Hallucinations in schizophrenia and other mental disorders: similarities and differences

Kinds

True. The patient sees, feels or hears something, but this phenomenon is bright, living in nature. The hallucination is real for the sufferer.
Pseudohallucinations. These are visions, sounds or sensations that occur outside of objective reality.

Important: false hallucinations usually depend on suggestion or the influence of external factors.

Hallucinations vary depending on the specific sense organs that perceive:

Visual. These can be entire storylines, mystical visions, just flashes of light or smoke. And also animals, identical objects, vision of organs in one’s body or foreign objects, etc.
Auditory. These include ordinary noises or sounds, as well as verbal ones: imperative, when a certain voice orders the patient to do something, usually it is negative; commenting - voices discuss the patient’s thoughts, feelings and sensations, they are also negative and judgmental; contrasting, when the patient hears 2 voices directed against each other, one condemns the patient, the other defends, but at the same time they give conflicting commands to the sufferer; speech motor - it seems to the patient that certain forces are speaking for him, in an unknown language.
Olfactory. The patient complains of unpleasant odors.
Flavoring. The patient may experience unpleasant tastes in the mouth.
Tactile: sensation of liquid, different temperatures, insects crawling, hugging.
Functional. Against the background of any objects or phenomena, imaginary images, sounds, etc. appear.
Hallucinations of Bonnet. The imaginary sensation is perceived by the analyzer that has completely or partially lost its function.
Hemianoptic. Occurs due to a disease called hemianopsia. This is when the patient sees only half of the field of vision. Imaginary sensations arise in the area that does not see.
Hypnagogic and hypnopompic hallucinations. They can occur even in a healthy person. They appear in the form of imaginary images or sounds that accompany a person when waking up or falling asleep. They are connected with the events of the day experienced.

Types of hallucinations depending on the analyzer:

Psychomotor, when the patient feels that part of his body is in motion.
Reflex, when, with a real impact on one analyzer, another is excited.
Ecstatic. Vivid pictures or entire images appear in a state of altered consciousness.

Important: hallucinations must be distinguished from mirages and illusions, because they arise based on other factors.

Symptoms and signs of hallucinations

To explain it in simple terms, hallucinations arise as a result of a malfunction of any system responsible for the perception of the surrounding world. So the patient may seem to have some visual objects or his auditory perception may be distorted. A psychiatrist diagnoses hallucinations.

Most often, at the initial stage, such hallucinations occur with the eyes closed, when a person goes to sleep. This is preceded by frequent abuse of alcohol or drugs.

Hallucinations can be true or false. The difference is this: true hallucinations - a person is confident in their reality, and does not question the fact that they do not exist in reality, and this is the result of a failure in his perception system. The patient sees such phenomena in the world around him.

False hallucinations arise in a person’s head. For example, a patient hears voices in his head; he may believe that someone is communicating with him mentally and influencing his condition and decisions. Such conditions accompany schizophrenia.

Causes

Misleading images, sounds, or sensations may occur when:

Dementia. It seems to the patient that objects are moving.
Parkinson's disease. Visual images appear: people, animals, objects, or even entire situations.
Migraine. Patients see flickering or colored zigzag lines in the central region of the visual field. They leave behind a white spot that disappears after half an hour.
Epilepsy. Visual images, in the form of bright spots or outlines.
Sleep disturbance. Usually occur when waking up or falling asleep.
Brain stem infarction. Bright and colorful scenes appear. They usually carry a semantic load. They can last from 1 minute to several hours.
A brain tumor. Hallucinations can be of different types. This depends on the localization of the pathological process.
Creutzfeldt-Jakob disease. It occurs due to prion infection and causes dystrophic processes in the cerebral and spinal cord, basal ganglia. Visual hallucinations occur: color changes, perception in reduced sizes, distortion of object characteristics, etc.
Sclerosis of cerebral vessels. Auditory and visual hallucinations appear.
Stroke.

In addition to the reasons described above, the culprits of hallucinations may be: Aging.

Infectious diseases.
Pathologies of internal organs.
Intoxication with medications.
Poisoning with toxic substances.

Diseases accompanied by hallucinations

First of all, of course, it is worth noting that the presence of hallucinations is one of the main positive signs of schizophrenia. The most common in schizophrenia are auditory hallucinations (they occur in approximately 75% of patients). This disease is also characterized by hallucinations of sensations (tactile, olfactory, auditory). Olfactory hallucinations also appear in temporal lobe epilepsy.

Visual hallucinations also occur in schizophrenia, although relatively rarely. D. Goodwin et al. (1971) believed that the percentage of patients with schizophrenia suffering from such a disorder is only 5%. In most cases, these hallucinations are symptoms of organic brain damage, delirious confusion, alcoholic or intoxication psychosis.

If we once again analyze the causes of hallucinations mentioned above, we can conclude that this disorder may indicate brain damage, tumors, various dysfunctions of the central nervous system, and intoxication of the body (typical of alcoholism and drug addiction).

Which doctor should I contact?

Hallucination is not a separate disease, but a symptom that occurs when a particular organ is damaged, in most cases the brain. But in order to identify the real cause of the pathology, you need to consult the following specialists:

Psychiatrist.
Neurologist.
Oncologist.
Expert in narcology.
Infectious disease specialist.

Hallucinations are an important symptom that indicates that the patient has certain disturbances in awareness of the surrounding reality. Patients are often embarrassed or afraid to talk about the presence of hallucinations, because they think that only people with mental disorders experience hallucinatory experiences.

IMPORTANT! This is a false, persistent belief; different specialists need to work with hallucinations. The fact is that hallucinations can occur due to the presence of a neoplasm or infectious pathology.

Therefore, make an appointment with a specialist from our center - a psychiatrist, neurologist, oncologist, narcologist or infectious disease specialist to find the root of the problem and eliminate the symptom!

Sulfur, rotten onions and solvent: how the sense of smell changes after coronavirus

Can we breathe a sigh of relief if the coronavirus is behind us? As it turned out, not always. Often, those who have recovered from the disease complain of distorted perception of smells (parosmia) and olfactory hallucinations (phantosmia). Why does this happen and what can be done? Yulia Vladimirovna Roshchupkina, a neurologist at the Expert Clinic Tula, told us about this.

– Yulia Vladimirovna, what are olfactory hallucinations, what are they?

– These are deceptions of smell, that is, the perception of a smell that is absent in reality. People can smell neutral, aversive, and pleasant aromas. Many patients who suffered from long-term COVID-19 complained of “disgusting smells of fish, sulfur.” Some began to smell a “sweetish, unpleasant odor.”

– Why do such hallucinations appear after coronavirus infection?

– This side effect was explained by the fact that SARS-CoV-2 is a neurotropic virus. The reason for the distortion of odors is always either damage to the olfactory receptors or impaired identification of odors by the cerebral cortex.

– What is the risk that a person will experience olfactory hallucinations after illness? Is there any way to reduce this probability?

– According to doctors, after recovering from COVID-19, many experience olfactory hallucinations and parosmia. Most often, this happens to people who have completely lost their sense of smell for some time during illness. Sometimes for those who previously experienced loss of smell and taste, this symptom appears weeks or even months after recovery.

COVID-19 is a very insidious disease. It affects all organs, including nerve endings, causing the perception of aromas to become distorted. This does not manifest itself in all those who have recovered from the disease, and the reason for this selectivity has not yet been conclusively established. There is a hypothesis that olfactory hallucinations are one of the stages of recovery of the nervous system after an illness. When at least three to five years have passed since the first clinical cases were recorded and reliable statistical data can be obtained, we may be able to answer the question of how to reduce the risk of parosmia and phantosmia.

– Will the hallucinations go away and how soon?

– According to Italian scientists, after COVID-19, the normal functioning of olfactory receptors is restored on average in eighty days. Their colleagues from Germany talk about sixty days. But distortions due to impaired function of the cerebral cortex can last indefinitely. For people whose cortical part of the analyzer has been affected by the virus, it may take up to six months to return to normal sensations. The average time for smells to return is one to two months.

– Are there any recommendations for restoring normal sense of smell and getting rid of hallucinations?

– The problem is extremely urgent, but scientists have not yet found an optimal solution for it. All over the world, residual effects and features of post-Covid rehabilitation continue to be studied.

Doctor of Medical Sciences, infectious disease specialist Natalya Vorobyova says that the restoration of olfactory and taste neurons and their receptors will take some time, and this is determined by the processes of neuroplasticity.

To restore your sense of smell, experts from the charity AbScent, which supports people with parosmia and anosmia, advise training it: inhale essential oils of rose, clove and lemon for 20 seconds every day. The nose and brain will seem to be reacquainted with smells and remember them. Don't forget about peace of mind and mental health: meditate, try different relaxation practices, consult a psychologist or psychotherapist. Otherwise, a vicious circle is formed: significant disturbances in the sense of smell lead to severe stress, and stress, in turn, worsens well-being.

– Which doctor should I go to if hallucinations do not go away?

– As a rule, if the sense of smell is partially restored, there is a good prognosis for the restoration of the sense of smell in general. If olfactory disturbances turn out to be persistent, you should contact an otolaryngologist and neurologist to exclude other possible causes of phantosmia or parosmia.

If the rehabilitation period is prolonged, the patient may be prescribed a course of treatment aimed at restoring peripheral nerves. As a rule, it includes anticholinesterase drugs, special vitamin preparations and drugs that improve microcirculation.

– Is it dangerous to ignore olfactory hallucinations?

– Of course it’s dangerous! After all, hallucinations after COVID-19 are often delayed, and people sometimes mistake the symptoms of another disease for complications of a previous coronavirus infection.

The most common cause of olfactory hallucinations is brain damage. It can be caused by traumatic brain injury, cancer affecting one or another part of the brain, stroke, or neuroinfection.

Other unfavorable factors include: • mental illness (such as schizophrenia, personality disorder); • epilepsy; • intoxication of the body; • the influence of potent medications, psychotropic or narcotic drugs; • damage to the mucous membrane of the nasal sinuses; • dental problems; • diseases of the gastrointestinal tract.

There are many people who turn a blind eye to olfactory illusions for many years, without thinking about the impending danger.

There are three main ways to determine what is causing a symptom: • MRI of the brain • CT scan of the brain • EEG

For reference:

Yulia Vladimirovna Roshchupkina 2001 – graduated from the medical faculty of Kursk State Medical University. From 2001 to 2002 she completed an internship in the specialty “Neurology”. She specializes in acupuncture. Currently he holds the position of neurologist at the Expert Clinic in Tula. Receives at the address: st. Boldina, 74.

Treatment methods

Treatment methods for pathology depend on the causes that caused it. There is no single scheme. For example, in case of poisoning with toxic substances, you need to stop their effect on the body. If there are neurological causes, it is necessary to begin appropriate therapy or stop the acute form of the disease.

Treatment is usually carried out with:

Neuroleptics.
Antidepressants.
Means to improve blood circulation in the brain.
Antiparkinsonian drugs.

Auditory hallucinations in children

Auditory hallucinations in children of preschool and primary school age are a very common phenomenon. At this age, they are often caused by fever, various infectious diseases and traumatic brain injuries. But they can also appear due to violence, serious psychological shock as a result of any events they have seen or experienced that are terrible for them. Poisoning with various poisons and toxic substances can also cause a similar phenomenon. In addition, such hallucinations sometimes indicate the presence of a mental illness. But sometimes similar illusions arise in healthy children due to severe fatigue.

Lifestyle during hallucinations

The patient’s further life depends on the reasons that caused the pathology. If there is a disease that cannot be treated, then you need to constantly maintain normal functioning with the help of medications. If hallucinations were caused by certain diseases, then after getting rid of them you need to engage in further prevention.

Important: you should also give up bad habits, lead a healthy lifestyle, and strengthen your immune system.

If hallucinations occur, you should consider going to the doctor. Especially if the pathology is protracted. The symptom may indicate deep brain damage. If you make a diagnosis in time and start treatment, you can get rid of intrusive images, sensations or sounds.

How to get rid of auditory hallucinations

In addition, often the answer to the question: “How to get rid of auditory hallucinations?” The psychologist also knows. Contacting him will be advisable if this problem is caused by violence, psychological trauma, severe fear or puberty in adolescents.

If such hallucinations are suspected in children, parents should be able to distinguish this problem from the manifestation of a child’s violent imagination or the child’s retelling of his dreams. And parents of teenagers, if they have sound or other hallucinations, should exclude the abuse of alcohol, drugs and other psychoactive or toxic substances.