An overview of psychological and social factors in Charles Bonnet syndrome

Abstract

Charles Bonnet syndrome (CBS) is a condition where cognitively normal individuals with sight impairment experience simple and/or complex visual hallucinations. The exact pathogenesis of CBS is unknown; however, deafferentation is often recognised as a causal mechanism. Studies have provided insight into the multifaceted impact of CBS on wellbeing. Onset of CBS may cause distress among those believing visual hallucinations are indicative of a neurological condition. Hallucinatory content is often congruent with the emotional response. For example, hallucinations of a macabre nature typically result in a fearful response. Visual hallucinations may be highly disruptive, causing everyday tasks to become challenging. Clinical management relies on forewarning and pre-emptive questioning. Yet, knowledge and awareness of CBS is typically low. In this review, we provide a summary of the social and psychological implications of CBS and explore recent developments aimed at raising awareness and improving patient management.

Charles Bonnet Syndrome With Superimposed Delirium

“…This is likely because of the inconsistency of the diagnostic criteria of CBS. What constitutes a VH is not well-defined and may be caused by many conditions, as described above [3,7]. CBS symptoms include VH that can be simple or complex [3,7,8].…”

“…What constitutes a VH is not well-defined and may be caused by many conditions, as described above [3,7]. CBS symptoms include VH that can be simple or complex [3,7,8]. Examples of simple images include lines, light flashes, and geometric shapes.…”

“…Examples of simple images include lines, light flashes, and geometric shapes. Examples of complex images include people, animals, or scenes [3,7]. The hallucinations can be distressing in a significant number of patients with CBS [8].…”

“…The duration of CBS also varies, with patients reporting experiencing hallucinations for a year to five years or more [8]. Studies suggest that social isolation, poor quality relationships, and loneliness are associated with CBS [7].…”

“…The Sydney Health Partners Emergency Department (SHaPED) trial has shown that educating at-risk patients and encouraging patients to report symptoms before they manifest resulted in better outcomes. The trial also provides a framework for how to best treat patients; it includes psychoeducation, career support, and CBT therapy [7,10]. Evidence suggests supportive care is often the most effective treatment for CBS.…”