Visual hallucinations in schizophrenia: confusion between imagination and perception.
OBJECTIVE
An association between hallucinations and reality-monitoring deficit has been repeatedly observed in patients with schizophrenia. Most data concern auditory/verbal hallucinations. The aim of this study was to investigate the association between visual hallucinations and a specific type of reality-monitoring deficit, namely confusion between imagined and perceived pictures.


METHODS
Forty-one patients with schizophrenia and 43 healthy control participants completed a reality-monitoring task. Thirty-two items were presented either as written words or as pictures. After the presentation phase, participants had to recognize the target words and pictures among distractors, and then remember their mode of presentation.


RESULTS
All groups of participants recognized the pictures better than the words, except the patients with visual hallucinations, who presented the opposite pattern. The participants with visual hallucinations made more misattributions to pictures than did the others, and higher ratings of visual hallucinations were correlated with increased tendency to remember words as pictures. No association with auditory hallucinations was revealed.


CONCLUSIONS
Our data suggest that visual hallucinations are associated with confusion between visual mental images and perception.
Brébion
Gildas
G
0000-0002-7095-4788
Institute of Psychiatry, King's College.
Ohlsen
Ruth I
RI
Institute of Psychiatry, King's College.
Pilowsky
Lyn S
LS
Institute of Psychiatry, King's College.
David
Anthony S
AS
Institute of Psychiatry, King's College.
D000328:Adult; D003221:Confusion; D005260:Female; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D007092:Imagination / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010465:Perception / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D011936:Reality Testing; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology