Clinical characteristics of disclosed visual hallucinations in users of an Early Intervention in Psychosis Service

Visual hallucinations (VH) are ill-understood phenomena, and can be distressing and disabling to people with psychosis. Current models of VH emphasise that the appraisal of the VH helps explain the distress associated with the experiences. However, we were also interested in the content of what people saw in order to determine if distressing content and perceived control may help us understand the distress reported. We report the prevalence and phenomenology of VH in a large number (176) of people experiencing their first episode of psychosis. Care coordinators working with service users in an early intervention in psychosis service were asked about the experiences reported, using a semi structured interview. The findings indicate that around one third of service users at some point report visual hallucinations but only around 11% continue to report distressing visual hallucinations. Most report seeing a human-like figure, some with a particularly unpleasant content and many report having little perceived control over the experiences. For some, then, understanding and addressing the content of the experience, and perceived control, may be important if we are to help people better manage these upsetting experiences.