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Atypical Charles Bonnet Hallucinations: An Elf in the Woodshed, a Spirit of Evil, and the Cowboy Malefactors


The Journal of Nervous & Mental Disease: February 2000 - Volume 188 - Issue 2 - p 108-115

In this article, the authors review the literature on the Charles Bonnet syndrome (CBS), a condition involving visual hallucinations in normal persons with severe sight loss. Attempts to assess the characteristics of this "phantom vision" have resulted in descriptions of a "typical" CBS hallucination. However, the many exceptions to a modal CBS experience cause the authors to postulate two other general categories of CBS hallucinations: a) the atypical sensory/perceptual (ASP), and b) the atypical psychodynamic (APD) hallucinations. Case studies illustrating these two types are provided. Extending the categories of Charles Bonnet hallucinations allows for more specific diagnosis, treatment, and may result in the possibility of greater precision in future research.

1 Psychology Services, Department of Veterans Affairs Connecticut Healthcare System, 950 Campbell Avenue, West Haven, Connecticut 06516. Send reprint requests to Dr. Needham.

2 Psychology Services, Department of Veterans Affairs Medical Center, 700 South 19th Street, Birmingham, Alabama 35233.

The authors would like to express their appreciation to Marilyn Newman, Geoffrey Schultz, Ph.D., and Alexandre Bennett, Ph.D. who assisted in the study.

© 2000 Lippincott Williams & Wilkins, Inc.