Hostname: page-component-7c8c6479df-p566r Total loading time: 0 Render date: 2024-03-27T10:29:47.933Z Has data issue: false hasContentIssue false

The prevalence of visual hallucinations in non-affective psychosis, and the role of perception and attention

Published online by Cambridge University Press:  17 March 2016

M. M. van Ommen
Affiliation:
Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands
M. van Beilen
Affiliation:
Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands University of Groningen, University Medical Center Groningen, School of Behavioral and Cognitive Neurosciences, The Netherlands Department of Psychiatry, University of Groningen, University Medical Center Groningen, Department of Hearing Voices, the Netherlands University of Groningen, University Medical Center Groningen, BCN NeuroImaging Center, The Netherlands
F. W. Cornelissen
Affiliation:
University of Groningen, University Medical Center Groningen, BCN NeuroImaging Center, The Netherlands Laboratory for Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, The Netherlands
H. G. O. M. Smid
Affiliation:
University of Groningen, University Medical Center Groningen, BCN NeuroImaging Center, The Netherlands
H. Knegtering
Affiliation:
University of Groningen, University Medical Center Groningen, BCN NeuroImaging Center, The Netherlands Department of Psychiatry, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, The Netherlands Lentis Center for Mental Health, Groningen, The Netherlands
A. Aleman
Affiliation:
University of Groningen, University Medical Center Groningen, BCN NeuroImaging Center, The Netherlands Department of Psychology, University of Groningen, The Netherlands
T. van Laar
Affiliation:
Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands University of Groningen, University Medical Center Groningen, School of Behavioral and Cognitive Neurosciences, The Netherlands

Abstract

Background

Little is known about visual hallucinations (VH) in psychosis. We investigated the prevalence and the role of bottom-up and top-down processing in VH. The prevailing view is that VH are probably related to altered top-down processing, rather than to distorted bottom-up processing. Conversely, VH in Parkinson's disease are associated with impaired visual perception and attention, as proposed by the Perception and Attention Deficit (PAD) model. Auditory hallucinations (AH) in psychosis, however, are thought to be related to increased attention.

Method

Our retrospective database study included 1119 patients with non-affective psychosis and 586 controls. The Community Assessment of Psychic Experiences established the VH rate. Scores on visual perception tests [Degraded Facial Affect Recognition (DFAR), Benton Facial Recognition Task] and attention tests [Response Set-shifting Task, Continuous Performance Test-HQ (CPT-HQ)] were compared between 75 VH patients, 706 non-VH patients and 485 non-VH controls.

Results

The lifetime VH rate was 37%. The patient groups performed similarly on cognitive tasks; both groups showed worse perception (DFAR) than controls. Non-VH patients showed worse attention (CPT-HQ) than controls, whereas VH patients did not perform differently.

Conclusions

We did not find significant VH-related impairments in bottom-up processing or direct top-down alterations. However, the results suggest a relatively spared attentional performance in VH patients, whereas face perception and processing speed were equally impaired in both patient groups relative to controls. This would match better with the increased attention hypothesis than with the PAD model. Our finding that VH frequently co-occur with AH may support an increased attention-induced ‘hallucination proneness’.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2016 

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.)

References

Aarsland, D, Ballard, C, Larsen, JP, McKeith, I (2001). A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia. International Journal of Geriatric Psychiatry 16, 528536.Google Scholar
Abi-Dargham, A (2004). Do we still believe in the dopamine hypothesis? New data bring new evidence. International Journal of Neuropsychopharmacology 7 (Suppl. 1), S1S5.CrossRefGoogle ScholarPubMed
Aleman, A, Böcker, KBE, Hijman, R, de Haan, EHF, Kahn, RS (2003). Cognitive basis of hallucinations in schizophrenia: role of top-down information processing. Schizophrenia research 64, 175185.Google Scholar
Aleman, A, Larøi, F (2008 a). Cognitive-perceptual processes: bottom-up and top-down. In Hallucinations: The Science of Idiosyncratic Perception, 1st edn (ed. Aleman, A. and Larøi, F.), pp. 91108. American Psychological Association: Washington, DC.Google Scholar
Aleman, A, Larøi, F (2008 b). Groups of hallucinators. In Hallucinations: The Science of Idiosyncratic Perception, 1st edn (ed. Aleman, A. and Larøi, F.), pp. 4789. American Psychological Association: Washington, DC.CrossRefGoogle Scholar
Andreasen, NC, Flaum, M, Arndt, S (1992). The comprehensive assessment of symptoms and history (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615623.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, 4th, Text Revision edn. American Psychiatric Publishing: Washington, DC.Google Scholar
Balzan, R, Delfabbro, P, Galletly, C, Woodward, T (2013). Confirmation biases across the psychosis continuum: the contribution of hypersalient evidence-hypothesis matches. British Journal of Clinical Psychology 52, 5369.CrossRefGoogle ScholarPubMed
Benton, AL, Sivan, AB, de Hamsher, KS, Varney, NR, Spreen, O (1983). Benton's Test of Facial Recognition. Oxford University Press: New York.Google Scholar
Bilder, RM, Turkel, E, Lipschutz-Broch, L, Lieberman, JA (1992). Antipsychotic medication effects on neuropsychological functions. Psychopharmacology Bulletin 28, 353366.Google Scholar
Blom, JD, Sommer, IEC (2011). Visual hallucinations. In Hallucinations: Research and Practice (ed. Collerton, D., Dudley, R. and Mosimann, U.P.), pp. 7590. Springer Science + Business Media: New York, NY.Google Scholar
Brenner, CA, Lysaker, PH, Wilt, MA, O'Donnell, BF (2002). Visual processing and neuropsychological function in schizophrenia and schizoaffective disorder. Psychiatry Research 111, 125136.CrossRefGoogle ScholarPubMed
Cohen, J (1992). A power primer. Psychological Bulletin 112, 155159.Google Scholar
Collerton, D, Perry, E, McKeith, I (2005). Why people see things that are not there: a novel perception and attention deficit model for recurrent complex visually hallucinations. Behavioral and Brain Sciences 28, 737757.CrossRefGoogle ScholarPubMed
Dakin, S, Carlin, P, Hemsley, D (2005). Weak suppression of visual context in chronic schizophrenia. Current Biology 15, R822R824.Google Scholar
Dang, LC, O'Neil, JP, Jagust, WJ (2012). Dopamine supports coupling of attention-related networks. Journal of Neuroscience 32, 95829587.Google Scholar
Diederich, NJ, Goetz, CG, Stebbins, GT (2005). Repeated visual hallucinations in Parkinson's disease as disturbed external/internal perceptions: focused review and a new integrative model. Movement Disorders 20, 130140.Google Scholar
Dolgov, I, McBeath, MK (2005). A signal-detection theory representation of normal and hallucinatory perception. Behavioral and Brain Sciences 28, 761762.Google Scholar
Fabbrini, G, Barbanti, P, Aurilia, C, Pauletti, C, Lenzi, GL, Meco, G (2004). Donepezil in the treatment of hallucinations and delusions in Parkinson's disease. Neurological Sciences 23, 4143.Google Scholar
Fénelon, G, Mahieux, F, Huon, R, Ziégler, M (2000). Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. Brain 123, 733745.CrossRefGoogle ScholarPubMed
Francis, PT, Perry, EK (2007). Cholinergic and other neurotransmitter mechanisms in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies. Movement Disorders 22, S351S357.Google Scholar
Gallagher, DA, Parkkinen, L, O'Sullivan, SS, Spratt, A, Shah, A, Davey, CC, Bremner, FD, Revesz, T, Williams, DR, Lees, AJ, Schrag, A (2011). Testing an aetiological model of visual hallucinations in Parkinson's disease. Brain 134(Pt 11), 32993309.Google Scholar
Gibson, G, Mottram, PG, Burn, DJ, Hindle, JV, Landau, S, Samuel, M, Hurt, CS, Brown, RG, Wilson, KC (2013). Frequency, prevalence, incidence and risk factors associated with visual hallucinations in a sample of patients with Parkinson's disease: a longitudinal 4-year study. International Journal of Geriatric Psychiatry 28, 626631.Google Scholar
Goodwin, DW, Rosenthal, R (1971). Clinical significance of hallucinations in psychiatric disorders: a study of 116 hallucinatory patients. Archives of General Psychiatry 24, 7680.CrossRefGoogle ScholarPubMed
Harding, AJ, Broe, GA, Halliday, GM (2002). Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe. Brain 125, 391403.Google Scholar
Heinrichs, RW, Miles, AA, Ammari, N, Muharib, E (2013). Cognition as a central illness feature in schizophrenia. In Cognitive Impairment in Schizophrenia: Characteristics, Assessment and Treatment (ed. Harvey, P. D.), pp. 123. Cambridge University Press.Google Scholar
Janssens, M, Lataster, T, Simons, CJP, Oorschot, M, Lardinois, M, van Os, J, Myin-Germeys, I (2012). Emotion recognition in psychosis: no evidence for an association with real world social functioning. Schizophrenia Research 142, 116121.CrossRefGoogle ScholarPubMed
Jardri, R, Cachia, A, Thomas, P, Pins, D (ed.) (2013). The Neuroscience of Hallucinations, 1st edn. Springer: New York.Google Scholar
Jardri, R, Thomas, P, Delmaire, C, Delion, P, Pins, D (2013). The neurodynamic organization of modality-dependent hallucinations. Cerebral Cortex 23, 11081117.Google Scholar
Koerts, J, Borg, MA, Meppelink, AM, Leenders, KL, van Beilen, M, van Laar, T (2010). Attentional and perceptual impairments in Parkinson's disease with visual hallucinations. Parkinsonism and Related Disorders 16, 270274.CrossRefGoogle ScholarPubMed
Konings, M, Bak, M, Hanssen, M, van Os, J, Krabbendam, L (2006). Validity and reliability of the CAPE: a self-report instrument for the measurement of psychotic experiences in the general population. Acta Psychiatrica Scandinavica 114, 5561.Google Scholar
Korver, N, Quee, PJ, Boos, HBM, Simons, CJP, de Haan, L, GROUP investigators (2012). Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research 21, 205221.Google Scholar
Levin, HS, Hamsher, K, Benton, AL (1975). A short form of the test of facial recognition for clinical use. Journal of Psychology 91, 223228.CrossRefGoogle Scholar
Líndal, E, Stefánsson, JG, Stefánsson, SB (1994). The qualitative difference of visions and visual hallucinations: a comparison of a general-population and clinical sample. Comprehensive Psychiatry 35, 405408.CrossRefGoogle ScholarPubMed
Manford, M, Andermann, F (1998). Complex visual hallucinations. Clinical and neurobiological insights. Brain 121, 18191840.Google Scholar
McKay, CM, Headlam, DM, Copolov, DL (2000). Central auditory processing in patients with auditory hallucinations. AJP 157, 759766.Google Scholar
McKeith, IG, Wesnes, KA, Perry, E, Ferrara, R (2004). Hallucinations predict attentional improvements with rivastigmine in dementia with lewy bodies. Dementia and Geriatric Cognitive Disorders 18, 94100.Google Scholar
Meijer, J, Simons, CJP, Quee, PJ, Verweij, K, GROUP Investigators (2012). Cognitive alterations in patients with non-affective psychotic disorder and their unaffected siblings and parents. Acta Psychiatrica Scandinavica 125, 6676.Google Scholar
Meppelink, AM, Koerts, J, Borg, M, Leenders, KL, van Laar, T (2008). Visual object recognition and attention in Parkinson's disease patients with visual hallucinations. Movement Disorders 23, 19061912.Google Scholar
Mosimann, UP, Mather, G, Wesnes, KA, O'Brien, JT, Burn, DJ, McKeith, IG (2004). Visual perception in Parkinson disease dementia and dementia with Lewy bodies. Neurology 63, 20912096.CrossRefGoogle ScholarPubMed
Mosimann, UP, Rowan, EN, Partington, CE, Collerton, D, Littlewood, E, O'Brien, JT, Burn, DJ, McKeith, IG (2006). Characteristics of visual hallucinations in parkinson disease dementia and dementia with lewy bodies. American Journal of Geriatric Psychiatry 14, 153160.CrossRefGoogle ScholarPubMed
Mueser, KT, Bellack, AS, Brady, EU (1990). Hallucinations in schizophrenia. Acta Psychiatrica Scandinavica 82, 2629.Google Scholar
Ndetei, DM, Singh, A (1983). Hallucinations in Kenyan schizophrenic patients. Acta Psychiatrica Scandinavica 67, 144147.Google Scholar
Nelson, EB, Sax, KW, Strakowski, SM (1998). Attentional performance in patients with psychotic and nonpsychotic major depression and schizophrenia. American Journal of Psychiatry 155, 137139.Google Scholar
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 2939.Google Scholar
Nuechterlein, KH, Dawson, ME (1984). Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophrenia Bulletin 10, 160203.Google Scholar
Onofrj, M, Thomas, A, Martinotti, G, Anzellotti, F, Di Giannantonio, M, Ciccocioppo, F, Bonanni, L (2015). The clinical associations of visual hallucinations. In The Neuroscience of Visual Hallucinations, 1st edn (ed. Collerton, D., Mosimann, U. P. and Perry, E.), pp. 91117. Wiley Blackwell: Chichester.Google Scholar
Schneider, SJ, Wilson, CR (1983). Perceptual discrimination and reaction time in hallucinatory schizophrenics. Psychiatry Research 9, 243253.Google Scholar
Shine, JM, Halliday, GM, Naismith, SL, Lewis, SJG (2011). Visual misperceptions and hallucinations in Parkinson's disease: dysfunction of attentional control networks? Movement Disorders 26, 21542159.Google Scholar
Smid, HGOM, Bruggeman, R, Martens, S (2013). Fragmented perception: slower space-based but faster object-based attention in recent-onset psychosis with and without schizophrenia. PLoS ONE 8, 2014, e59983.CrossRefGoogle ScholarPubMed
Stefanis, NC, Hanssen, M, Smirnis, NK, Avramopoulos, DA, Evdokimidis, IK, Stefanis, CN, Verdoux, H, Van Os, J (2002). Evidence that three dimensions of psychosis have a distribution in the general population. Psychological Medicine 32, 347358.Google Scholar
Van Dael, F, Versmissen, D, Janssen, I, Myin-Germeys, I, van Os, J, Krabbendam, L (2006). Data gathering: biased in psychosis? Schizophrenia Bulletin 32, 341351.Google Scholar
van der Gaag, M (2006). A Neuropsychiatric model of biological and psychological processes in the remission of delusions and auditory hallucinations. Schizophrenia Bulletin 32, s113s122.Google Scholar
van Lutterveld, R, Oranje, B, Kemner, C, Abramovic, L, Willems, AE, Boks, MPM, Glenthøj, BY, Kahn, RS, Sommer, IEC (2010). Increased psychophysiological parameters of attention in non-psychotic individuals with auditory verbal hallucinations. Schizophrenia Research 121, 153159.Google Scholar
van‘t Wout, M, Aleman, A, Kessels, RP, Larøi, F, Kahn, RS (2004). Emotional processing in a non-clinical psychosis-prone sample. Schizophrenia Research 68, 271281.Google Scholar
Van't Wout, M, van Dijke, A, Aleman, A, Kessels, RP, Pijpers, W, Kahn, RS (2007). Fearful faces in schizophrenia: the relationship between patient characteristics and facial affect recognition. Journal of Nervous and Mental Disease 195, 758764.Google Scholar
Vercammen, A, de Haan, EH, Aleman, A (2008). Hearing a voice in the noise: auditory hallucinations and speech perception. Psychological Medicine 38, 11771184.Google Scholar
Waters, F, Allen, P, Aleman, A, Fernyhough, C, Woodward, TS, Badcock, JC, Barkus, E, Johns, L, Varese, F, Menon, M, Vercammen, A, Larøi, F (2012). Auditory hallucinations in Schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin 38, 683693.CrossRefGoogle ScholarPubMed
Waters, F, Collerton, D, ffytche, DH, Jardri, R, Pins, D, Dudley, R, Blom, JD, Mosimann, UP, Eperjesi, F, Ford, S, Larøi, F (2014). Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophrenia Bulletin 40(Suppl. 4), S233S245.Google Scholar
Wechsler, D (1997). Wechsler Adult Intelligence Scale, 3rd edn. The Psychological Corporation: San Antonio.Google Scholar
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for clinical assessment in neuropsychiatry. Archives of General Psychiatry 47, 589593.Google Scholar
Wohlberg, GW, Kornetsky, C (1973). Sustained attention in remitted schizophrenics. Archives of General Psychiatry 28, 533537.Google Scholar
Zanto, TP, Rubens, MT, Thangavel, A, Gazzaley, A (2011). Causal role of the prefrontal cortex in top-down modulation of visual processing and working memory. Nature Neuroscience 14, 656661.Google Scholar
Zarroug, EA (1975). The frequency of visual hallucinations in schizophrenic patients in Saudi Arabia. British Journal of Psychiatry 127, 553555.Google Scholar
Supplementary material: File

van Ommen supplementary material

Table S1

Download van Ommen supplementary material(File)
File 15.8 KB