Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease


Much of the research on visual hallucinations (VHs) has been conducted in the context of eye disease and neurodegenerative conditions, but little is known about these phenomena in psychiatric and nonclinical populations. The purpose of this article is to bring together current knowledge regarding VHs in the psychosis phenotype and contrast this data with the literature drawn from neurodegenerative disorders and eye disease. The evidence challenges the traditional views that VHs are atypical or uncommon in psychosis. The weighted mean for VHs is 27% in schizophrenia, 15% in affective psychosis, and 7.3% in the general community. VHs are linked to a more severe psychopathological profile and less favorable outcome in psychosis and neurodegenerative conditions. VHs typically co-occur with auditory hallucinations, suggesting a common etiological cause. VHs in psychosis are also remarkably complex, negative in content, and are interpreted to have personal relevance. The cognitive mechanisms of VHs in psychosis have rarely been investigated, but existing studies point to source-monitoring deficits and distortions in top-down mechanisms, although evidence for visual processing deficits, which feature strongly in the organic literature, is lacking. Brain imaging studies point to the activation of visual cortex during hallucinations on a background of structural and connectivity changes within wider brain networks. The relationship between VHs in psychosis, eye disease, and neurodegeneration remains unclear, although the pattern of similarities and differences described in this review suggests that comparative studies may have potentially important clinical and theoretical implications. © 2014 The Author.

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Divisions: College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
College of Health & Life Sciences > School of Optometry > Optometry
Additional Information: © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Schizophrenia bulletin following peer review. The definitive publisher-authenticated version Waters, F., Collerton, D., Ffytche, D. H., Jardri, R., Pins, D., Dudley, R., Blom, J. D., Mosimann, U. P., Eperjesi, F., Ford, S., & Larøi, F. (2014). Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophrenia bulletin, 40(Suppl.4), S233-S245. is available online at:
Uncontrolled Keywords: cognition,imaging,psychosis,schizophrenia,visual hallucinations,Psychiatry and Mental health,Medicine(all)
Publication ISSN: 1745-1701
Last Modified: 24 May 2024 07:10
Date Deposited: 02 Jul 2014 14:40
Full Text Link: http://schizoph ... 40/Suppl_4/S233
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Special issue
Published Date: 2014-07
Authors: Waters, Flavie
Collerton, Daniel
Ffytche, Dominic H.
Jardri, Renaud
Pins, Delphine
Dudley, Robert
Blom, Jan Dirk
Mosimann, Urs Peter
Eperjesi, Frank (ORCID Profile 0000-0003-4358-0095)
Ford, Stephen
Larøi, Frank



Version: Accepted Version

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