Objective: To describe a middle-aged patient with Charles Bonnet syndrome (CBS) suffering from concurrent major depression.
Clinical picture: A 41-year-old Chinese man with retinitis pigmentosa developed complex and vivid visual hallucinations. This was followed by the onset of major depressive illness. His visual hallucinations were greatly influenced by his cultural background and changed during the course of his depression.
Treatment: The patient was treated with imipramine.
Outcome: The patient had a relapse of depression due to his non-compliance. He recovered after the resumption of imipramine but the visual hallucinations persisted.
Conclusions: Patients suffering from CBS can have another concurrent psychiatric illness. The content and form of this patient's visual hallucinations were modified by his cultural background and depressive illness. Sensory deprivation is suggested to be the pathogenic mechanism of his visual hallucination.
GoldKRabinsPVIsolated visual hallucinations and the Charles Bonnet syndrome. A review of literature and presentation of six cases. Comprehensive Psychiatry1989; 30:90–98.
2.
TeunisseRJCruysbergJRMVerbeekAZitmanFGCharles Bonnet syndrome: a large prospective study in the Netherlands. British Journal of Psychiatry1995; 166:254–257.
3.
RosenbaunFHaratiYRRolakL.Visual hallucinations in sane people: the Charles Bonnet syndrome. Journal of the American Geriatric Society1987; 35:66–68.
4.
FitzgeraldRGEbertJNChambersM.Reactions to blindness: a four year follow up study. Perceptual Motor Skills1987; 64:363–78.
5.
PatelHCKeshanvanMSMartinS.A case of Charles Bonnet syndrome with musical hallucinations. Canadian Journal of Psychiatry1987; 32:303–304.
6.
ChédruFFeldmanFAmériASalèsJRothM.Visual and auditory hallucinations in a psychologically normal woman. Lancet1996; 348:896.
7.
CoganDGVisual hallucinations as release phenomena. Albrecht vs. Graefes. Archiv Fuer Klinische und Experimentelle Ophtalmologie1973; 188:139–150.
8.
TaylorREMancilGLKramerSHVisual hallucinations: meaning and management. Journal of American Optometric Association1986; 57:889–892.
9.
BerriosGEBrookP.Visual hallucinations and sensory delusions in the elderly. British Journal of Psychiatry1984; 144:662–664.
10.
Damas-MoraJSkelton-RobinsonMJennerFAThe Charles Bonnet syndrome in perspective. Psychological Medicine1982; 12:251–261.
11.
TeunisseRJZitmanFGRaesDCMClinical evaluation of 14 patients with the Charles Bonnet syndrome (isolated visual hallucinations). Comprehensive Psychiatry1994; 35:77–85.
12.
HartmannPMKoskoDACohnJAThe Charles Bonnet syndrome (pseudohallucinations) in an AIDS patient with cytomegalovirus retinitis. Journal of Nervous and Mental Disease1995; 183:549–550.
13.
MaricleRATurnerLDLehmanKDThe Charles Bonnet syndrome: a brief review and case report. Psychiatric Services1995; 46:289–291.
