Commentary: Psychiatric Symptoms Related to Somatic Illness

Abstract

Although hallucinations, particularly auditory hallucinations, are most commonly associated with psychotic disorders such as schizophrenia, patients experiencing visual and even auditory hallucinations may actually have an underlying somatic illness that is causing the symptoms. This commentary discusses 2 cases of hallucinations due to nonpsychiatric causes, including a case of a semicircular canal dehiscence causing auditory hallucinations and a case of visual hallucinations in Charles Bonnet syndrome caused by hypertensive episodes. When patients with no history of psychosis present with hallucinations, it is crucial that medical providers perform a full evaluation, including an assessment of the patient’s psychiatric history. This is especially important when a patient with no history of psychosis presents later in life with hallucinations without other psychotic symptoms such as disorganization or delusions or other signs of a thought disorder, or when a patient presents with visual hallucinations without auditory hallucinations. Psychiatric consultation services can assist patients and their medical teams in arriving at the proper diagnosis.