Older People

Berrios, G. E., Brook, P. , Visual Hallucinations and Sensory Delusions in the Elderly British Journal of Psychiatry, June 1984, 144, 662–664

One hundred and fifty successive referrals to a psychogeriatrician were assessed for visual hallucinations. Forty-four (29.33 per cent) patients reported visual perceptual disturbances. No differences between hallucinators and non-hallucinators were found in terms of sex, age, length of illness, underlying psychiatric diagnosis or cognitive score. There was a significant correlation between presence of hallucinations and eye pathology (less than .001) and delusions (less than .001). The phenomenological characteristics of the visual hallucinations are analyzed. The “picture” sign is described in 7 patients and the Charles Bonnet syndrome in two. The significance of these findings is discussed.

Kobayashi, T., Kato, S., Osawa, T., Shioda, K. (2004) Commentary Hallucination in the Elderly: Three Case Reports Psychogeriatrics, September 2004, Vol. 4, No. 3, pp. 96-101(6)

Three elderly females with commentary hallucinations are presented. Here, the term ‘commentary hallucination’ is used as a comprehensive term describing a condition where the subject hears voices that comment on, command, or describe the subject’s actions or behavior. According to the DSM-IV, the three cases presented here met the criteria for a psychotic disorder not otherwise specified, a schizoaffective disorder, and schizophrenia, respectively. All three cases showed no evidence of abnormalities when examined using neuroimaging techniques but might have had some senile brain changes that were under the threshold of the neuroimaging studies. Although the commentary hallucinations in the three patients were not distinctively different from the hallucinations that are characteristic of schizophrenia, the subjects were able to keep some distance from the hallucinations; in other words, the hallucinations were not ego-invasive. The commentary hallucinations in the present patients might be explained as resulting from exhaustion caused by stressful life events, subtle senile organic brain changes, and a subsequent decline in psychological tension. These hallucinations may have originated from the pathological appearance of a background-inner speech accompanying the patients’ behavior.

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