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Visual release hallucinations presenting as psychosis - a scoping review
Nicholas Bonomo1, Ben Schoenbachler1, Steven Lippmann1
1School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, USA.
Visual release hallucinations can occur in patients with psychosis, potentially leading to treatment resistance. Reafferentation therapy showed promise for remission in these cases.
Area of Science:
- Neuroscience
- Psychiatry
Background:
- Visual release hallucinations are underdiagnosed perceptual disturbances in vision loss.
- Current understanding, often linked to Charles Bonnet syndrome, excludes many populations like those with psychiatric illness.
Purpose of the Study:
- To investigate the occurrence of visual release hallucinations in patients with psychosis.
- To explore treatment responses for visual release hallucinations in psychotic individuals.
Main Methods:
- A scoping review of the PubMed database was conducted up to April 2023.
- Cases of psychotic patients with suspected visual release hallucinations were collected and analyzed.
Main Results:
- Thirteen cases from 11 studies were summarized.
- Pharmacological management alone was often ineffective; however, all patients receiving reafferentation therapy achieved remission.
- Nearly half of the patients did not achieve remission overall.
Conclusions:
- Visual release hallucinations can manifest in psychosis and may contribute to treatment resistance.
- Recognizing visual release features could improve diagnosis and treatment in psychiatric populations.
- A preliminary screening index for visual release features is proposed to aid recognition.
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