Instituto Bairral, Itapira, Brazil.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
Psychol Med. 2021 Sep;51(12):2034-2043. doi: 10.1017/S0033291720000793. Epub 2020 Apr 22.
Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course.
We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2).
In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder.
Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.
尽管已经研究了幻觉的患病率及其与精神病理学和功能障碍的关联，但对于听觉以外的感觉模式（即触觉、视觉和嗅觉），以及幻觉的发生率、预测发生率的因素以及随后的病程知之甚少。
我们使用相似的方法，在同一国家的两个独特的前瞻性一般人群队列中，检查了不同感觉模式下幻觉体验的发生率、病程和危险因素，共有三个访谈阶段，一个是在 1996-1999 年期间（NEMESIS），另一个是在 2007-2015 年期间（NEMESIS-2）。
在 NEMESIS-2 中，自我报告的视觉幻觉的年发生率最高（0.33%），其次是触觉幻觉（0.31%）、听觉幻觉（0.26%）和嗅觉幻觉（0.23%）。NEMESIS-1 的发生率相似（分别为 0.35%、0.26%、0.23%和 0.22%）。临床确诊的幻觉发生率约为自我报告率的 60%。新发幻觉的持续率约为 20-30%，而现患幻觉的持续率约为 40-50%。一种感觉模式的新发幻觉与另一种感觉模式的发生非常密切相关（中位数 OR = 59），所有感觉模式都与妄想观念密切相关（中位数 OR = 21）。感觉模式与任何精神障碍的存在（中位数 OR = 4）、功能、寻求帮助的指标以及精神障碍的既定环境危险因素的相关性大致相同。
不同感觉模式的幻觉是一种非精神病性障碍的临床相关特征，需要相互之间以及与妄想观念进行研究，因为所有这些似乎都有一个共同的潜在机制。
