FM>Chap 21: Forensic Psychiatry>Short Essay 3

Hallucinations are false sense perceptions without any external object or stimulus to produce it, which are purely imaginary, and may affect any or all the special senses.
Many normal persons under certain conditions like high fever, drug intoxication, withdrawal symptoms etc. may experience them though they are much more common in insanity.
The various types of hallucinations are:
1. Visual hallucinations: the person visualizes either non existent shapes (unformed images) or people/ animals (formed images). He observes something without anything being present in front of him. They are commonest hallucinations present in organic mental disorders. They are present in delirium tremens, focal CNS lesions, toxic disturbances, schizophrenia & drug withdrawal syndromes.
2. Auditory hallucinations: the person hears imaginary voices or disturbed sounds without any such source. They are the commonest hallucinations in functional mental disorders like schizophrenia, delirium, psychotic mood disorders, and toxic and metabolic encephalopathies.
3. Olfactory hallucinations: the person perceives non-existent odours, either pleasant or unpleasant. it is associated with organic brain disease and major depressions.
4. Gustatory hallucinations: the person feels either sweet, sour, bitter, good or bad taste in the mouth, often without any apparent cause or food in mouth. It is found in organic brain diseases and temporal lobe epilepsy.
5. Tactile hallucinations: it may be in the form of imaginary sensations over the skin or in a limb that has been amputated (phantom limb).e.g., bugs crawling over ones skin (formication) or grains of sand over skin are perceived in cocainism.
6. Psychomotor hallucinations: the person has a feeling of movement of a part of his /her body in the absence of such movement.
7. Liliputism / Microscopic hallucinations: the person perceives objects to be much smaller than they actually are. It is seen in alcoholic delirium tremens.
8. Synesthesia: here a stimulus is perceived by a sensory organ other than the one that should normally perceive it. E.g., visualizing music, hearing different colours etc.
9. Command hallucinations: the person is ordered by hallucinatory voices to do things/acts, which may be frightening or dangerous. They may be pleasant, but more often dangerous. Its importance lies in the fact that a person suffering from unpleasant hallucinations may be stimulated to commit suicide or homicide.


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