The Charles Bonnet Syndrome: A Large Prospective Study in the Netherlands

Abstract

Background. The aims were to determine the prevalence of the Charles Bonnet syndrome (CBS) in low-vision patients and analyse possible associated ophthalmic and sociodemographic factors. Method. A semi-structured interview on visual hallucinations was given to 300 adult lowvision patients and 200 elderly general ophthalmic patients. Positive cases were examined with the Geriatric Mental State Schedule and the Mini Mental State Examination. Diagnostic criteria were as follows: complex, persistent, or repetitive visual hallucinations; full or partial retention of insight; no hallucinations in other modalities; and no delusions. Ophthalmic and sociodemographic data were gathered for all patients. Results. The prevalence of CBS in low-vision patients was 11%. CBS was significantly associated with an age over 64 years and a visual acuity in the best eye of 0.3 or less. No significant associations with ophthalmic diagnoses, patient sex, marital status, or social circumstances were found. Conclusion. Our findings support association of CBS with sensory deprivation and advanced age.

Delusional Misidentification Syndromes: A Descriptive Study

“…Pseudocyesis in 3 subjects and Othello syndrome in 3 subjects. The association with Charles Bonnet syndrome (a syndrome which consists of fully formed, complex, persistent and repetitive visual hallucinations in the context of full or partial insight, ab sence of delusions and of hallucinations in other modalities [34]). has not been previ ously reported.…”

Visual hallucinations and Charles Bonnet syndrome after photodynamic therapy for age related macular degeneration

“…10 CBS is more prevalent among visually impaired people: thus, it was diagnosed in 17 (25%) of 66 patients who became blind over a 1 year period, 19 and, recently, in the largest series reported, the prevalence of CBS was estimated at 11% in low vision patients, using very precise criteria: the presence of structured, complex, persistent, and repetitive visual hallucinations; full or partial retention of insight; absence of delusions; and absence of other kinds of hallucinations. 12 In another large study of a low vision population, CBS was found to be very common in the study population, as it was observed in 38% of patients. 20 Although the association of CBS with AMD has been reported in small series, 21 and larger studies, 6 12 to our knowledge, CBS is not known as a possible complication of photodynamic therapy.…”

“…9 11 12 In addition, a large prospective study indicated that common risk factors of CBS were age over 64 years and visual acuity in the better eye of 0.3 or less. 12 There are few data concerning the prevalence of CBS, although most authors consider it to be underestimated. 9 13 Patients do not usually describe their hallucinations spontaneously, because they are afraid of being thought mentally ill. Psychiatric studies showed that CBS could be diagnosed in 1-2% of elderly patients referred for psychiatric inpatient care, 9 and among patients referred to a psychiatrist because of visual hallucinations.…”

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia

“…Onset of similar hallucinatory behavior has been previously observed with sensory losses of visual and auditory systems; association of visual hallucinations with loss of visual acuity has been reported in patients with cataract [138], and with age, sometimes referred to as Bonnet syndrome [139,140,141,142,143]; auditory hallucinations without subsequent clinical motor activity have been reported in patients with loss of auditory acuity [144,145,146]. …”