Hallucinosis

HALLUCINOSIS [from Latin (h)al(l)ucinatio—delirium], a psychopathological symptom complex characterized by the presence of abundant, predominantly auditory hallucinations while consciousness is preserved. The content of the hallucinations most often consists of voices uttering threats and insults or mocking, giving orders, speaking the patient's thoughts aloud, etc. Usually, these are sound phenomena that bear a completely real and distinct character with specific nuances and timbres that vary individually for different voices. Almost never do they appear to the patient as belonging to actual people around him, but for the most part, they emanate from the walls and corners of the room, from the pillow, from under the floor, etc. Most often, many different voices are heard simultaneously, and sometimes they follow a certain rhythm or beat quite strictly—for example, that of the pulse, a clock, etc. Most frequently, individual words or short phrases are uttered. Sometimes the voices carry on a conversation among themselves, always about the patient, wherein the latter is mentioned in the third person. A critical attitude toward one's morbid state is rarely maintained in hallucinosis; therefore, a corresponding delusion—of persecution, influence, etc.—usually develops in parallel with the hallucinations. Acute hallucinosis is spoken of in cases where the disease begins suddenly, lasts a relatively short time, and is accompanied by a more or less intense affect of fear corresponding to the unpleasant and threatening content of the sensory deceptions. Chronic hallucinosis, which is most characterized by the stereotypical repetition of the same hallucinations and the gradual fading of affect, is typical of terminal states and is usually accompanied by the development of more or less significant dementia. Most often, hallucinatory states of the described type develop in schizophrenics, and much less frequently in circular depressions. An extremely characteristic picture is provided by the hallucinosis of chronic alcoholics, as well as other drug addicts (e.g., cocaine addicts). Acute hallucinatory states also develop in patients with lues cerebri (cerebral syphilis), sometimes in tabetics, in paralytics immediately after malaria treatment, as well as in certain infectious, arteriosclerotic, and senile psychoses. Finally, reactive psychoses (most often prison psychoses) sometimes take the form of hallucinosis. Despite the features described common to most cases of hallucinosis, in each individual disease, they also present a series of characteristic peculiarities that distinguish them from those encountered in other illnesses.