Visual hallucinations are mediated by cognitive ability and level of insight, according to study results published in the International Journal of Geriatric Psychiatry.

Researchers conducted in-depth interviews with 10 individuals with dementia and 11 individuals with Parkinson disease, all of whom experienced visual hallucinations. Interviews were also conducted with the informal caregivers of the participants with dementia (n=11) and Parkinson disease (n=9). An “inductive thematic approach” was utilized to analyze and qualify interview elements.

In the study, 3 primary themes were identified: (1) “insight and distress,” (2) “caregiver approach: challenging [vs] reassurance,” and (3) “normality and stigma.” Across interviews, “insight” was identified as a protective measure; if participants recognized their visual hallucinations as an element of their disorder, they were less likely to feel threatened or afraid. Caregiver approach to visual hallucinations was also identified as a significant influence; some challenged the existence of visual hallucinations, whereas individuals caring for more impaired individuals often “colluded” with the visual hallucinations in order to reassure the patient. Interviewees also highlighted the stigma associated with hallucinations, and patients who felt their situation was “abnormal” were less likely to seek help. This trend was more common in patients with Parkinson disease than patients with dementia, although both described feeling “embarrassed or ashamed.”

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As a qualitative study, this research provides insight into patient experiences. Based on these data, the researchers suggested that therapeutic efforts focus on support “according to the level of insight and cognitive impairment,” and that the medical community provide an additional measure of support by working to destigmatize hallucinations.


Renouf S, ffytche D, Pinto R, Murray J, Lawrence V. Visual hallucinations in dementia and Parkinson’s disease: a qualitative exploration of patient and caregiver experiences [published online June 28, 2018]. Int J Geriatr Psychiatry. doi:10.1002/gps.4929