Are depression, anxiety, and loneliness associated with visual hallucinations in younger adults with Charles Bonnet Syndrome?

Robin Walker, Caecilie Valla Broman, Sam Hopkins, Mark Gould, Juliet Holdstock

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Abstract

Background
Charles Bonnet Syndrome (CBS) refers to the presence of visual hallucinations experienced by people, without cognitive, or psychiatric deficits that are related to sight loss. This study surveyed younger adults (18-60 years) with visual impairments, to assess the impact of anxiety, depression, loneliness and the Covid-19 lockdowns on their visual hallucinations.
Objectives
To examine the association between depression, anxiety, loneliness, and the Covid-19 lockdowns, and visual hallucinations in younger adults with CBS.
Design
An on-line survey was used with an opportunistic sample of people with sight loss.
Methods
A survey assessed the frequency, duration and valence of visual hallucinations using a 5-point Likert scale, assessed anxiety, depression and loneliness using the Hospital Anxiety and Depression Scale and UCLA loneliness scale, respectively.
Results
29 young adults (21 female), aged 22-59 years with vision loss from a range of causes, who experience visual hallucinations, were included in the survey. The majority (76%) of participants had experienced hallucinations within the past week, with 83% stating they occurred frequently or very frequently. For 59% of participants the hallucinations were of short duration (<2 mins), but 34% experienced them continuously. Hallucinations were regarded as being unpleasant by 34% of participants, while 59% rated them as being neutral. The incidence of depression and anxiety were high in the sample (48% and 65% respectively) and 65% experienced loneliness. Participants with scores indicating anxiety or borderline anxiety had significantly more frequent hallucinations than other participants and a similar trend was found for depression. The Covid-19 lockdowns exacerbated hallucinations in 24% of cases, but for 68% they remained unchanged.
Conclusion
The study demonstrated that Charles Bonnet Syndrome is observed in people of all ages, with sight-loss arising from a wide range of underlying causes. Depression, anxiety and loneliness are observed in many cases of CBS. While there was some indication that high anxiety, and to some extent depression, was associated with frequent hallucinations, no other relationships were found between the psychosocial factors (depression, anxiety and loneliness) and the frequency, duration, or valence of their visual hallucinations.
Original languageEnglish
Number of pages11
JournalTherapeutic Advances in Ophthalmology
Volume16
Early online date7 Nov 2024
DOIs
Publication statusPublished - 2024

Keywords

  • Charles Bonnet Syndrome
  • Visual hallucinations
  • Younger adults
  • Depression
  • Anxiety
  • Loneliness

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