title: [Negative hallucination, self-consciousness and ageing].
abstract: Negative hallucinations are characterized by a defect in perception of an object or a person, or a denial of the existence of their perception. Negative hallucinations create blank spaces, due to both an impossible representation and an incapability of investment in reality. They have a close relationship with Cotard's syndrome, delusional theme of organ denial observed in melancholic syndromes in the elderly.
  
  
  
  Phenomenological approach. The phenomenology of negative hallucinations provides quite an amount of information on the origin of the psychotic symptoms when one is rather old.
  
  
  
  The connections between hallucinations, mood disorders and negative symptoms are often difficult to live with for the nearest and dearest. Negative hallucinations require a strict approach to identify their expression that is crucial because a wide heterogeneity exists within the pathological pictures, as in Cotard's syndrome. Although the negative hallucination has an anti traumatic function in elderly people fighting against mental pain, it still represents a deficiency in symbolization. The prevalence of this symptom is without doubt underestimated, although its presence often underlines thymic suffering that is more striking. These hallucinatory symptoms have an important impact on the patients' daily life, and they appear to be prisoners of a suffering, which cannot be revealed.
  
  
  
  We propose in this article to review the clinical symptoms of negative hallucinations in the elderly and the way to manage them. The medicinal approaches are not always effective. A greater place must be given to what is in connection with the body, aiming at a strong impact and thus to offer non-pharmacological approaches, such as somatic ones, which can be either invasive (electroconvulsive therapy) or not (transcranial magnetic stimulation).
authors.affiliation: Service de l'intersecteur de psychiatrie du sujet âgé, hôpital de Bohars, CHU de Brest, route de Ploudalmézeau, 29820 Bohars, France; EA éthique professionnalisme et santé, EA 4486, université UBO, 29820 Bohars, France. Electronic address: cyril.hazifthomas@chu-brest.fr.
authors.forename: C
authors.initials: C
authors.lastname: Hazif-Thomas
authors.affiliation: Service hospitalo-universitaire de psychiatrie adulte, hôpital de Bohars, CHRU de Brest, 29820 Bohars, France; EA laboratoire de neurosciences de Brest (EA 4685), UFR de médecine, université de Bretagne Occidentale, 22, avenue Camille-Desmoulins, CS 93837, 29230 Brest cedex 3, France.
authors.forename: F
authors.initials: F
authors.lastname: Stephan
authors.affiliation: EA éthique professionnalisme et santé, EA 4486, université UBO, 29820 Bohars, France; Service hospitalo-universitaire de psychiatrie adulte, hôpital de Bohars, CHRU de Brest, 29820 Bohars, France; EA laboratoire de neurosciences de Brest (EA 4685), UFR de médecine, université de Bretagne Occidentale, 22, avenue Camille-Desmoulins, CS 93837, 29230 Brest cedex 3, France.
authors.forename: M
authors.initials: M
authors.lastname: Walter
authors.affiliation: Centre Jean-Marie-Léger, CHU de Limoges, 87025 Limoges, France.
authors.forename: P
authors.initials: P
authors.lastname: Thomas
mesh_terms: D000375:Aging / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003702:Delusions / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003717:Denial, Psychological; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D004565:Electroconvulsive Therapy; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D006801:Humans; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D011936:Reality Testing; D012649:Self Concept; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D050781:Transcranial Magnetic Stimulation
keywords: Conscience de soi; Cotard's syndrome; Elderly; Hallucination négative; Hypochondria; Hypocondrie; Melancholia; Mélancolie; Negative hallucination; SMTr; Self consciousness; Sujet âgé; Syndrome de Cotard