Teunisse R J, Cruysberg J R, Hoefnagels W H, Verbeek A L, Zitman F G
Department of Psychiatry, University Hospital Nijmegen, The Netherlands.
Lancet. 1996 Mar 23;347(9004):794-7. doi: 10.1016/s0140-6736(96)90869-7.
Charles Bonnet's Syndrome (CBS), characterised by the presence of complex visual hallucinations in psychologically normal people, was considered for a long time to be rare. Systematic research on CBS has been limited. However, it has been realised that CBS occurs frequently in elderly, visually handicapped patients, and we have been able to study the syndrome in a large number of patients.
After screening 505 visually handicapped patients, 60 were found to meet proposed diagnostic criteria for CBS (generally, the existence of hallucinations without delusions or loss of insightful cognition.) Psychopathological characteristics, personal meaning, and the emotional impact of hallucinations, as well as factors influencing the hallucinations, were analysed.
Although diagnostic criteria demand merely "partial insight", all patients had full insight into the unreal nature of their hallucinations. Other characteristics varied. In 46 (77%) patients, hallucinations lacked a personal meaning. Sensory deprivation and a low level of arousal seemed to favour the occurrence of hallucinations. CBS caused considerable distress in only 17 (28%) patients. However, all patients were glad to be told that their hallucinations were not due to mental disease. The proper diagnosis had been made in only one of the 16 patients who had consulted a doctor.
Although largely unrecognised in clinical practice, CBS should be considered as a diagnosis in patients who complain of hallucinations and who meet defined diagnostic criteria. There is no proven treatment, but many patients will benefit from reassurance that their hallucinations do not imply mental illness.
查尔斯·邦尼特综合征（CBS）的特征是心理正常的人出现复杂的视幻觉，长期以来人们认为这种综合征很罕见。对CBS的系统性研究一直有限。然而，现在已经认识到CBS在老年视力障碍患者中频繁出现，并且我们已经能够对大量患者进行该综合征的研究。
在对505名视力障碍患者进行筛查后，发现60名患者符合CBS的拟议诊断标准（一般而言，存在幻觉但无妄想或洞察力认知丧失）。分析了幻觉的精神病理学特征、个人意义、情感影响以及影响幻觉的因素。
尽管诊断标准仅要求“部分洞察力”，但所有患者都完全明白其幻觉的非真实性质。其他特征各不相同。46名（77%）患者的幻觉缺乏个人意义。感觉剥夺和低唤醒水平似乎有利于幻觉的发生。CBS仅在17名（28%）患者中引起了相当大的痛苦。然而，所有患者都很高兴被告知他们的幻觉并非由精神疾病引起。在咨询过医生的16名患者中，只有1人得到了正确诊断。
尽管在临床实践中CBS很大程度上未被认识，但对于抱怨有幻觉且符合既定诊断标准的患者，应考虑将CBS作为一种诊断。目前尚无经证实的治疗方法，但许多患者会因得到保证其幻觉并不意味着患有精神疾病而受益。
