis,intoxication
or neurological disorder
 There is reduced vision resulting from eye
diseases.

24.  It is a perceptual experience which is
figurative not concretely real and occurs in
inner subjective space , not in external
objective space.
 Recognized by the subject as having no
external correlation.
 Eg of pseudohallucination the voice heard by
a depressed person- described by the patient
as a voice, but is recognized as his own
thoughts.

25. ‘WHAT THE DOCTOR CALLS AS
HALLUCINATION IS A NORMAL SENSORY
EXPERIENCE TO PATIENT.’
‘IT IS NOT INFORMATION THAT THESE
PATIENTS WISH TO CONVEY, BUT AN
IMPRESSION THAT THEY WISH TO CREATE’
- F. M. R. WALSHE

26.  FISH CLINICAL PSYCHOPATHOLOGY- 2ND
EDITION
 SYMPTOMS IN THE MIND- 3RD EDITION