2025년 11월 7일 금요일

hallucination, 幻覚 げんかく환각 - 위키백과

환각 - 위키백과, 우리 모두의 백과사전


환각

위키백과, 우리 모두의 백과사전.
 인공지능 용어에 대해서는 환각 (인공지능) 문서를 참고하십시오.
환각
진료과정신건강의학, medical psychology, 심리요법 위키데이터에서 편집하기

환각(幻覺, 영어: hallucination)은 정신의학 용어의 하나로, 대상 없는 지각, 즉 아무런 감각 기관의 자극이 없음에도 마치 어떠한 사물이 있는 것처럼 지각하는 증상이다. 실제로 입력이 있던 감각 정보를 잘못 체험하는 증상은 착각으로 불린다. 청각, 후각, 미각, 촉각 등 모든 종류의 감각에서 환각이 나타날 수 있으며, 한 번에 두 종 이상의 감각에서도 환각이 나타날 수 있다.[1][2]

종류

환각에는 이하의 것이 있다.

환청

환청(幻聽, auditory hallucination)은 청각의 환각으로, 실재하지 않는 소리를 듣는 것이다.[3] 들리는 것은 요소적인 것으로부터 사람의 이야기 소리, 몇사람의 회화와 복잡한 것까지 정도는 여러가지이다. 환청은 간질 등에서도 일어날 수 있지만, 회화 등 의미가 있는 말소리를 직접 듣는 환각이 나타난다면 조현병일 가능성이 높다.[4] 통합 실조증에서는 의식 장해시는 아니고 의식 청명기에 일어나, 귀로부터 들려 오는, 머릿속에 직접 영향을 주어 오는, 복부로부터 들려 오는 경우도 있다. 통합 실조증에서는 단순한 소리이거나 아는 사람의 소리, 욕이나 명령이나 자신의 생각이거나 회화이거나 내용은 여러가지이다, 망상에 결합되는 것이 특징이다. 급성기는 선명히 들리지만, 경쾌 하는 것에 따라 불선명이 되기 위해 양성 증상의 지표나 된다. 들으려고 하면 들린다, 들으려고 하지 않아도 들린다, 소리에 거역할 수 없다고 한 것도 중증도의 기준이 된다. 예로서 벽을 두드리는 소리가 들리는 등.

환시

환시(幻視, visual hallucination)는 시각의 환각으로, 실재하지 않는 것을 보는 것이다.[5] 단순한 요소적인 것으로부터 복잡하고 구체적인 것까지 정도는 여러가지이다. 많은 경우는 의식이 혼탁한 의식 장해 시간에 일어나는 것이 많아, 특히 알콜 중독이라고 하는 중독성 질환이나 신경 변성 질환으로 인정된다. 알콜 중독으로 인정되는 환시는 전형적으로는 작은 동물이 인정된다고 하는 것이다. 이것들은 의식 변용에 의해서 일어나는 것이라고 생각된다. 특수한 예로서는 뇌의 중추부병변 시에 환각 모습효험이 일어나는 일이 있어, 뇌각성 환각이라고 말해진다. 뇌줄기는 의식에 대해 지극히 중요한 역할을 담당하는 부위이며, 대뇌와 뇌의 중추부의 연락의 장해가 가위눌림이라고 생각된다. 조현병으로 환시가 인정되는 것은 지극히 드물다. 예로서 존재하지 않는 사람, 물건, 건물이 마치 정말로 존재하는 것 같이 보이는 등. 또, 시각 장애자의 1할 정도는 뇌의 과활동으로부터, 정신에 이상이 없어도 걸리지 않고 환시를 본다(샤르르보네 증후군). 다른 예로서 조난 중에 환시를 보는 것이 많다. 이쪽은 반대로 구조자나 음료, 돌아가는 집 등 자신의 기대하는 것을 뇌가 만들어내는 것으로 보인다.

환후

환후(幻嗅, olfactory hallucination)는 후각의 환각으로, 실재하지 않는 냄새를 맡는 것이다.[6] 대부분의 경우 금방 사라지나,[7] 오래 지속될 경우 비강의 감염, 발작, 뇌졸중, 뇌종양의 증상일 수 있다.[8][9]

환미

환미(幻味, gustatory hallucination)는 미각의 환각으로, 실재하지 않는 맛을 느끼는 것이다. 뇌전증 환자에서 나타날 수 있는데, 뇌섬엽 등의 영역의 문제로 여겨진다.[10][11]

환지

환지(幻肢)는 촉각의 착각으로, 실재하지 않는 촉각을 느끼는 것이다. 피부에 벌레가 기어다니는 것 같은 느낌인 의주감도 여기에 속한다.[12]

병의 용태

다양한 설이 제안되고 있지만, 현재로서는 분명히는 모른다.

중뇌변연계의 도파민 신경의 과활동
도파민 작동약인 각성제나 대마의 성분이 환각을 일으키는 것, 환각에 대해서 도파민 대항약인 항정신병제제가 유효하다고 추측된다.
자기 모니터링 기능의 장애
자기와 다른 사람의 구별을 실시하는 기능인 자기 모니터링 기능이 정상적으로 작동하고 있는 사람이면, 공상시 등에 자기의 뇌안에서 생기는 내적인 발성을 외부로부터의 음성이라고 지각할 것은 없지만, 이 기능이 장해된 경우, 외부로부터의 음성이라고 지각하고 환청이 생기게 된다.

원인

환각은, 마약 등의 복용, 혹은 정신병이나 외상 후 스트레스 장애(PTSD) 등의, 특수한 상황에서만 일어나는 것은 아니다. 정상인이어도, 야간의 고속도로를 쭉 달리고 있을 때 등, 자극이 적은, 말하자면 감각 차단에 가까운 상태가 계속했을 경우에 발생하는 일이 있다. 고립 탱크와 같이 철저히 감각을 차단했을 때도 환각을 볼 수 있다.

기질성

뇌의 기질 질환에 의해 환각이 일어날 수 있다. 기면증, 뇌혈관 장해, 뇌염, 뇌외상, 뇌종양, 어느 종류의 간질, 치매 등.

증상성

전신성의 질환에 연발해 환각이 일어나는 일이 있다. 대사성 질환, 내분비성 질환, 신경 질환 등.

정신병성

주로 조현병권의 질환으로 환각이 보인다. 조현병을 시작해 조현병 모양 장해, 비정형 정신병 등. 감정 장해에서도 환청이 일어나는 일이 있다.

심인성

중증의 심인반응, PTSD 등. 그 밖에, 조난 중에 구조자나 음료의 환각을 보는 것은 흔하다. 모두 뇌의 방위 본능에 의한 것으로 여겨진다.

약리성

LSD 등의 환각제, 각성제, 대마 등의 약물 남용에 의한다. 스테로이드 등의 치료약에서도 환각이 일어나는 일이 있다.

특수 상황하의 정상적인 반응

단면, 감각 차단, 고전자장 등

환각의 원인과 내용의 관련

질환에 따라 환각의 내용이 다른 경향이 있다고 한다. 예를 들면 조현병은 환청이, 레비 작은 몸병은 환시가, 알코올 의존증의 이탈 증상에서는 작은 동물 환시(작은 벌레 등이 보인다)가 많다고 여겨지고 있지만, 반드시 전례에 들어맞는 것은 아니다.

같이 보기

각주

  1.  Montagnese, Marcella; Leptourgos, Pantelis; Fernyhough, Charles; Waters, Flavie; Laroi, Frank; Jardri, Renaud; McCarthy-Jones, Simon; Thomas, Neil; Dudley, Rob (2020년 2월 3일). “A Review of Multimodal Hallucinations: Categorisation, Assessment, Theoretical Perspectives And Clinical Recommendations”. 《dx.doi.org》. doi:10.31219/osf.io/zebxv. S2CID 243338891. 2022년 4월 26일에 확인함.
  2.  Dudley, Robert; Aynsworth, Charlotte; Cheetham, Rea; McCarthy-Jones, Simon; Collerton, Daniel (November 2018). “Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations”. 《Psychiatry Research》 269: 25–30. doi:10.1016/j.psychres.2018.08.032. ISSN 0165-1781. PMID 30145297. S2CID 52092886.
  3.  “Paracusia”. thefreedictionary.com.
  4.  Thompson A (2006년 9월 15일). “Hearing Voices: Some People Like It”. LiveScience.com. 2006년 11월 2일에 원본 문서에서 보존된 문서. 2006년 11월 25일에 확인함.
  5.  Pelak V. “Approach to the patient with visual hallucinations”. 《www.uptodate.com》. 2014년 8월 26일에 원본 문서에서 보존된 문서. 2014년 8월 25일에 확인함.
  6.  HealthUnlocked (2014), “Phantosmia (Smelling Odours That Aren't There)”, 《NHS Choices》, 2016년 8월 2일에 원본 문서에서 보존된 문서, 2016년 8월 6일에 확인함
  7.  HealthUnlocked (2014), “Phantosmia (Smelling Odours That Aren't There)”, 《NHS Choices》, 2016년 8월 2일에 원본 문서에서 보존된 문서, 2016년 8월 6일에 확인함
  8.  HealthUnlocked (2014), “Phantosmia (Smelling Odours That Aren't There)”, 《NHS Choices》, 2016년 8월 2일에 원본 문서에서 보존된 문서, 2016년 8월 6일에 확인함
  9.  Leopold D (September 2002). “Distortion of olfactory perception: diagnosis and treatment”. 《Chemical Senses》 27 (7): 611–615. doi:10.1093/chemse/27.7.611. PMID 12200340.
  10.  Panayiotopoulos CP (2007). 《A clinical guide to epileptic syndromes and their treatment》 2판. London: Springer. ISBN 978-1846286438. based on the ILAE classification and practice parameter guidelines
  11.  Barker P (1997). 《Assessment in psychiatric and mental health nursing: in search of the whole person》. Cheltenham, UK: Stanley Thornes Publishers. 245쪽. ISBN 978-0748731749.
  12.  Berrios GE (April 1982). “Tactile hallucinations: conceptual and historical aspects”. 《Journal of Neurology, Neurosurgery, and Psychiatry》 45 (4): 285–293. doi:10.1136/jnnp.45.4.285. PMC 491362. PMID 7042917.

==

幻覚

出典: フリー百科事典『ウィキペディア（Wikipedia）』
曖昧さ回避人工知能における幻覚については「ハルシネーション (人工知能)」をご覧ください。
曖昧さ回避「幻覚」のその他の用法については「幻覚 (曖昧さ回避)」をご覧ください。
幻覚
概要
診療科精神医学
分類および外部参照情報
Patient UK幻覚

幻覚（げんかく、英語: hallucination）とは、外部からの刺激がないときに、現実の知覚と同じような性質を知覚することである。幻覚は鮮明で実質が伴っており、外部の客観的空間に位置するように知覚される。また、幻覚は、脳の覚醒とレム睡眠という2つの意識状態の組み合わせである[1]。それらは、覚醒を伴わない夢（レム睡眠）、現実の知覚を模倣せず、非現実として正確に知覚する偽幻覚、歪んだあるいは誤った解釈の現実知覚を伴う錯覚、現実知覚を模倣しない自発的制御下にある心像などのいくつかの関連現象と区別される[2]。そして、幻覚は、正しく知覚・解釈された刺激（現実の知覚）に何らかの付加的な意味を与える「妄想的知覚」とも異なる。多くの幻覚は、睡眠麻痺の間にも起こる[3]。

幻覚は、視覚、聴覚、嗅覚、味覚、触覚、体性感覚、平衡感覚、侵害受容、熱受容、時間知覚のあらゆる感覚様相で起こりうる。複数の感覚様相で起こる幻覚は、マルチモーダル（multimodal）と呼ばれる[4][5]。

軽度の幻覚は「乱れ」と呼ばれ、上記のほとんどの感覚に現れることがある。例えば、周辺視野に動きが見えたり、かすかな物音や声が聞こえたりするような場合である。また、幻聴は統合失調症においては非常によくみられる。その場合の幻聴は善意のもの（対象者に自分について良いことを言う）であったり、悪意のあるもの（対象者を罵倒する）であったりする。55％の幻聴は悪意のある内容で[6]、例えば、対象者に直接語りかけるのではなく、対象者について語るようなものとなっている。また、幻聴と同様に、対象者の背後に視覚的な対応物の発生源があることもある[要出典]。そして幻聴と幻視はしばしば一緒に体験される[7]。

半眠性幻覚と覚醒時幻覚は正常な現象であると考えられている。半眠性幻覚は入眠時に覚醒時幻覚は覚醒時に発生する。幻覚は、薬物使用（特にせん妄）、睡眠不足、精神病、神経障害、振戦せん妄などと関連している。

幻覚（hallucination）という言葉自体は、17世紀の医師トーマス・ブラウンが1646年に、心の中をさまようという意味のラテン語「alucinari」から派生させ英語に取り入れた。ブラウンにとって幻覚とは、「堕落し誤って対象を受け取る」一種の視覚を意味していた[8]。

分類

幻覚は様々な形で現れる[9]。色々な形態の幻覚は、異なる感覚に影響を与え時には同時に発生し、体験者に複数の感覚に由来する幻覚を生じさせる。

幻聴

幻聴とは、外部からの刺激なしに音を知覚することで、錯聴としても知られている[10]。幻聴は、初歩的なものと複雑なもの、そして言語的なものと非言語的なものに分けられる。こうした幻覚は最も一般的なタイプであり、言語性幻覚は非言語性幻覚よりも一般的である[11]。初歩的な幻聴とは、「シュー」という音、口笛、伸びた音などの音を知覚することである。多くの場合、耳鳴りは初歩的な幻聴である。しかし、ある種の耳鳴り、特に拍動性の耳鳴りを経験する人の中には、実際に耳の近くの血管を流れる血液の音を聞いている人もいる。この場合は聴覚刺激があるため、幻覚と認められることはない。

複雑な幻覚とは、声、音楽、その他の音がはっきり聞こえるかどうか、聞き覚えがあるかないか、友好的か攻撃的か、その他の可能性のあるものである。1人または複数の話し声の幻覚は、特に統合失調症などの精神障害に関連し、これらの疾患を診断する上では特別な意味を持つことになる。

統合失調症では通常、声は人の外から聞こえてくるものだと認識されるが、解離性障害では人の中から聞こえてくるものだと認識され、背後ではなく頭の中で人の声が聞こえる。また、統合失調症と解離性障害の鑑別診断は、特に幻覚などのシュナイダーの一級症状など重複する症状が多いため、困難とされている[12]。しかし、診断可能な精神疾患を持たない多くの人が、時に同じように声を聞くことが見られる[13]。錯聴の患者を鑑別診断する際に外側側頭葉てんかんであるのかどうかを考慮することが重要である。他にもウィルソン病、さまざまな内分泌疾患、多数の代謝異常、多発性硬化症、全身性エリテマトーデス、ポルフィリン症、サルコイドーシスなど、多くの疾患が精神病を呈する可能性があるため、精神病の特徴を示したとしても、必ずしもそれ自体が精神疾患であるとは限らないと考えることが必要である。

音楽的な幻聴も複雑な幻聴の中では比較的多く、難聴（シャルル・ボネ症候群の聴覚版である音楽耳症候群など）、外側側頭葉てんかん[14]、動静脈奇形[15]、脳卒中、病巣、膿瘍、腫瘍に至るまで幅広い原因によって発生することがある[16]。

カフェインの大量摂取は、幻聴を経験する可能性を高めると言われている。ラトローブ大学心理科学部の研究によると、1日5杯のコーヒー（約500mgのカフェイン）が幻聴を誘発する可能性があることが明らかになった[17]。

幻視

幻視とは、「何も存在しないのに、外部の視覚刺激を知覚すること」である[18]。これとは別に関連する現象に錯視があり、これは実際の外部刺激が歪曲されたものである。幻視は、単純なものと複雑なものに分類される。

  • 単純幻視（SVH）は、非形成視覚幻覚、初等視覚幻覚とも呼ばれる。これらは、光、色、幾何学的形状、そして不定形の物体の幻視のことを指す。さらに、構造を持たない幻視（眼閃）と幾何学的構造を持つ幻視（光視症）に分けられる。
  • 複雑幻視（CVH）は、形成された幻視とも呼ばれる。複雑な幻視は、人、動物、物、場所など、鮮明でリアルなイメージや情景が知覚される。

例えば、キリンの幻覚が見えると報告されることがある。単純幻視は、キリンに形や色が似ている（キリンに見える）不定形の図形であるが、複雑幻視は、紛れもなくキリンそのものの個別の実物大画像が知覚されている。

多くの場合、幻視は意識混濁という意識障害時に起こることが多く、特に薬物離脱症状（アルコールなどの中毒性疾患[19]）や神経変性疾患、認知症でよく認められる[19]。

命令幻覚

命令幻覚とは、外部からの指令のように聞こえる幻覚、または、被験者の頭の中から出てくるように感じられる幻覚のことである[20]。幻覚の内容は、無害なものから、自分や他人に危害を加えるように命令するものまでさまざまなものがある[20]。そしてこの幻覚はしばしば統合失調症と関連している。この幻覚を経験した人は、状況に応じて、幻視された命令に従うこともあれば、従わないこともある。非暴力的な命令であれば、従うことがより一般的である[21]。

命令幻覚は、しばしば殺人など、犯した犯罪を弁護するために使われることがある[22]。これは、人の耳に聞こえる声で、それが聞き手に何をすべきかを伝えるのである。「立て」や「ドアを閉めろ」といった、極めて穏当な命令であることもある[23]。それが単純なものであろうと、脅威となるものであろうと、やはり「命令幻聴」とみなされる。このような症状があるかどうかを判断するのに役立つ質問には、次のようなものがある。「声は何をするように言っていますか？」「声はいつからあなたに何かをするように言っていますか？」「自分（または他人）を傷つけるように言っている人がわかりますか？」 「声が言っていることをするのに抵抗できると思いますか？」などである[23]。

幻嗅

実際にはないにおいを嗅ぐ異嗅症（嗅覚性幻覚）[24]、実際のにおいを吸い込んだのに記憶と違うにおいと感じる異嗅症（嗅覚性錯覚）は[25]、嗅覚（嗅覚系）のゆがみであり、ほとんどの場合、深刻な原因はなく時間がたてば自然に治ることが多いが、この嗅覚性幻覚と嗅覚性錯覚を併発した場合は注意が必要になる[24]。この併発は、鼻の感染症、鼻ポリープ、歯の問題、偏頭痛、頭部外傷、発作、脳卒中、脳腫瘍など、さまざまな条件によって生じる可能性があるためである[24][26]。喫煙、ある種の化学物質（殺虫剤や溶剤など）への暴露、頭頸部癌の放射線治療など、環境暴露も原因となることがある[24]。また、うつ病、双極性障害、中毒、物質禁断症状、精神疾患（統合失調症など）などの精神障害の症状として現れることもある[26]。知覚される臭いは通常不快で、一般に焦げた臭い、不潔な臭い、甘ったるい臭い、腐った臭いなどと表現される[24]。

幻触覚

幻触覚は、触覚の入力において錯覚が発生し、皮膚や他の器官への様々な種類の圧力がシミュレーションされるものである。幻触覚の1つの亜型である蟻走感は、皮膚の下を虫が這っているような感覚であり、コカインの長期使用と関連していることが多い[27]。しかし、蟻走感は、更年期などの正常なホルモンの変化や、末梢神経障害、高熱、ライム病、皮膚癌などの疾患の結果であることもある[27]。

幻味

このタイプの幻覚は、刺激なしに味を知覚するというものである。このような幻覚は、典型的には奇妙な、あるいは不快なもので、ある種の局所てんかん、特に外側側頭葉てんかんを有する人に比較的よくみられる。この場合、味覚の幻覚に関与する脳の領域は、島皮質とシルビウス裂上である[28][29]。

一般体感幻覚

自分の体がねじられたり、裂かれたり、内臓を抜かれたりしているような幻覚的な体感のことを一般体感幻覚という。また、胃の中のヘビや直腸の中のカエルなど、内臓に動物が侵入していると報告するケースもある。そして自分の体の肉が腐敗しているという一般的な感覚も、この幻覚のタイプに分類される[29][要出典]。

マルチモーダル

感覚様相を含む幻覚はマルチモーダルと呼ばれ、1つの感覚様相しか持たないユニモーダルな幻覚と類似している。複数の感覚様相は、同時にまたは遅れて発生し、互いに関連することもあれば無関係である場合もあり、現実と一致する、またはしないことがありうる[4][5]。例えば、幻覚の中で人が話しているのは現実と一致するが、猫が話しているのは現実と一致しない。

マルチモーダルな幻覚は、精神的な健康状態の悪化と相関しており、よりリアルに感じられることが多い[4]。

病態

さまざまな説が提案されているが、現在のところはっきりとは分かっていない。

中脳辺縁系のドーパミン神経の過活動
ドーパミン作動薬である覚醒剤や大麻の成分が幻覚を起こすこと、幻覚に対してドーパミン拮抗薬である抗精神病薬が有効なことなどから推測される。
自己モニタリング機能の障害
自己と他者の区別を行う機能である自己モニタリング機能が正常に作動している人であれば、空想時などに自己の脳の中で生じる内的な発声を外部からの音声だと知覚することはないが、この機能が障害されている場合、外部からの音声だと知覚して幻聴が生じることになる。

原因

幻覚は、麻薬などの服用、あるいは精神病や心的外傷後ストレス障害 (PTSD) などといった、特殊な状況でのみ起きるわけではない。正常人であっても、夜間の高速道路をずっと走っている時など、刺激の少ない、いわば感覚遮断に近い状態が継続した場合に発生することがある。アイソレーション・タンクのように徹底して感覚を遮断することでも幻覚が見られる。

器質性

脳の器質疾患により幻覚が起こりうる。ナルコレプシー、脳血管障害、脳炎、脳外傷、脳腫瘍、あるタイプのてんかん、痴呆など。

レビー小体型認知症 (DLB) において特徴的な症状である[30][19]。

症状性

全身性の疾患に続発して幻覚が起こることがある。代謝性疾患、内分泌性疾患、神経疾患など。

精神病性

主に統合失調症圏の疾患で幻覚がみられる[19]。統合失調症をはじめ、統合失調症様障害、非定型精神病など。感情障害でも幻聴が起こることがある[31]。

心因性

重度の心因反応、PTSDなど。他に、遭難中に救助者や飲み物の幻覚を見ることは多い。いずれも脳の防衛本能によるものとされる。

薬理性

LSDなどの幻覚剤、覚醒剤、大麻などの薬物使用によって生じることがある。ステロイドなどの治療薬でも幻覚が起こることがある。フラッシュバック (薬物)も起こることもある。

特殊状況下の正常な反応

断眠、感覚遮断、高電磁場など

幻覚の原因と内容の関連

疾患により幻覚の内容が異なる傾向があると言われている。例えば統合失調症では幻聴が、レビー小体病では幻視が、アルコール依存症の離脱症状では小動物幻視（小さい虫などが見える）が多いとされているが、必ずしも全例に当てはまる訳ではない。

脚注

[脚注の使い方]
  1. ^ Purves, Dale; Augustine, George; Fitzpatrick, David; Hall, William C.; LaMantia, Anthony; Mooney, Richard; White, Leonard E. (2018-07-04) (英語). Neuroscience. Sinauer. ISBN 978-1-60535-380-7
  2. ^ “Differential diagnosis and management of hallucinations”. Journal of the Hong Kong Medical Association t 41 (3): 292–7. (1989).
  3. ^ “The neuropharmacology of sleep paralysis hallucinations: serotonin 2A activation and a novel therapeutic drug”. Psychopharmacology 235 (11): 3083–3091. (November 2018). doi:10.1007/s00213-018-5042-1. PMC 6208952. PMID 30288594.
  4. ^ a b c Montagnese, Marcella; Leptourgos, Pantelis; Fernyhough, Charles; Waters, Flavie; Laroi, Frank; Jardri, Renaud; McCarthy-Jones, Simon; Thomas, Neil et al. (2020-02-03). “A Review of Multimodal Hallucinations: Categorisation, Assessment, Theoretical Perspectives And Clinical Recommendations”. Schizophrenia bulletin (Oxford University Press US) 47 (1): 237-248. doi:10.31219/osf.io/zebxv 2022年11月22日閲覧。.
  5. ^ a b Dudley, Robert; Aynsworth, Charlotte; Cheetham, Rea; McCarthy-Jones, Simon; Collerton, Daniel (November 2018). “Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations”. Psychiatry Research 269: 25-30. doi:10.1016/j.psychres.2018.08.032. ISSN 0165-1781. PMID 30145297.
  6. ^ Flavie Waters, MSc (30 December 2014). “Auditory Hallucinations in Adult Populations”. Psychiatric Times. Vol 31 No 12 31 (12) 2021年2月1日閲覧。.
  7. ^ “Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease”. Schizophrenia Bulletin 40 Suppl 4 (4): S233–S245. (July 2014). doi:10.1093/schbul/sbu036. PMC 4141306. PMID 24936084.
  8. ^ “XVIII: That Moles are blinde and have no eyes”. Pseudodoxia Epidemica. III. (1646)
  9. ^ “Recognition of hallucinations: a new multidimensional model and methodology”. Psychopathology 29 (1): 54–63. (1996). doi:10.1159/000284972. PMID 8711076.
  10. ^ “Paracusia”. thefreedictionary.com. 2022年10月29日閲覧。
  11. ^ Abnormal Psychology (6e ed.). McGraw-Hill. (2014). p. 283
  12. ^ “[Differential diagnosis between dissociative disorders and schizophrenia]”. Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica 113 (9): 906–911. (2011). PMID 22117396.
  13. ^ “Hearing Voices: Some People Like It”. LiveScience.com (2006年9月15日). 2006年11月2日時点のオリジナルよりアーカイブ。2006年11月25日閲覧。
  14. ^ Engmann, Birk; Reuter, Mike: "Spontaneous perception of melodies – hallucination or epilepsy?" Nervenheilkunde 2009 Apr 28: 217-221. ISSN 0722-1541
  15. ^ “De novo cerebral arteriovenous malformation: Pink Floyd's song "Brick in the Wall" as a warning sign”. The Journal of Emergency Medicine 43 (1): e17–e20. (July 2012). doi:10.1016/j.jemermed.2009.05.035. PMID 19682829.
  16. ^ “Rare Hallucinations Make Music In The Mind”. ScienceDaily.com (2000年8月9日). 2006年12月5日時点のオリジナルよりアーカイブ。2006年12月31日閲覧。
  17. ^ “Too Much Coffee Can Make You Hear Things That Are Not There”. Medical News Today (2011年6月8日). 2013年3月11日時点のオリジナルよりアーカイブ。2022年10月29日閲覧。
  18. ^ “Approach to the patient with visual hallucinations”. www.uptodate.com. 2014年8月26日時点のオリジナルよりアーカイブ。2014年8月25日閲覧。
  19. ^ a b c d 春日武彦『援助者必携 はじめての精神科』（3版）医学書院、2020年、Chapt.3。ISBN 978-4-260-04235-2。
  20. ^ a b “Acting on command hallucinations: a cognitive approach”. The British Journal of Clinical Psychology 36 (1): 139–148. (February 1997). doi:10.1111/j.2044-8260.1997.tb01237.x. PMID 9051285.
  21. ^ “Command hallucinations among Asian patients with schizophrenia”. Canadian Journal of Psychiatry 49 (12): 838–842. (December 2004). doi:10.1177/070674370404901207. PMID 15679207.
  22. ^ “Insanity Defense Evaluations: Toward a Model for Evidence-Based Practice”. Brief Treatment and Crisis Intervention 8 (1): 92–110. (2008). doi:10.1093/brief-treatment/mhm024.
  23. ^ a b “Uncovering Command Hallucinations”. raining Institute for Suicide Assessment. 2014年1月2日時点のオリジナルよりアーカイブ。2022年10月29日閲覧。
  24. ^ a b c d e HealthUnlocked (2014), Phantosmia (Smelling Odours That Aren't There), オリジナルの2 August 2016時点におけるアーカイブ。 2016年8月6日閲覧。
  25. ^ “Distorted olfactory perception: a systematic review”. Acta Oto-Laryngologica 132 Suppl 1 (S1): S27–S31. (June 2012). doi:10.3109/00016489.2012.659759. PMID 22582778.
  26. ^ a b “Distortion of olfactory perception: diagnosis and treatment”. Chemical Senses 27 (7): 611–615. (September 2002). doi:10.1093/chemse/27.7.611. PMID 12200340.
  27. ^ a b “Tactile hallucinations: conceptual and historical aspects”. Journal of Neurology, Neurosurgery, and Psychiatry 45 (4): 285–293. (April 1982). doi:10.1136/jnnp.45.4.285. PMC 491362. PMID 7042917.
  28. ^ A clinical guide to epileptic syndromes and their treatment (2nd ed.). London: Springer. (2007). ISBN 978-1846286438. "based on the ILAE classification and practice parameter guidelines"
  29. ^ a b Assessment in psychiatric and mental health nursing: in search of the whole person. Cheltenham, UK: Stanley Thornes Publishers. (1997). p. 245. ISBN 978-0748731749
  30. ^ “Dementia with Lewy bodies”. NHS (2015年1月22日). 2015年1月22日閲覧。
  31. ^ “私の頭の中の声”. TED. 2017年12月3日閲覧。

参考文献

関連項目

==

환각

출처: 무료 백과사전 '위키피디아(Wikipedia)'
모호함 회피인공지능의 환각에 대해서는 「하루시네이션(인공지능)」을 봐 주세요.
모호함 회피환각 의 다른 용법에 대해서는 환각 (모호함 회피)을 참조하십시오.
환각
개요
진료과정신의학
분류 및 외부 참조 정보
Patient UK환각

환각 (영어, 영어 : hallucination )은 외부에서 자극이 없을 때 현실의 지각과 유사한 성질을 지각하는 것이다. 환각은 선명하고 실질이 수반되며 외부 객관적 공간 에 위치하도록 인식됩니다. 또한 환각은 두뇌의 각성과 렘 수면이라는 두 가지 의식 상태의 조합이다 [ 1 ] . 이들은 각성을 동반하지 않는 꿈( 렘 수면 ), 현실의 지각을 모방하지 않고, 비현실로서 정확하게 지각하는 위환각, 왜곡되거나 틀린 해석의 현실 지각을 수반하는 착각 , 현실 지각을 모방하지 않는 자발적 제어하에 있는 심상 등의 몇 가지 관련 현상과 구별된다 . 그리고 환각은 정확하게 지각·해석된 자극(현실의 지각)에 어떠한 부가적인 의미를 주는 「망상적 지각」과도 다르다. 많은 환각은 수면 마비 중에도 발생합니다 [ 3 ] .

환각은 시각, 청각, 후각, 미각 , 촉각 , 체성 감각 , 평형 감각, 침해 수용 , 열 수용, 시간 지각의 모든 감각 양상에서 발생할 수 있습니다. 복수의 감각 양상에서 일어나는 환각은 멀티모달( multimodal )이라고 불린다 [ 4 ] [ 5 ] .

가벼운 환각은 "혼란"이라고 불리며 위의 대부분의 감각에 나타날 수 있습니다. 예를 들면, 주변 시야 에 움직임이 보이거나, 희미한 물음이나 목소리가 들리거나 하는 경우이다. 또한 환청은 정신 분열증 에서 매우 흔합니다. 그 경우의 환청은 선의의 것(대상자에게 자신에 대해 좋은 것을 말한다)이거나, 악의가 있는 것(대상자를 매도한다)이기도 한다. 55%의 환청은 악의적인 내용으로 [ 6 ] 예를 들어 대상자에게 직접 말하는 것이 아니라 대상자에 대해 말하는 것과 같다. 또한 환청과 마찬가지로 대상자 뒤에 시각적 대응 물의 발생원이 있는 경우 도 있다 . 그리고 환청과 환시는 종종 함께 체험된다 [ 7 ] .

반면성 환각과 각성시 환각은 정상적인 현상으로 여겨진다. 반면성 환각은 입면시 각성시 환각은 각성시에 발생한다. 환각은 약물 사용 (특히 섬망 ), 수면 부족 , 정신병 , 신경 장애, 진전 섬망 등과 관련이 있습니다.

환각(hallucination)이라는 말 자체는 17세기 의사 토마스 브라운 이 1646년에 마음 속을 방황하라는 의미의 라틴어 'alucinari'에서 파생시켜 영어에 도입했다. 브라운에게 환각이란 "타락 실수로 대상을 받는" 일종의 시각을 의미하고 있었다 [ 8 ] .

분류

환각은 다양한 형태로 나타난다 [ 9 ] . 다양한 형태의 환각은 서로 다른 감각에 영향을 미칠 때 동시에 발생하여 경험자가 여러 감각에서 유래 한 환각을 생성합니다.

환청

환청 은 외부로부터의 자극 없이 소리를 지각하는 것으로, 착청으로도 알려져 있다 [ 10 ] . 환청은 초보적이고 복잡한 것, 그리고 언어적인 것과 비언어적인 것들로 나뉜다. 이러한 환각은 가장 일반적인 유형이며 언어 성 환각은 비언어 성 환각보다 더 일반적입니다 [ 11 ] . 초보적인 환청이란 '슈'라는 소리, 휘파람, 뻗은 소리 등의 소리를 지각하는 것이다. 종종 이명은 초보 적인 환청이다. 그러나 어떤 이명, 특히 박동성 이명을 경험하는 사람들 중 일부는 실제로 귀 근처의 혈관을 흐르는 혈액 소리를 듣는 사람들도 있습니다. 이 경우에는 청각 자극이 있기 때문에 환각으로 인정되지 않는다.

복잡한 환각은 목소리, 음악 및 기타 소리가 분명하게 들릴지, 듣지 못하거나, 친절하거나 공격적이거나, 기타 가능성이 있습니다. 하나 이상의 말하기의 환각은 특히 정신 분열증 과 같은 정신 장애 와 관련이 있으며 이러한 질병을 진단하는 데 특별한 의미를 갖습니다.

정신분열증에서는 보통 목소리는 사람 밖에서 들려오는 것이라고 인식되지만, 해리성 장애에서는 사람 속에서 들려오는 것이라고 인식되며 배후가 아니라 머리 속에서 사람의 목소리가 들린다. 또한 정신 분열증과 해리 성 장애의 감별 진단은 특히 환각과 같은 슈나이더의 일급 증상과 같은 중복되는 증상이 많기 때문에 어려운 것으로 알려져 있다 [ 12 ] . 그러나 진단 가능한 정신 질환이 없는 많은 사람들이 때로는 똑같이 목소리를들을 수 있습니다 [ 13 ] . 착청 환자를 감별 진단 할 때 외측 측두엽 간질인지 여부를 고려하는 것이 중요합니다. 그 밖에도 윌슨병 , 다양한 내분비 질환 , 다수의 대사 이상, 다발성 경화증 , 전신성 홍 반성 루푸스 , 포르피린증, 유육종증 등 많은 질환이 정신병을 나타낼 가능성이 있기 때문에, 정신병 의 특징을 나타냈다고 해도 , 반드시 그 자체가 정신 질환이라고는

음악적인 환청도 복잡한 환청 중에서는 비교적 많아, 난청( 샤를르보네 증후군 의 청각판인 음악이 증후군 등), 외측두엽 간질 [ 14 ] , 동정맥 기형 [ 15 ] , 뇌졸중 , 병소 , 농양, 종양에 이르기까지 폭 넓은 원인 .

카페인 의 대량 섭취는 환청을 경험할 가능성을 높이는 것으로 알려져 있다. 라트로브 대학 심리과학부의 연구에 따르면, 하루 5잔의 커피(약 500mg의 카페인)가 환청을 유발할 가능성이 있는 것이 밝혀졌다 [ 17 ] .

환시

환시란, 「아무것도 존재하지 않는데, 외부의 시각 자극을 지각하는 것」이다 [ 18 ] . 이와는 별도로 관련된 현상에 착시가 있어, 이것은 실제의 외부 자극이 왜곡 된 것이다. 환시는 단순하고 복잡한 것으로 분류됩니다.

  • 단순 환시 (SVH)는 비형성 시각 환각, 초등 시각 환각이라고도 불린다. 이들은 빛, 색, 기하학적 형상 및 불규칙한 물체의 환시를 의미합니다. 또한, 구조가 없는 환시( 안섬 )와 기하학적 구조를 갖는 환시( 광시증 )로 나뉜다.
  • 복잡한 환시 (CVH)는 형성된 환시라고도 불린다. 복잡한 환시는 사람, 동물, 물건, 장소 등 선명하고 리얼한 이미지와 정경이 지각된다.

예를 들어, 기린의 환각이 보인다고 보고될 수 있다. 단순 환시는 기린과 모양과 색이 비슷하다(기린으로 보이는) 부정형의 도형이지만, 복잡한 환시는 틀림없이 기린 그 자체의 개별 실물 큰 이미지가 지각되고 있다.

많은 경우 환시는 의식 혼탁이라는 의식 장애시에 종종 발생하며, 특히 약물 이탈 증상 ( 알코올 등의 중독성 질환 [ 19 ] ) 이나 신경퇴행성 질환, 치매 에서 자주 인정 된다 [ 19 ] .

명령 환각

명령 환각은 외부의 지시처럼 들리는 환각 또는 피험자의 머리 속에서 나오는 것처럼 느껴지는 환각이다 [ 20 ] . 환각의 내용은 무해한 것부터 자신이나 타인에게 해를 가하도록 명령하는 것까지 다양한 것이 있다 [ 20 ] . 그리고이 환각은 종종 정신 분열증 과 관련이 있습니다. 이 환각을 경험한 사람은 상황에 따라 환시된 명령을 따를 수도 있고, 따르지 않을 수도 있다. 비폭력적인 명령이라면 따르는 것이 더 일반적이다 [ 21 ] .

명령 환각은 종종 살인과 같은 범한 범죄를 변호하는 데 사용될 수 있습니다 [ 22 ] . 이것은 사람의 귀에 들리는 목소리로, 그것이 청취자에게 무엇을 해야 하는지를 전하는 것이다. '세워'나 '문을 닫으라'라는 매우 온화한 명령일 수도 있다 [ 23 ] . 그것이 단순한 것이든, 위협이 되는 것이든, 역시 "명령 환청"으로 간주된다. 이러한 증상이 있는지 여부를 판단하는 데 도움이되는 질문은 다음과 같습니다. "목소리는 무엇을 하도록 말하고 있습니까?" "목소리는 언제부터 당신에게 무언가를 하도록 말하고 있습니까 ? "

환각

실제로는 냄새를 맡는 이후증(후각성 환각 ) [ 24 ] , 실제의 냄새를 흡입했는데 기억과 다른 냄새라고 느끼는 이후증(후각성 착각 ) 은 [ 25 ] , 후각 (후각계)의 왜곡이며, 대부분의 경우, 심각한 원인은 없고 시간이 지나면 자연적으로 치유되는 경우가 많지만, 이 후각성 환각과 후각성 착각을 병발한 경우는 주의가 필요하다 [ 24 ] . 이 병발은 코 감염, 코 폴립 , 치아 문제, 편두통, 두부 외상, 발작, 뇌졸중 , 뇌종양 등 다양한 조건에 의해 발생할 수 있기 때문 이다 [ 24 ] [ 26 ] . 흡연, 특정 화학물질(살충제 및 용제 등)에 대한 노출, 두 경부암 의 방사선 치료 등 환경 노출도 원인이 될 수 있다 [ 24 ] . 또한 우울증 , 양극성 장애 , 중독, 물질 금단 증상, 정신 질환 (통합 실조증 등)과 같은 정신 장애의 증상으로 나타날 수 있습니다 [ 26 ] . 인식되는 냄새는 일반적으로 불쾌하며 일반적으로 탄 냄새, 불결한 냄새, 달콤한 냄새, 썩은 냄새 등으로 표현된다 [ 24 ] .

환각

환각은 촉각의 입력에서 환상이 발생하고 피부와 다른 기관에 대한 다양한 종류의 압력이 시뮬레이션되는 것입니다. 환촉각의 하나의 아형인 개주감은 피부 아래를 벌레가 기어가는 것 같은 감각이며, 코카인 의 장기 사용과 관련되는 경우가 많다 [ 27 ] . 그러나 개미감은 폐경과 같은 정상적인 호르몬의 변화와 말초 신경 장애, 고열, 라임병 , 피부암 과 같은 질병 의 결과 일 수 있다 [ 27 ] .

환미

이 유형의 환각은 자극없이 맛을 인식하는 것입니다. 이러한 환각 은 전형적으로 이상하거나 불쾌한 것으로, 특정 국소 간질 , 특히 외측 두엽 간질을 갖는 사람에게 비교적 흔하다. 이 경우 미각의 환각에 관여하는 뇌의 영역은 섬 피질 과 실비 우스 균열 이다 [ 28 ] [ 29 ] .

일반 체감 환각

자신의 몸이 뒤틀리거나, 찢어지거나, 내장을 빼내거나 하고 있는 것 같은 환각적인 체감을 일반 체감 환각이라고 한다. 또, 위 속의 뱀이나 직장 속의 개구리 등, 내장에 동물이 침입 하고 있다고 보고하는 경우도 있다. 그리고 자신의 몸의 고기가 부패하고 있다는 일반적인 감각도, 이 환각의 타입으로 분류된다 [ 29 ] [ 요출전 ] .

멀티 모달

감각양상을 포함한 환각은 멀티모달이라고 불리며, 하나의 감각양상밖에 가지지 않는 유니모달 환각과 유사하다. 복수의 감각 양상은 동시에 또는 늦게 발생할 수 있으며, 서로 관련이 있거나 무관할 수 있으며, 현실과 일치하거나 하지 않을 수 있다 [ 4 ] [ 5 ] . 예를 들어, 환각에서 사람이 말하는 것은 현실과 일치하지만 고양이가 말하는 것은 현실과 일치하지 않습니다.

멀티 모달 환각은 정신적 건강 상태의 악화와 관련이 있으며 더 현실적으로 느껴지는 경우가 많다 [ 4 ] .

병태

다양한 설이 제안되고 있지만, 현재로서는 분명하게는 알려져 있지 않다.

중뇌 변연계의 도파민 신경의 과활동
도파민 작용제인 각성제나 대마초 성분이 환각을 일으키는 것, 환각에 대해 도파민 길항제인 항정신병약이 유효한 것 등으로부터 추측된다.
자체 모니터링 기능 장애
자기와 타자의 구별을 하는 기능인 자기 모니터링 기능이 정상적으로 작동하고 있는 사람이라면 공상시 등에 자기의 뇌 속에서 생기는 내적인 발성을 외부로부터의 음성이라고 지각하지는 않지만, 이 기능이 장애가 있을 경우 외부로부터의 음성이라고 지각하여 환청이 발생하게 된다.

원인

환각은 마약 등의 복용, 혹은 정신병 이나 심적 외상 후 스트레스 장애 (PTSD) 등과 같은 특수한 상황에서만 일어나는 것은 아니다 . 정상인이라도, 야간의 고속도로를 계속 달리고 있을 때 등, 자극이 적은, 이른바 감각 차단 에 가까운 상태가 계속되었을 경우에 발생하는 일이 있다. 아이솔레이션 탱크 처럼 철저히 감각을 차단하는 것도 환각을 볼 수 있다.

기질성

뇌의 기질 질환으로 환각이 발생할 수 있습니다. 나르코렙 시 , 뇌혈관 장애 , 뇌염 , 뇌 외상 , 뇌종양 , 어떤 종류의 간질 , 치매 등.

레비 소체형 치매 (DLB)에서 특징적인 증상이다 [ 30 ] [ 19 ] .

증상성

전신성 질환에 속발하여 환각이 일어날 수 있다. 대사성 질환, 내분비 성 질환, 신경 질환 등.

정신병성

주로 정신 분열증의 질병에서 환각이 보인다 [ 19 ] . 정신 분열증 을 비롯한 정신 분열증과 같은 장애, 비정형 정신병 등. 감정장애에서도 환청이 일어날 수 있다 [ 31 ] .

심인성

심한 심인 반응, PTSD 등. 그 밖에 조난 중에 구조자나 음료의 환각을 보는 경우가 많다. 모두 뇌의 방위 본능에 의한 것으로 여겨진다.

약리성

LSD 와 같은 환각제 , 각성제 , 대마초 등의 약물 사용으로 인해 발생할 수 있습니다. 스테로이드 등의 치료제에서도 환각이 일어날 수 있다. 플래시백(약물)도 일어날 수도 있다.

특수 상황에서 정상적인 반응

단면, 감각 차단, 고전자장 등

환각의 원인과 내용의 관련

질병에 의해 환각의 내용이 다른 경향이 있다고 한다. 예를 들어 정신분열증 에서는 환청이, 레비 소체병 에서는 환시가, 알코올 의존증 의 이탈 증상에서는 작은 동물 환시 (작은 벌레 등이 보인다)가 많다고 여겨지고 있지만, 반드시 전례에 해당되는 것은 아니다.

각주

[ 각주 사용법 ]
  1. ↑ Purves, Dale; Augustine, George; Fitzpatrick, David; Hall, William C.; LaMantia, Anthony; Mooney, Richard; White, Leonard E. (2018-07-04) (영어). Neuroscience . Sinauer. ISBN  978-1-60535-380-7
  2. ↑ “Differential diagnosis and management of hallucinations” . Journal of the Hong Kong Medical Association t 41 (3): 292–7. (1989) .
  3. ↑ “The neuropharmacology of sleep paralysis hallucinations : serotonin 2A activation and a novel therapeutic drug” . Psychopharmacology 235 (11): 3083–3091. (November 2018). doi : 10.1013 PMC  6208952. PMID 30288594 .​ 
  4. ↑ a b c Montagnese, Marcella; Leptourgos, Pantelis; Fernyhough, Charles; Waters, Flavie; Laroi, Frank; Jardri, Renaud; McCarthy-Jones, Simon; Thomas, Neil et al. (2020-02-03). “A Review of Multimodal Hallucinations:Categoris Recommendations” . Schizophrenia bulletin (Oxford University Press US) 47 (1): 237-248. doi : 10.31219/osf.io/zebxv 2022년 11월 22일에 확인함. .
  5. ^ a b Dudley, Robert; Aynsworth, Charlotte ; Cheetham, Rea; McCarthy-Jones, Simon; Collerton, Daniel (November 2018). “Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations ” 3 Ps2 doi : 10.1016/j.psychres.2018.08.032 . ISSN 0165-1781 . PMID 30145297 .  
  6. ↑ Flavie Waters, MSc (30 December 2014). “Auditory Hallucinations in Adult Populations” . Psychiatric Times . Vol 31 No 12 31 (12) 2021년 2월 1일에 확인함. .
  7. ↑ “Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease” . Schizophrenia Bulletin 40 Suppl 4 (4): S233–S245. (July 2014). doi : 10.1093 / s  4141306. PMID 24936084 .​ 
  8. ↑ “XVIII: That Moles are blinde and have no eyes”. Pseudodoxia Epidemica . III . (1646)
  9. ↑ “Recognition of hallucinations: a new multidimensional model and methodology”. Psychopathology 29 (1): 54–63. (1996). doi : 10.1159/000284972 . PMID 8711076 . 
  10. ↑ “ Paracusia ”. thefreedictionary.com. 2022년 10월 29일에 확인함.
  11. ↑ Abnormal Psychology (6e ed.). McGraw-Hill. (2014). p. 283
  12. ↑ “[Differential diagnosis between dissociative disorders and schizophrenia]”. Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica 113 (9): 906–911. (2011). PMID 22117396 . 
  13. ^ “ Hearing Voices: Some People Like It ”. LiveScience.com (2006년 9월 15일). 2006년 11월 2일 시점의 오리지널보다 아카이브 . 2006년 11월 25일에 확인함.
  14. ↑ Engmann, Birk; Reuter, Mike: "Spontaneous perception of melodies – hallucination or epilepsy?" Nervenheilkunde 2009 Apr 28: 217-221. ISSN 0722-1541 
  15. ↑ “De novo cerebral arteriovenous malformation: Pink Floyd's song "Brick in the Wall" as a warning sign”. The Journal of Emergency Medicine 43 (1): e17–e20. (July 2012). doi : 10.1010/2 . PMID 19682829 . 
  16. ^ “ Rare Hallucinations Make Music In The Mind ”. ScienceDaily.com (2000년 8월 9일). 2006년 12월 5일 시점의 오리지널보다 아카이브 . 2006년 12월 31일에 확인함.
  17. ^ “ Too Much Coffee Can Make You Hear Things That Are Not There ”. Medical News Today (2011년 6월 8일). 2013년 3월 11일 시점의 오리지널 보다 아카이브. 2022년 10월 29일에 확인함.
  18. ^ “ Approach to the patient with visual hallucinations ”. www.uptodate.com . 2014년 8월 26일 시점의 오리지널보다 아카이브 . 2014년 8월 25일에 확인함.
  19. ↑ a b c d 가스가 타케히코 『원조자 필휴 처음의 정신과』(3판) 의학 서원, 2020년, Chapt.3. ISBN 978-4-260-04235-2 . 
  20. ^ a b “Acting on command hallucinations: a cognitive approach”. The British Journal of Clinical Psychology 36 ( 1): 139–148. (February 1997). doi : 10.1111 /j.2044-8260.19 9051285 . 
  21. ↑ “Command hallucinations among Asian patients with schizophrenia”. Canadian Journal of Psychiatry 49 ( 12 ): 838–842. (December 2004). doi : 10.1177/070674370404901207 . 
  22. ↑ “Insanity Defense Evaluations: Toward a Model for Evidence-Based Practice”. Brief Treatment and Crisis Intervention 8 (1): 92–110. (2008). doi : 10.1093/brief-treatment/mhm024 .
  23. ^ a b “ Uncovering Command Hallucinations ”. raining Institute for Suicide Assessment . 2014년 1월 2일 시점의 오리지널보다 아카이브 . 2022년 10월 29일에 확인함.
  24. ^ a b c d e HealthUnlocked (2014), Phantosmia (Smelling Odours That Aren't There) , 원래 2 August 2016 시점의 아카이브. 2016년 8월 6일에 확인함.
  25. ↑ “Distorted olfactory perception: a systematic review”. Acta Oto-Laryngologica 132 Suppl 1 ( S1): S27 –S31 . (June 2012). doi : 10.3109/00016489.2012.6597 
  26. ^ a b “Distortion of olfactory perception: diagnosis and treatment”. Chemical Senses 27 (7): 611–615. (September 2002). doi : 10.1093/chemse/27.7.611 . PMID 122003 
  27. ↑ “ Tactile hallucinations: conceptual and historical aspects” . Journal of Neurology, Neurosurgery, and Psychiatry 45 ( 4 ): 285–293. (April 1982) . doi : 10.1136 / jnnp . 7042917 .   
  28. ^ A clinical guide to epileptic syndromes and their treatment (2nd ed.). London: Springer. (2007). ISBN 978-1846286438 . "based on the ILAE classification and practice parameter guidelines"  
  29. ^ a b Assessment in psychiatric and mental health nursing: in search of the whole person . Cheltenham, UK: Stanley Thornes Publishers. (1997). p. 245. ISBN 978-0748731749  
  30. ↑ “ Dementia with Lewy bodies ”. NHS (2015년 1월 22일). 2015년 1월 22일에 확인함.
  31. ↑ “ 내 머리 속의 목소리 ”. TED . 2017년 12월 3일에 확인함.

참고문헌

관련 항목

==

==

Hallucination

From Wikipedia, the free encyclopedia
For other uses, see Hallucination (disambiguation).
"Hallucinate" redirects here. For the song, see Hallucinate (song).
Hallucination
My eyes at the moment of the apparitions by August Natterer, a German artist who created many drawings of his hallucinations
SpecialtyPsychiatry
CausesHypnagogia, Peduncular hallucinosis, Delirium tremens, Parkinson's disease, Delusion, Lewy body dementia, Charles Bonnet syndrome, hallucinogens, sensory deprivation, schizophrenia, psychedelics, sleep paralysis, drug intoxication or withdrawal, sleep deprivation, epilepsy, psychological stress, non-celiac gluten sensitivity, fever,[1] covert weaponry[2][3]
TreatmentCognitive behavioral therapy[4] and metacognitive training[5]
MedicationAntipsychotic, AAP

A hallucination is a perception in the absence of an external context stimulus that has the compelling sense of reality.[6] They are distinguishable from several related phenomena, such as dreaming (REM sleep), which does not involve wakefulness; pseudohallucination, which does not mimic real perception, and is accurately perceived as unreal; illusion, which involves distorted or misinterpreted real perception; and mental imagery, which does not mimic real perception, and is under voluntary control.[7] Hallucinations also differ from "delusional perceptions", in which a correctly sensed and interpreted stimulus (i.e., a real perception) is given some additional significance.[8]

Hallucinations can occur in any sensory modality—visual, auditory, olfactory, gustatory, tactile, proprioceptive, equilibrioceptive, nociceptive, thermoceptive and chronoceptive. Hallucinations are referred to as multimodal if multiple sensory modalities occur.[9][10]

A mild form of hallucination is known as a disturbance, and can occur in most of the senses above. These may be things like seeing movement in peripheral vision, or hearing faint noises or voices. Auditory hallucinations are very common in schizophrenia. They may be benevolent (telling the subject good things about themselves) or malicious (cursing the subject). 55% of auditory hallucinations are malicious in content,[11] for example, people talking about the subject, not speaking to them directly. Like auditory hallucinations, the source of the visual counterpart can also be behind the subject. This can produce a feeling of being looked or stared at, usually with malicious intent.[12][13] Frequently, auditory hallucinations and their visual counterpart are experienced by the subject together.[14]

Hypnagogic hallucinations and hypnopompic hallucinations are considered normal phenomena. Hypnagogic hallucinations can occur as one is falling asleep and hypnopompic hallucinations occur when one is waking up. Hallucinations can be associated with drug use (particularly deliriants), sleep deprivation, psychosis (including stress-related psychosis[15]), neurological disorders, and delirium tremens. Many hallucinations happen also during sleep paralysis.[16]

The word "hallucination" itself was introduced into the English language by the 17th-century physician Sir Thomas Browne in 1646 from the derivation of the Latin word alucinari meaning to wander in the mind. For Browne, hallucination means a sort of vision that is "depraved and receive[s] its objects erroneously".[17]

Classification

Hallucinations may be manifested in a variety of forms.[18] Various forms of hallucinations affect different senses, sometimes occurring simultaneously, creating multiple sensory hallucinations for those experiencing them.[9]

Auditory

Main article: Auditory hallucination

Auditory hallucinations (also known as paracusia)[19] are the perception of sound without outside stimulus. Auditory hallucinations can be divided into elementary and complex, along with verbal and nonverbal. These hallucinations are the most common type of hallucination, with auditory verbal hallucinations being more common than nonverbal.[20][21] Elementary hallucinations are the perception of sounds such as hissing, whistling, an extended tone, and more.[22] In many cases, tinnitus is an elementary auditory hallucination.[21] However, some people who experience certain types of tinnitus, especially pulsatile tinnitus, are actually hearing the blood rushing through vessels near the ear. Because the auditory stimulus is present in this situation, it does not qualify it as a hallucination.[23]

Complex hallucinations are those of voices, music,[21] or other sounds that may or may not be clear, may or may not be familiar, and may be friendly, aggressive, or among other possibilities. A hallucination of a single individual person of one or more talking voices is particularly associated with psychotic disorders such as schizophrenia, and hold special significance in diagnosing these conditions.[24]

In schizophrenia, voices are normally perceived coming from outside the person, but in dissociative disorders they are perceived as originating from within the person, commenting in their head instead of behind their back. Differential diagnosis between schizophrenia and dissociative disorders is challenging due to many overlapping symptoms, especially Schneiderian first rank symptoms such as hallucinations.[25] However, many people who do not have a diagnosable mental illness may sometimes hear voices as well.[26] One important example to consider when forming a differential diagnosis for a patient with paracusia is lateral temporal lobe epilepsy. Despite the tendency to associate hearing voices, or otherwise hallucinating, and psychosis with schizophrenia or other psychiatric illnesses, it is crucial to take into consideration that, even if a person does exhibit psychotic features, they do not necessarily have a psychiatric disorder on its own. Disorders such as Wilson's disease, various endocrine diseases, numerous metabolic disturbances, multiple sclerosis, systemic lupus erythematosus, porphyria, sarcoidosis, and many others can present with psychosis.[27]

Musical hallucinations are also relatively common in terms of complex auditory hallucinations and may be the result of a wide range of causes ranging from hearing-loss (such as in musical ear syndrome, the auditory version of Charles Bonnet syndrome), lateral temporal lobe epilepsy,[28] arteriovenous malformation,[29] stroke, lesion, abscess, or tumor.[30]

The Hearing Voices Movement is a support and advocacy group for people who hallucinate voices, but do not otherwise show signs of mental illness or impairment.[31]

High caffeine consumption has been linked to an increase in likelihood of one experiencing auditory hallucinations.[32] A study conducted by the La Trobe University School of Psychological Sciences revealed that as few as five cups of coffee a day (approximately 500 mg of caffeine) could trigger the phenomenon.[33]

Visual

Main article: Visual hallucination
See also: Pareidolia and Palinopsia

A visual hallucination is "the perception of an external visual stimulus where none exists".[34] A separate but related phenomenon is a visual illusion, which is a distortion of a real external stimulus. Visual hallucinations are classified as simple or complex:

  • Simple visual hallucinations (SVH) are also referred to as non-formed visual hallucinations and elementary visual hallucinations. These terms refer to lights, colors, geometric shapes, and indiscrete objects. These can be further subdivided into phosphenes which are SVH without structure, and photopsias which are SVH with geometric structures.
  • Complex visual hallucinations (CVH) are also referred to as formed visual hallucinations. CVHs are clear, lifelike images or scenes such as people, animals, objects, places, etc.

For example, one may report hallucinating a giraffe. A simple visual hallucination is an amorphous figure that may have a similar shape or color to a giraffe (looks like a giraffe), while a complex visual hallucination is a discrete, lifelike image that is, unmistakably, a giraffe.

Command

See also: Bicameral mentality

Command hallucinations are hallucinations in the form of commands; they appear to be from an external source, or can appear coming from the subject's head.[35] The contents of the hallucinations can range from the innocuous to commands to cause harm to the self or others.[35] Command hallucinations are often associated with schizophrenia. People experiencing command hallucinations may or may not comply with the hallucinated commands, depending on the circumstances. Compliance is more common for non-violent commands.[36]

Command hallucinations are sometimes used to defend a crime that has been committed, often homicides.[37] In essence, it is a voice that one hears and it tells the listener what to do. Sometimes the commands are quite benign directives such as "Stand up" or "Shut the door."[38] Whether it is a command for something simple or something that is a threat, it is still considered a "command hallucination." Some helpful questions that can assist one in determining if they may have this includes: "What are the voices telling you to do?", "When did your voices first start telling you to do things?", "Do you recognize the person who is telling you to harm yourself (or others)?", "Do you think you can resist doing what the voices are telling you to do?"[38]

Olfactory

Main articles: Phantosmia and Parosmia

Phantosmia (olfactory hallucinations), smelling an odor that is not actually there,[39] and parosmia (olfactory illusions), inhaling a real odor but perceiving it as different scent than remembered,[40] are distortions to the sense of smell (olfactory system), and in most cases, are not caused by anything serious and will usually go away on their own in time.[39] It can result from a range of conditions such as nasal infections, nasal polyps, dental problems, migraines, head injuries, seizures, strokes, or brain tumors.[39][41] Environmental exposures can sometimes cause it as well, such as smoking, exposure to certain types of chemicals (e.g., insecticides or solvents), or radiation treatment for head or neck cancer.[39] It can also be a symptom of certain mental disorders such as depression, bipolar disorder, intoxication, substance withdrawal, or psychotic disorders (e.g., schizophrenia).[41] The perceived odors are usually unpleasant and commonly described as smelling burned, foul, spoiled, or rotten.[39]

Tactile

Main article: Tactile hallucination

Tactile hallucinations are the illusion of tactile sensory input, simulating various types of pressure to the skin or other organs. One subtype of tactile hallucination, formication, is the sensation of insects crawling underneath the skin and is frequently associated with prolonged cocaine use.[42] However, formication may also be the result of normal hormonal changes such as menopause, or disorders such as peripheral neuropathy, high fevers, Lyme disease, skin cancer, and more.[42]

Gustatory

This type of hallucination is the perception of taste without a stimulus. These hallucinations, which are typically strange or unpleasant, are relatively common among individuals who have certain types of focal epilepsy, especially temporal lobe epilepsy. The regions of the brain responsible for gustatory hallucination in this case are the insula and the superior bank of the sylvian fissure.[43][44]

Sexual

Sexual hallucinations are the perception of erogenous or orgasmic stimuli. They may be unimodal or multimodal in nature and frequently involve sensation in the genital region, though it is not exclusive.[45] Frequent examples of sexual hallucinations include the sensation of being penetrated, experiencing orgasm, feeling as if one is being touched in an erogenous zone, sensing stimulation in the genitals, feeling the fondling of one's breasts or buttocks and tastes or smells related to sexual activity.[46] Visualizations of sexual content and auditory voices making sexually explicit remarks may sometimes be included in this classification. While it features components of other classifications, sexual hallucinations are distinct due to the orgasmic component and unique presentation.[47]

The regions of the brain responsible differ by the subsection of sexual hallucination. In orgasmic auras, the mesial temporal lobe, right amygdala and hippocampus are involved.[48][49] In males, genital specific sensations are related to the postcentral gyrus and arousal and ejaculation are linked to stimulation in the posterior frontal lobe.[50][51] In females, however, the hippocampus and amygdala are connected.[51][52] Limited studies have been done to understand the mechanism of action behind sexual hallucinations in epilepsy, substance use, and post-traumatic stress disorder etiologies.[47]

Somatic

Somatic hallucinations refer to an interoceptive sensory experience in the absence of stimulus. Somatic hallucinations can be broken down into further subcategories: general, algesic, kinesthetic, and cenesthopathic.[45][47]

  • Cenesthopathic- Effecting the cenesthetic sensory modality, cenesthopathic hallucinations are a pathological alteration in the sense of bodily existence, caused by aberrant bodily sensations. Most often, cenesthopathic hallucinations will refer to sensation in the visceral organs. Therefore, it is also known as visceral hallucinations.[53][47] Manifestations are often subjective, hard to describe and unique to the sufferer. Common manifestations include pressure, burning, tickling, or tightening in various body systems.[54] While these hallucinations can be experienced by a variety of psychiatric and neurological disorder, cenesthopathic schizophrenia is recognized by the ICD as a subtype of schizophrenia marked by primarily cenesthopathic hallucinations and other body image aberrations.[55][47]
  • Kinesthetic- Kinesthetic hallucinations, effecting the sensory modality of the same name, are the sensation of movement of the limbs or other body parts without actual movement.[56][47][54][53]
  • Algesic- Algesic hallucinations, effecting the algesic sensory modality, refers to a perceived perception of pain.[47][54][53]
  • General- General somatic hallucination refers to somatic hallucinations not otherwise categorized by the above subsections. Common examples include when an individual feels that their body is being mutilated, i.e. twisted, torn, or disemboweled. Other reported cases are invasion by animals in the person's internal organs, such as snakes in the stomach or frogs in the rectum. The general feeling that one's flesh is decomposing is also classified under this type of this hallucination.[47]

Multimodal

A hallucination involving sensory modalities is called multimodal, analogous to unimodal hallucinations which have only one sensory modality. The multiple sensory modalities can occur at the same time (simultaneously) or with a delay (serial), be related or unrelated to each other, and be consistent with reality (congruent) or not (incongruent).[9][10] For example, a person talking in a hallucination would be congruent with reality, but a cat talking would not be.

Multimodal hallucinations are correlated to poorer mental health outcomes, and are often experienced as feeling more real.[9]

Cause

See also: Psychosis (causes)

Hallucinations can be caused by a number of factors.[3]

Hypnagogic hallucination

Main article: Hypnagogia

These hallucinations occur just before falling asleep and affect a high proportion of the population: in one survey 37% of the respondents experienced them twice a week.[57] The hallucinations can last from seconds to minutes; all the while, the subject usually remains aware of the true nature of the images. These may be associated with narcolepsy. Hypnagogic hallucinations are sometimes associated with brainstem abnormalities, but this is rare.[58]

Peduncular hallucinosis

Main article: Peduncular hallucinosis

Peduncular means pertaining to the peduncle, which is a neural tract running to and from the pons on the brain stem. These hallucinations usually occur in the evenings, but not during drowsiness, as in the case of hypnagogic hallucination. The subject is usually fully conscious and then can interact with the hallucinatory characters for extended periods of time. As in the case of hypnagogic hallucinations, insight into the nature of the images remains intact. The false images can occur in any part of the visual field, and are rarely polymodal.[58]

Delirium tremens

Main article: Delirium tremens

One of the more enigmatic forms of visual hallucination is the highly variable, possibly polymodal delirium tremens. It is associated with withdrawal in alcohol use disorder. Individuals with delirium tremens may be agitated and confused, especially in the later stages of this disease.[59] Insight is gradually reduced with the progression of this disorder. Sleep is disturbed and occurs for a shorter period of time, with rapid eye movement sleep.[60]

Parkinson's disease and Lewy body dementia

Parkinson's disease is linked with Lewy body dementia for their similar hallucinatory symptoms. Presence hallucinations can be an early indicator of cognitive decline in Parkinson's Disease.[61] The symptoms strike during the evening in any part of the visual field, and are rarely polymodal. The segue into hallucination may begin with illusions[62] where sensory perception is greatly distorted, but no novel sensory information is present. These typically last for several minutes, during which time the subject may be either conscious and normal or drowsy/inaccessible. Insight into these hallucinations is usually preserved and REM sleep is usually reduced. Parkinson's disease is usually associated with a degraded substantia nigra pars compacta, but recent evidence suggests that PD affects a number of sites in the brain. Some places of noted degradation include the median raphe nuclei, the noradrenergic parts of the locus coeruleus, and the cholinergic neurons in the parabrachial area and pedunculopontine nuclei of the tegmentum.[58]

Migraine coma

This type of hallucination is usually experienced during the recovery from a comatose state. The migraine coma can last for up to two days, and a state of depression is sometimes comorbid. The hallucinations occur during states of full consciousness, and insight into the hallucinatory nature of the images is preserved. It has been noted that ataxic lesions accompany the migraine coma.[58]

Migraine attacks

See also: Migraine aura and Scintillating scotoma

Migraine attacks may result in visual hallucinations including auras and in rarer cases, auditory hallucinations.[63]

Charles Bonnet syndrome

Charles Bonnet syndrome is the name given to visual hallucinations experienced by a partially or severely sight impaired person. The hallucinations can occur at any time and can distress people of any age, as they may not initially be aware that they are hallucinating. They may fear for their own mental health initially, which may delay them sharing with carers until they start to understand it themselves. The hallucinations can frighten and disconcert as to what is real and what is not. The hallucinations can sometimes be dispersed by eye movements, or by reasoned logic such as, "I can see fire but there is no smoke and there is no heat from it" or perhaps, "We have an infestation of rats but they have pink ribbons with a bell tied on their necks." Over elapsed months and years, the hallucinations may become more or less frequent with changes in ability to see. The length of time that the sight impaired person can have these hallucinations varies according to the underlying speed of eye deterioration. A differential diagnosis are ophthalmopathic hallucinations.[64]

Focal epilepsy

Visual hallucinations due to focal seizures differ depending on the region of the brain where the seizure occurs. For example, visual hallucinations during occipital lobe seizures are typically visions of brightly colored, geometric shapes that may move across the visual field, multiply, or form concentric rings and generally persist from a few seconds to a few minutes. They are usually unilateral and localized to one part of the visual field on the contralateral side of the seizure focus, typically the temporal field. However, unilateral visions moving horizontally across the visual field begin on the contralateral side and move toward the ipsilateral side.[43][65]

Temporal lobe seizures, on the other hand, can produce complex visual hallucinations of people, scenes, animals, and more as well as distortions of visual perception. Complex hallucinations may appear to be real or unreal, may or may not be distorted with respect to size, and may seem disturbing or affable, among other variables. One rare but notable type of hallucination is heautoscopy, a hallucination of a mirror image of one's self. These "other selves" may be perfectly still or performing complex tasks, may be an image of a younger self or the present self, and tend to be briefly present. Complex hallucinations are a relatively uncommon finding in temporal lobe epilepsy patients. Rarely, they may occur during occipital focal seizures or in parietal lobe seizures.[43]

Distortions in visual perception during a temporal lobe seizure may include size distortion (micropsia or macropsia), distorted perception of movement (where moving objects may appear to be moving very slowly or to be perfectly still), a sense that surfaces such as ceilings and even entire horizons are moving farther away in a fashion similar to the dolly zoom effect, and other illusions.[66] Even when consciousness is impaired, insight into the hallucination or illusion is typically preserved.[67]

Drug-induced hallucination

Main article: Hallucinogen

Drug-induced hallucinations are caused by hallucinogens, dissociatives, and deliriants, including many drugs with anticholinergic actions and certain stimulants, which are known to cause visual and auditory hallucinations. Some psychedelics such as lysergic acid diethylamide (LSD) and psilocybin can cause hallucinations that range in the spectrum of mild to intense.[citation needed]

Hallucinations, pseudohallucinations, or intensification of pareidolia, particularly auditory, are known side effects of opioids to different degrees—it may be associated with the absolute degree of agonism or antagonism of especially the kappa opioid receptor, sigma receptors, delta opioid receptor and the NMDA receptors or the overall receptor activation profile as synthetic opioids like those of the pentazocine, levorphanol, fentanyl, pethidine, methadone and some other families are more associated with this side effect than natural opioids like morphine and codeine and semi-synthetics like hydromorphone, amongst which there also appears to be a stronger correlation with the relative analgesic strength. Three opioids, Cyclazocine (a benzormorphan opioid/pentazocine relative) and two levorphanol-related morphinan opioids, Cyclorphan and Dextrorphan are classified as hallucinogens, and Dextromethorphan as a dissociative.[68][69][70] These drugs also can induce sleep (relating to hypnagogic hallucinations) and especially the pethidines have atropine-like anticholinergic activity, which was possibly also a limiting factor in the use, the psychotomimetic side effects of potentiating morphine, oxycodone, and other opioids with scopolamine (respectively in the Twilight Sleep technique and the combination drug Skophedal, which was eukodal (oxycodone), scopolamine and ephedrine, called the "wonder drug of the 1930s" after its invention in Germany in 1928, but only rarely specially compounded today) (q.q.v.).[71]

Sensory deprivation hallucination

Hallucinations can be caused by sensory deprivation when it occurs for prolonged periods of time, and almost always occurs in the modality being deprived (visual for blindfolded/darkness, auditory for muffled conditions, etc.)[72]

Experimentally-induced hallucinations

Main article: Hallucinations in the sane

Anomalous experiences, such as so-called benign hallucinations, may occur in a person in a state of good mental and physical health, even in the apparent absence of a transient trigger factor such as fatigue, intoxication or sensory deprivation.

The evidence for this statement has been accumulating for more than a century. Studies of benign hallucinatory experiences go back to 1886 and the early work of the Society for Psychical Research,[73][74] which suggested approximately 10% of the population had experienced at least one hallucinatory episode in the course of their life. More recent studies have validated these findings; the precise incidence found varies with the nature of the episode and the criteria of "hallucination" adopted, but the basic finding is now well-supported.[75]

Non-celiac gluten sensitivity

There is tentative evidence of a relationship with non-celiac gluten sensitivity, the so-called "gluten psychosis".[76]

Pathophysiology

Dopaminergic and serotonergic hallucinations

It has been reported that in serotonergic hallucinations, the person maintains an awareness that they are hallucinating, unlike dopaminergic hallucinations.[16]

Neuroanatomy

Hallucinations are associated with structural and functional abnormalities in primary and secondary sensory cortices. Reduced grey matter in regions of the superior temporal gyrus/middle temporal gyrus, including Broca's area, is associated with auditory hallucinations as a trait, while acute hallucinations are associated with increased activity in the same regions along with the hippocampus, parahippocampus, and the right hemispheric homologue of Broca's area in the inferior frontal gyrus.[77] Grey and white matter abnormalities in visual regions are associated with hallucinations in diseases such as Alzheimer's disease, further supporting the notion of dysfunction in sensory regions underlying hallucinations.[78]

One proposed model of hallucinations posits that over-activity in sensory regions, which is normally attributed to internal sources via feedforward networks to the inferior frontal gyrus, is interpreted as originating externally due to abnormal connectivity or functionality of the feedforward network.[77] This is supported by cognitive studies of those with hallucinations, who have demonstrated abnormal attribution of self generated stimuli.[79]

Disruptions in thalamocortical circuitry may underlie the observed top down and bottom up dysfunction.[80] Thalamocortical circuits, composed of projections between thalamic and cortical neurons and adjacent interneurons, underlie certain electrophysical characteristics (gamma oscillations) that are associated with sensory processing. Cortical inputs to thalamic neurons enable attentional modulation of sensory neurons. Dysfunction in sensory afferents, and abnormal cortical input may result in pre-existing expectations modulating sensory experience, potentially resulting in the generation of hallucinations. Hallucinations are associated with less accurate sensory processing, and more intense stimuli with less interference are necessary for accurate processing and the appearance of gamma oscillations (called "gamma synchrony"). Hallucinations are also associated with the absence of reduction in P50 amplitude in response to the presentation of a second stimuli after an initial stimulus; this is thought to represent failure to gate sensory stimuli, and can be exacerbated by dopamine release agents.[81]

Abnormal assignment of salience to stimuli may be one mechanism of hallucinations. Dysfunctional dopamine signaling may lead to abnormal top down regulation of sensory processing, allowing expectations to distort sensory input.[82]

Treatments

There are few treatments for many types of hallucinations. However, for those hallucinations caused by mental disease, a psychologist or psychiatrist should be consulted, and treatment will be based on the observations of those doctors. Antipsychotic and atypical antipsychotic medication may also be utilized to treat the illness if the symptoms are severe and cause significant distress.[83] For other causes of hallucinations there is no factual evidence to support any one treatment is scientifically tested and proven. However, abstaining from hallucinogenic drugs, stimulant drugs, managing stress levels, living healthily, and getting plenty of sleep can help reduce the prevalence of hallucinations. In all cases of hallucinations, medical attention should be sought out and informed of one's specific symptoms. Meta-analyses show that cognitive behavioral therapy[4] and metacognitive training[5] can also reduce the severity of hallucinations. Furthermore, there are recovery movements all around the world that advocate for individuals with schizophrenia or voice-hearers (individuals that hear voices). The Hearing Voices Movement,[84][circular reference] starting in Europe, aims to[neutrality is disputed] utilize knowledge and experience of voice hearers combined with experts in disorders such as schizophrenia, such as psychiatrists.

Epidemiology

Prevalence of hallucinations varies depending on underlying medical conditions,[85][9] which sensory modalities are affected,[10] age[86][85] and culture.[87] As of 2022, auditory hallucinations are the most well studied and most common sensory modality of hallucinations, with an estimated lifetime prevalence of 9.6%.[86] Children and adolescents have been found to experience similar rates (12.7% and 12.4% respectively) which occur mostly during late childhood and adolescence. In this group, hallucinations are not necessarily indicative of later psychopathology and are recognized to occur on a continuum which includes normal, transient hallucinatory phenomena.[88] However, hallucinations become increasingly associated with psychopathology in late adolescence.[88]

The prevalence of hallucinations in adults and those over 60 is comparatively lower (with rates of 5.8% and 4.8% respectively).[86][85] For those with schizophrenia, the lifetime prevalence of hallucinations is 80%[9] and the estimated prevalence of visual hallucinations is 27%, compared to 79% for auditory hallucinations.[9] A 2019 study suggested 16.2% of adults with hearing impairment experience hallucinations, with prevalence rising to 24% in the most hearing impaired group.[89]

A risk factor for multimodal hallucinations is prior experience of unimodal hallucinations.[9] In 90% cases of psychosis, a visual hallucination occurs in combination with another sensory modality, most often being auditory or somatic.[9] In schizophrenia, multimodal hallucinations are twice as common as unimodal ones.[9]

A 2015 review of 55 publications from 1962 to 2014 found 16–28.6% of those experiencing hallucinations report at least some religious content in them,[90]: 415  along with 20–60% reporting some religious content in delusions.[90]: 415  There is some evidence for delusions being a risk factor for religious hallucinations, with and 61.7% of people having experienced any delusion and 75.9% of those having experienced a religious delusion found to also experience hallucinations.[90]: 421 

See also

References

  1.  Adamis D, Treloar A, Martin FC, Macdonald AJ (December 2007). "A brief review of the history of delirium as a mental disorder". History of Psychiatry. 18 (72 Pt 4): 459–69. doi:10.1177/0957154X07076467. hdl:2262/51619. PMID 18590023. S2CID 24424207.
  2.  Burke M (4 February 2019). "Russian Navy has new weapon that makes targets hallucinate, vomit: Report". The Hill.
  3.  Patterson C, Procter N (2023-05-24). "Hallucinations in the movies tend to be about chaos, violence and mental distress. But they can be positive too". The Conversation. Archived from the original on 2023-05-28. Retrieved 2023-05-28.
  4.  Turner DT, Burger S, Smit F, Valmaggia LR, van der Gaag M (March 2020). "What Constitutes Sufficient Evidence for Case Formulation-Driven CBT for Psychosis? Cumulative Meta-analysis of the Effect on Hallucinations and Delusions". Schizophrenia Bulletin. 46 (5): 1072–1085. doi:10.1093/schbul/sbaa045. PMC 7505201. PMID 32221536.
  5.  Penney D, Sauvé G, Mendelson D, Thibaudeau É, Moritz S, Lepage M (March 2022). "Immediate and Sustained Outcomes and Moderators Associated With Metacognitive Training for Psychosis: A Systematic Review and Meta-analysis". JAMA Psychiatry. 79 (5): 417–429. doi:10.1001/jamapsychiatry.2022.0277. PMC 8943641. PMID 35320347.
  6.  El-Mallakh RS, Walker KL (2010). "Hallucinations, Psuedohallucinations, and Parahallucinations". Psychiatry: Interpersonal and Biological Processes. 73 (1): 34–42. doi:10.1521/psyc.2010.73.1.34. PMID 20235616. Retrieved 8 May 2024.
  7.  Chiu LP (1989). "Differential diagnosis and management of hallucinations" (PDF). Journal of the Hong Kong Medical Association. t 41 (3): 292–7. Archived (PDF) from the original on 2021-02-24. Retrieved 2014-05-29.
  8.  Adámek P, Langová V, Horáček J (2022-03-21). "Early-stage visual perception impairment in schizophrenia, bottom-up and back again". Schizophrenia. 8 (1): 27. doi:10.1038/s41537-022-00237-9. ISSN 2754-6993. PMC 8938488. PMID 35314712.
  9.  Montagnese M, Leptourgos P, Fernyhough C, Waters F, Larøi F, Jardri R, et al. (January 2021). "A Review of Multimodal Hallucinations: Categorization, Assessment, Theoretical Perspectives, and Clinical Recommendations". Schizophrenia Bulletin. 47 (1): 237–248. doi:10.31219/osf.io/zebxv. PMC 7825001. PMID 32772114. S2CID 243338891.
  10.  Dudley R, Aynsworth C, Cheetham R, McCarthy-Jones S, Collerton D (November 2018). "Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations". Psychiatry Research. 269: 25–30. doi:10.1016/j.psychres.2018.08.032. PMID 30145297. S2CID 52092886.
  11.  Waters F (30 December 2014). "Auditory Hallucinations in Adult Populations". Psychiatric Times. Vol 31 No 12. 31 (12). Archived from the original on 2022-06-07. Retrieved 2021-02-01.
  12.  "The Sense of Being Stared At -- Part 1: Is it Real or Illusory?".
  13.  "Auditory Hallucinations". clevelandclinic.org.
  14.  Waters F, Collerton D, Ffytche DH, Jardri R, Pins D, Dudley R, et al. (July 2014). "Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease". Schizophrenia Bulletin. 40 (4): S233 – S245. doi:10.1093/schbul/sbu036. PMC 4141306. PMID 24936084.
  15.  Prateek Varshney, Santosh Kumar Chaturvedi: Stress related and stress induced psychosis
  16.  Jalal B (November 2018). "The neuropharmacology of sleep paralysis hallucinations: serotonin 2A activation and a novel therapeutic drug". Psychopharmacology. 235 (11): 3083–3091. doi:10.1007/s00213-018-5042-1. PMC 6208952. PMID 30288594.
  17.  Browne T (1646). "XVIII: That Moles are blinde and have no eyes". Pseudodoxia Epidemica. Vol. III.
  18.  Chen E, Berrios GE (1996). "Recognition of hallucinations: a new multidimensional model and methodology". Psychopathology. 29 (1): 54–63. doi:10.1159/000284972. PMID 8711076.
  19.  "Paracusia". thefreedictionary.com. Archived from the original on 2008-05-16. Retrieved 2008-08-13.
  20.  Nolen-Hoeksema S (2014). Abnormal Psychology (6e ed.). McGraw-Hill. p. 283.
  21.  "Auditory Hallucinations: Causes, Symptoms, Types & Treatment". Cleveland Clinic. Archived from the original on 2024-01-01. Retrieved 2024-01-01.
  22.  "Mental State Examination 3 – Perception and Mood – Pathologia". Archived from the original on 2024-01-01. Retrieved 2024-01-01.
  23.  Tracy D, Shergill S (2013-04-26). "Mechanisms Underlying Auditory Hallucinations—Understanding Perception without Stimulus". Brain Sciences. 3 (2): 642–669. doi:10.3390/brainsci3020642. ISSN 2076-3425. PMC 4061847. PMID 24961419.
  24.  Chaudhury S (2010). "Hallucinations: Clinical aspects and management". Industrial Psychiatry Journal. 19 (1): 5–12. doi:10.4103/0972-6748.77625. ISSN 0972-6748. PMC 3105559. PMID 21694785.
  25.  Shibayama M (2011). "[Differential diagnosis between dissociative disorders and schizophrenia]". Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica. 113 (9): 906–911. PMID 22117396.
  26.  Thompson A (September 15, 2006). "Hearing Voices: Some People Like It". LiveScience.com. Archived from the original on November 2, 2006. Retrieved 2006-11-25.
  27.  Endres D, Matysik M, Feige B, Venhoff N, Schweizer T, Michel M, et al. (2020-09-14). "Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)". Diagnostics. 10 (9): 691. doi:10.3390/diagnostics10090691. ISSN 2075-4418. PMC 7555162. PMID 32937787.
  28.  Engmann B, Reuter M (2009). "Melodiewahrnehmung ohne äußeren Reiz: Halluzination oder Epilepsie? Ein Fallbericht" [Spontaneous perception of melodies: Hallucination or epilepsy?]. Nervenheilkunde (in German). 28 (4): 217–221. doi:10.1055/s-0038-1628605.
  29.  Ozsarac M, Aksay E, Kiyan S, Unek O, Gulec FF (July 2012). "De novo cerebral arteriovenous malformation: Pink Floyd's song "Brick in the Wall" as a warning sign". The Journal of Emergency Medicine. 43 (1): e17 – e20. doi:10.1016/j.jemermed.2009.05.035. PMID 19682829.
  30.  "Rare Hallucinations Make Music In The Mind". ScienceDaily.com. August 9, 2000. Archived from the original on December 5, 2006. Retrieved 2006-12-31.
  31.  Schaefer B, Boumans J, van Os J, van Weeghel J (2021-04-21). "Emerging Processes Within Peer-Support Hearing Voices Groups: A Qualitative Study in the Dutch Context". Frontiers in Psychiatry. 12 647969. doi:10.3389/fpsyt.2021.647969. PMC 8098806. PMID 33967856.
  32.  Fiegl A. "Caffeine Linked to Hallucinations". Smithsonian Magazine. Archived from the original on 2024-01-01. Retrieved 2024-01-01.
  33.  "Too Much Coffee Can Make You Hear Things That Are Not There". Medical News Today. 8 June 2011. Archived from the original on 2013-03-11.
  34.  Pelak V. "Approach to the patient with visual hallucinations". www.uptodate.com. Archived from the original on 2014-08-26. Retrieved 2014-08-25.
  35.  Beck-Sander A, Birchwood M, Chadwick P (February 1997). "Acting on command hallucinations: a cognitive approach". The British Journal of Clinical Psychology. 36 (1): 139–148. doi:10.1111/j.2044-8260.1997.tb01237.x. PMID 9051285.
  36.  Lee TM, Chong SA, Chan YH, Sathyadevan G (December 2004). "Command hallucinations among Asian patients with schizophrenia". Canadian Journal of Psychiatry. 49 (12): 838–842. doi:10.1177/070674370404901207. PMID 15679207.
  37.  Knoll JL, Resnick PJ (February 2008). "Insanity Defense Evaluations: Toward a Model for Evidence-Based Practice". Brief Treatment and Crisis Intervention. 8 (1): 92–110. doi:10.1093/brief-treatment/mhm024.
  38.  Shea SC. "Uncovering Command Hallucinations". raining Institute for Suicide Assessment. Archived from the original on 2014-01-02.
  39.  HealthUnlocked (2014), "Phantosmia (Smelling Odours That Aren't There)", NHS Choices, archived from the original on 2 August 2016, retrieved 6 August 2016
  40.  Hong SC, Holbrook EH, Leopold DA, Hummel T (June 2012). "Distorted olfactory perception: a systematic review". Acta Oto-Laryngologica. 132 (S1): S27 – S31. doi:10.3109/00016489.2012.659759. PMID 22582778. S2CID 207416134.
  41.  Leopold D (September 2002). "Distortion of olfactory perception: diagnosis and treatment". Chemical Senses. 27 (7): 611–615. doi:10.1093/chemse/27.7.611. PMID 12200340.
  42.  Berrios GE (April 1982). "Tactile hallucinations: conceptual and historical aspects". Journal of Neurology, Neurosurgery, and Psychiatry. 45 (4): 285–293. doi:10.1136/jnnp.45.4.285. PMC 491362. PMID 7042917.
  43.  Panayiotopoulos CP (2010). A Clinical Guide to Epileptic Syndromes and their Treatment. doi:10.1007/978-1-84628-644-5. ISBN 978-1-84628-643-8.[page needed]
  44.  Barker P (1997). Assessment in psychiatric and mental health nursing: in search of the whole person. Cheltenham, UK: Stanley Thornes Publishers. p. 245. ISBN 978-0-7487-3174-9.
  45.  Blom JD, Mangoenkarso E (9 May 2018). "Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma". Frontiers in Psychiatry. 9: 193. doi:10.3389/fpsyt.2018.00193. PMC 5954108. PMID 29867612.
  46.  Akhtar S, Thomson JA (April 1980). "Schizophrenia and sexuality: a review and a report of twelve unusual cases--part I". The Journal of Clinical Psychiatry. 41 (4): 134–142. PMID 7364736.
  47.  Blom JD (2024). "The Diagnostic Spectrum of Sexual Hallucinations". Harvard Review of Psychiatry. 32 (1): 1–14. doi:10.1097/HRP.0000000000000388. hdl:1887/3730958. PMC 11449261. PMID 38181099.
  48.  Penfield W, Rasmussen T. The cerebral cortex of man: a clinical study of localization of function. London: Macmillan, 1950.[page needed]
  49.  Janszky J, Ebner A, Szupera Z, Schulz R, Hollo A, Szücs A, et al. (September 2004). "Orgasmic aura—a report of seven cases". Seizure. 13 (6): 441–444. doi:10.1016/j.seizure.2003.09.005. PMID 15276150.
  50.  Sem-Jacobsen CW. Depth-electrographic stimulation of the human brain and behavior. Toronto: Ryerson, 1968.[page needed]
  51.  Surbeck W, Bouthillier A, Nguyen DK (2013). "Bilateral cortical representation of orgasmic ecstasy localized by depth electrodes". Epilepsy & Behavior Case Reports. 1: 62–65. doi:10.1016/j.ebcr.2013.03.002. PMC 4150648. PMID 25667829.
  52.  Chaton L, Chochoi M, Reyns N, Lopes R, Derambure P, Szurhaj W (December 2018). "Localization of an epileptic orgasmic feeling to the right amygdala, using intracranial electrodes". Cortex. 109: 347–351. doi:10.1016/j.cortex.2018.07.013. PMID 30126613.
  53.  Lim A, Hoek HW, Deen ML, Blom JD, Bruggeman R, Cahn W, et al. (October 2016). "Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders". Schizophrenia Research. 176 (2–3): 493–499. doi:10.1016/j.schres.2016.06.010. PMID 27349814.
  54.  Bilder RM (August 2013). "The Neuroscience of Hallucinations". Archives of Clinical Neuropsychology. 28 (5): 511–512. doi:10.1093/arclin/act029.
  55.  Jenkins G, Röhricht F (2007). "From Cenesthesias to Cenesthopathic Schizophrenia: A Historical and Phenomenological Review". Psychopathology. 40 (5): 361–368. doi:10.1159/000106314. PMID 17657136.
  56.  Moreno FC, Barea MV (April 2021). "A first psychotic episode with kinesthetic hallucinations. Report of a case". European Psychiatry. 64 (S1): S795. doi:10.1192/j.eurpsy.2021.2101. PMC 9479843.
  57.  Ohayon MM, Priest RG, Caulet M, Guilleminault C (October 1996). "Hypnagogic and hypnopompic hallucinations: pathological phenomena?". The British Journal of Psychiatry. 169 (4): 459–467. doi:10.1192/bjp.169.4.459. PMID 8894197. S2CID 3086394.
  58.  Manford M, Andermann F (October 1998). "Complex visual hallucinations. Clinical and neurobiological insights". Brain. 121 ( Pt 10) (10): 1819–1840. doi:10.1093/brain/121.10.1819. PMID 9798740.
  59.  Rahman A, Paul M (2023). "Delirium Tremens". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29489272. Archived from the original on 2023-12-04. Retrieved 2024-01-08.
  60.  Grover S, Ghosh A (December 2018). "Delirium Tremens: Assessment and Management". Journal of Clinical and Experimental Hepatology. 8 (4): 460–470. doi:10.1016/j.jceh.2018.04.012. PMC 6286444. PMID 30564004.
  61.  Franchina P (2023-06-30). "Presence Hallucinations as an Early Indicator of Cognitive Decline in Parkinson's Disease". American Parkinson Disease Association. Retrieved 2024-07-27.
  62.  Derr D (14 February 2006). "Marilyn and Me". The New York Times. Archived from the original on 2011-09-26.
  63.  Zegar A (2022-12-15). "Migraine Doctor Rice Village 77005". Rice Emergency Room. Retrieved 2024-07-27.
  64.  Engmann B (2008). "Phosphene und Photopsien – Okzipitallappeninfarkt oder Reizdeprivation?" [Phosphenes and photopsias - ischaemic origin or sensorial deprivation? - Case history]. Zeitschrift für Neuropsychologie (in German). 19 (1): 7–13. doi:10.1024/1016-264X.19.1.7.
  65.  Teeple RC, Caplan JP, Stern TA (2009). "Visual hallucinations: differential diagnosis and treatment". Primary Care Companion to the Journal of Clinical Psychiatry. 11 (1): 26–32. doi:10.4088/PCC.08r00673. PMC 2660156. PMID 19333408.
  66.  Bien CG, Benninger FO, Urbach H, Schramm J, Kurthen M, Elger CE (February 2000). "Localizing value of epileptic visual auras". Brain. 123 ( Pt 2) (2): 244–253. doi:10.1093/brain/123.2.244. PMID 10648433.
  67.  Teeple RC, Caplan JP, Stern TA (2009-02-15). "Visual Hallucinations: Differential Diagnosis and Treatment". The Primary Care Companion to the Journal of Clinical Psychiatry. 11 (1): 26–32. doi:10.4088/PCC.08r00673. ISSN 1523-5998. PMC 2660156. PMID 19333408.
  68.  "Fentanyl (Transdermal Route) Side Effects - Mayo Clinic". Mayo Clinic. Archived from the original on 2018-04-24. Retrieved 2018-04-24.
  69.  "Talwin Injection - FDA prescribing information, side effects and uses". Archived from the original on 2018-04-24. Retrieved 2018-04-24.
  70.  "Prescription Drugs That Can Cause Hallucinations". azcentral.com. Archived from the original on 2021-08-28. Retrieved 2018-04-24.
  71.  Trauner R, Obwegeser H (July 1957). "The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin". Oral Surgery, Oral Medicine, and Oral Pathology. 10 (7): 677–89, contd. doi:10.1016/S0030-4220(57)80063-2. PMID 13441284.
  72.  Mason OJ, Brady F (October 2009). "The psychotomimetic effects of short-term sensory deprivation". The Journal of Nervous and Mental Disease. 197 (10): 783–785. doi:10.1097/NMD.0b013e3181b9760b. PMID 19829208. S2CID 23079468.
  73.  Gurney E, Myers FW, Podmore F (1886). Phantasms of the Living, Vols. I and II. London: Trubner and Co.
  74.  Sidgwick E, Johnson A, et al. (1894). "Report on the Census of Hallucinations". Proceedings of the Society for Psychical Research. X. London.
  75.  Slade PD, Bentall RP (1988). Sensory Deception: a scientific analysis of hallucination. London: Croom Helm.
  76.  Losurdo G, Principi M, Iannone A, Amoruso A, Ierardi E, Di Leo A, et al. (April 2018). "Extra-intestinal manifestations of non-celiac gluten sensitivity: An expanding paradigm". World Journal of Gastroenterology (Review). 24 (14): 1521–1530. doi:10.3748/wjg.v24.i14.1521. PMC 5897856. PMID 29662290.
  77.  Brown GG, Thompson WK (2010). "Functional Brain Imaging in Schizophrenia: Selected Results and Methods". Behavioral Neurobiology of Schizophrenia and Its Treatment. Current Topics in Behavioral Neurosciences. Vol. 4. pp. 181–214. doi:10.1007/7854_2010_54. ISBN 978-3-642-13716-7. PMID 21312401.
  78.  El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P (December 2017). "Clinical and neurocognitive aspects of hallucinations in Alzheimer's disease". Neuroscience and Biobehavioral Reviews. 83: 713–720. doi:10.1016/j.neubiorev.2017.02.021. PMC 5565710. PMID 28235545.
  79.  Boksa P (July 2009). "On the neurobiology of hallucinations". Journal of Psychiatry & Neuroscience. 34 (4): 260–262. PMC 2702442. PMID 19568476.
  80.  Kumar S, Soren S, Chaudhury S (July 2009). "Hallucinations: Etiology and clinical implications". Industrial Psychiatry Journal. 18 (2): 119–126. doi:10.4103/0972-6748.62273. PMC 2996210. PMID 21180490.
  81.  Behrendt RP (May 2006). "Dysregulation of thalamic sensory "transmission" in schizophrenia: neurochemical vulnerability to hallucinations". Journal of Psychopharmacology. 20 (3): 356–372. doi:10.1177/0269881105057696. PMID 16174672. S2CID 17104995.
  82.  Aleman A, Vercammon A. "The Bottom Up and Top Down Components of Hallucinatory Phenomenon". In Jardri R, Cachia A, Pins D, Thomas P (eds.). The Neuroscience of Hallucinations. Springer.
  83.  "Hallucinations: Definition, Causes, Treatment & Types". Cleveland Clinic. Archived from the original on 2024-01-08. Retrieved 2024-01-08.
  84.  Wikipedia contributors (February 2024). "Hearing Voices Movement". Archived from the original on 2023-11-28. Retrieved 2024-03-03.
  85.  de Leede-Smith S, Barkus E (2013). "A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals". Frontiers in Human Neuroscience. 7: 367. doi:10.3389/fnhum.2013.00367. PMC 3712258. PMID 23882203.
  86.  Maijer K, Begemann MJ, Palmen SJ, Leucht S, Sommer IE (April 2018). "Auditory hallucinations across the lifespan: a systematic review and meta-analysis". Psychological Medicine. 48 (6): 879–888. doi:10.1017/s0033291717002367. PMID 28956518. S2CID 3820537.
  87.  Bunevičius P, Stompe R, Adomaitienė T, Vaškelytė V, Kupčinskas JJ, Stakišaitis L, et al. (2008-09-08). The impact of personal religiosity and culture on the content of delusions and hallucinations in schizophrenia. Lithuanian Academic Libraries Network (LABT). OCLC 654554799.
  88.  Maijer K, Hayward M, Fernyhough C, Calkins ME, Debbané M, Jardri R, et al. (2019-02-01). "Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians". Schizophrenia Bulletin. 45 (45 Suppl 1): S5 – S23. doi:10.1093/schbul/sby119. ISSN 1745-1701. PMC 6357982. PMID 30715540.
  89.  Linszen MM, van Zanten GA, Teunisse RJ, Brouwer RM, Scheltens P, Sommer IE (January 2019). "Auditory hallucinations in adults with hearing impairment: a large prevalence study" (PDF). Psychological Medicine. 49 (1): 132–139. doi:10.1017/S0033291718000594. PMID 29554989.
  90.  Cook CC (June 2015). "Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder". The International Journal of Social Psychiatry. 61 (4): 404–425. doi:10.1177/0020764015573089. PMC 4440877. PMID 25770205.

Further reading

  • Johnson FH (1978). The Anatomy of Hallucinations. Chicago: Nelson-Hall. ISBN 0-88229-155-6.
  • Slade PD, Bentall RP (1988). Sensory Deception: A Scientific Analysis of Hallucination. London Sydney: Croom Helm. ISBN 0-7099-3961-2.
  • Aleman A, Larøi F (2008). Hallucinations: The Science of Idiosyncratic Perception. Washington, DC: American Psychological Association. ISBN 978-1-4338-0311-6.
  • Sacks OW (2012). Hallucinations (1. American ed.). New York: Knopf. ISBN 978-0-307-95724-5.
Wikimedia Commons has media related to Hallucination.
Wikiquote has quotations related to Hallucination.
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