Visual Hallucinations in First-Episode Psychosis: Association with Childhood Trauma.

Liss Gøril Anda,Martine Solesvik,Wenche Ten Velden Hegelstad,Kolbjørn Brønnick,Kenji Hashimoto,Johannes Langeveld,Jens Gisselgård,Jan Olav Johannessen,Jone Bjørnestad,Inge Joa,Tor Ketil Larsen

doi:10.1371/journal.pone.0153458

Abstract

BackgroundHallucinations are a core diagnostic criterion for psychotic disorders and have been investigated with regard to its association with childhood trauma in first-episode psychosis samples. Research has largely focused on auditory hallucinations, while specific investigations of visual hallucinations in first-episode psychosis remain scarce.ObjectivesThe aims of this study were to describe the prevalence of visual hallucinations, and to explore the association between visual hallucination and childhood trauma in a first-episode psychosis sample.MethodsSubjects were included from TIPS-2, a first episode psychosis study in south Rogaland, Norway. Based on the medical journal descriptions of the Positive and Negative Symptoms Scale (PANSS), a separate score for visual and auditory hallucinations was created (N = 204). Patients were grouped according to hallucination severity (none, mild, and psychotic hallucinations) and multinomial logistic regression was performed to identify factors associated with visual hallucination group.ResultsVisual hallucinations of a psychotic nature were reported by 26.5% of patients. The experience of childhood interpersonal trauma increased the likelihood of having psychotic visual hallucinations.ConclusionVisual hallucinations are common in first-episode psychosis, and are related to childhood interpersonal trauma.

Highlights

Hallucinations are a major group of clinical symptoms with diagnostic significance in the psychosis spectrum disorders [1], and in first-episode psychosis (FEP) the majority of patients report hallucinatory experiences [2, 3]
The experience of childhood interpersonal trauma increased the likelihood of having psychotic visual hallucinations
The main findings of this study were that FEP patients reporting childhood interpersonal trauma had increased likelihood of reporting psychotic visual hallucinations

Summary

Introduction

Hallucinations are a major group of clinical symptoms with diagnostic significance in the psychosis spectrum disorders [1], and in first-episode psychosis (FEP) the majority of patients report hallucinatory experiences [2, 3]. Voices arguing and commenting were named “first rank” symptoms by Schneider, and were included in the DSM-IV as sufficient symptomatic criteria for a schizophrenia diagnosis. This special status of first rank symptoms has been removed in DSM-5, granting equal importance to hallucinations in any modality in diagnosing psychosis. Research has largely focused on auditory hallucinations, while specific investigations of visual hallucinations in first-episode psychosis remain scarce. Editor: Kenji Hashimoto, Chiba University Center for Forensic Mental Health, JAPAN Received: October 20, 2015 Accepted: March 30, 2016 Published: May 4, 2016

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