They may occur in schizophrenia and severe depressive disorders, but they may suggest temporal lobe epilepsy or irritation of the olfactory bulb or pathways by tumor, so their presence indicate medical investigation. Hallucinations of taste and smell are infrequent.Examples like sensation of being touched, sensation of insects moving under the skin occurs in cocaine abuse and occasionally in schizophrenia. Tactile hallucinations or haptic hallucinations generally are of little diagnostic significance.NOTE: isolated visual hallucinations should always raise the possibility of an organic cause (medical disorder or drug abuse) and investigations should be done. Visual hallucinations are seen in dissociation and conversion disorder, severe affective disorder, organic mental conditions, substance abuse and schizophrenia, but the contents of the visual hallucination are of little diagnostic significance. Visual hallucinations are experienced as located outside the field of vision (eg, behind the head) or involve experience beyond the sensory range (eg, being able to look out the window and see someone in distant city). Visual hallucinations may be elementary or complex.NOTE: Auditory hallucinations are one of the diagnostic criteria of schizophrenia and other psychotic disorders. Hallucination may be inferred when the patient appears to be talking in response to voice and may whisper, mutter to himself incomprehensively, or talk normally or shout out loudly as occurring in schizophrenics. May be noises or voices, it can be heard clearly or indistinctly, they may seem to speak words or phrases or sentences. Auditory hallucinations is the most common type of hallucinations in psychiatric disorders.A few normal people experience them, especially when tired, also occur in healthy people during transition between sleep and waking they are called hypnagogic while falling asleep or hypnapompic while awaking. Hallucinations are not restricted to the mentally ill. For example, in a dark, a frightened person is more likely to perceive the outline of a bush as that of an attacker. Illusions may occur more often when attention is not focused on the sensory modality, or when ther is strong affective state. Nihilism (Patient believe that the self world and even time has been lost or destroyed).Delusion of love (Belive that he has a special romantic relationship with a public famous figure).Somatic delusions (Feelings that the body has been manipulated by outside forces).Grandiose delusions (The patient’s feelings of having special power and knowledge or special relationships with important figures).Delusions of reference (Believe that some events in the environment have special meaning to, and directed at the patient).Delusions of persecution (Believe that others are trying to harm).Delusions of influence (Believe that their thought and actions are controlled by outside force).So A is delusions, B is illusions, C is illusion also, and D is hallucinations.
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