A Psychiatrist with Lewy Body Dementia (LBD)

Hallucinations Part 2 of 3 — Types of hallucinations?

Hallucinations Part 1 — What are hallucinations?

Hallucinations Part 2 — Types of hallucinations?

Hallucinations Part 3 — How to handle hallucinations

Types

Hallucinations are categorized according to which sensory modality is involved and, in addition, are categorized as either mood-congruent or mood-incongruent. The types of hallucinations are:

  • Auditory: The false perception of sound, music, noises, or voices. Hearing voices when there is no auditory stimulus is the most common type of auditory hallucination in mental disorders. The voice may be heard either inside or outside one’s head and is generally considered more severe when coming from outside one’s head. The voices may be male or female, recognized as the voice of someone familiar or not recognized as familiar, and may be critical or positive. In mental disorders such as schizophrenia, however, the content of what the voices say is usually unpleasant and negative. In schizophrenia, a common symptom is to hear voices conversing and/or commenting. When someone hears voices conversing, they hear two or more voices speaking to each other (usually about the person who is hallucinating). In voices commenting, the person hears a voice making comments about his or her behavior or thoughts, typically in the third person (such as, "isn’t he silly"). Sometimes the voices consist of hearing a "running commentary" on the person’s behavior as it occurs ("she is showering"). Other times, the voices may tell the person to do something (commonly referred to as "command hallucinations").
  • Gustatory: A false perception of taste. Usually, the experience is unpleasant. For instance, an individual may complain of a persistent taste of metal. This type of hallucination is more commonly seen in some medical disorders (such as epilepsy) than in mental disorders.
  • Olfactory hallucination: A false perception of odor or smell. Typically, the experience is very unpleasant. For example, the person may smell decaying fish, dead bodies, or burning rubber. Sometimes, those experiencing olfactory hallucinations believe the odor emanates from them. Olfactory hallucinations are more typical of medical disorders than mental disorders.
  • Somatic/tactile hallucination: A false perception or sensation of touch or something happening in or on the body. A common tactile hallucination is feeling like something is crawling under or on the skin (also known as formication). Other examples include feeling electricity through one’s body and feeling like someone is touching one’s body but no one is there. Actual physical sensations stemming from medical disorders (perhaps not yet diagnosed) and hypochondriacal preoccupations with normal physical sensations, are not thought of as somatic hallucinations.
  • Visual hallucination: A false perception of sight. The content of the hallucination may be anything (such as shapes, colors, and flashes of light) but are typically people or human-like figures. For example, one may perceive a person standing before them when no one is
  • there. Sometimes an individual may experience the false perception of religious figure (such as the devil, or Christ). Perceptions that would be considered normal for an individual’s religion or culture are not considered hallucinations.
  • Mood-congruent hallucination: Any hallucination whose content is consistent with either the depressive or manic state the person may be in at the time. Depressive themes include guilt, death, disease, personal inadequacy, and deserved punishment. Manic themes include inflated self-worth, power, knowledge, skills, and identity and a special relationship with a famous person or deity. For example, a depressed person may hear voices saying that he or she is a horrible person, whereas a manic person may hear voices saying that he or she is an incredibly important person.
  • Mood-incongruent hallucination: Any hallucination whose content is not consistent with either the depressed or manic state the person is in at the time, or is mood-neutral. For example, a depressed person may experience hallucinations without any themes of guilt, death, disease, personal inadequacy, or deserved punishment. Similarly, a manic person may experience hallucinations without any themes of inflated self-worth, power, knowledge, skills, or identity or a special relationship to a famous person or deity.

                                                                                                          –William Osler

Warmly………David

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March 20, 2009 - Posted by David Thomas, MD | Miscellaneous | , , , , , | 6 Comments

6 Comments »

  1. [...] A Psychiatrist with Lewy Body Dementia (LBD) placed an interesting blog post on Hallucinations Part 2 of 3 â [...]

    Pingback by Topics about Religion » Hallucinations Part 2 of 3 — Types of hallucinations? | March 20, 2009

  2. Great article! Just wanted to share that Risperadol has worked wonderfully to stave away hallucinations for my step-dad. they were daily prior to starting this med at a low dose. After a couple of weeks, they have gone away completely,

    Comment by Paulette Carpenter | March 20, 2009

  3. Hello David,

    Thankyou for posting this article. I think I will refer to it, again, overtime. Dad recently had an hallucination. He seemed to be able to still reason that the lady he was seeing wasn’t there. If he began to argue that she was, I wasn’t going to argue back. I wonder, if how I handle these situations will need to change over time. And I dread the medication path, too much, too little, wrong all together. On a more positive note my brother from interstate visited today and he and Dad, together, did some maintenance, like they used to. Dad had a most enjoyable day. It really is often the simple things which give the greatest pleasure.

    I hope you’re enjoying your planting and again thankyou.

    Comment by no1daughteroflewydad | March 21, 2009

  4. Just how much do we truly know about reality? Maybe some people are not hallucinating but are experiencing an alternate reality? I wonder?

    Comment by WebSpeak Ezine | March 22, 2009

  5. Thanks for the info on the Gustatory hallucinations. That explains why my Mother complained of a metallic taste before she was diagnosed with LBD. The doctors ruled out medical reasons and I have always wonder what the metallic taste meant and now you have explained it.

    Keep up the good work.

    Comment by Laura | March 22, 2009

  6. [...] EDU-CA-Tion added an interesting post today on Hallucinations Part 2 of 3 â [...]

    Pingback by Topics about Medical » Archive » Hallucinations Part 2 of 3 — Types of hallucinations? | March 23, 2009


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