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Cognition, hallucination severity and hallucination-specific insight in neurodegenerative disorders and eye disease

Lookup NU author(s): Daniel Collerton, Dr Urs Mosimann, Professor John-Paul TaylorORCiD, Dr Kat Da Silva MorganORCiD, Dr Prabitha Urwyler



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Hallucinations occur across neurodegenerative disorders, with increasing severity, poorer cognition and impaired hallucination-specific insight associated with worse outcomes and faster disease progression. It remains unclear how changes in cognition, temporal aspects of hallucinations, hallucination-specific insight and distress relate to each other. Methods: Extant samples of patients experiencing visual hallucinations were included in the analyses: Parkinson’s Disease (n = 103), Parkinson’s Disease Dementia (n = 41), Dementia with Lewy Bodies (n = 27) and Eye Disease (n = 113). We explored the relationship between factors of interest with Spearman’s correlations and random-effect linear models. Results: Spearman’s correlation analyses at the whole-group level showed that higher hallucination-specific insight was related to higher MMSE score (r s = 0.39, p < 0.001) and less severe hallucinations (r s = −0.28, p <.01). Linear mixed-models controlling for diagnostic group showed that insight was related to higher MMSE (p <.001), to hallucination severity (p = 0.003), and to VH duration (p = 0.04). Interestingly, insight was linked to the distress component but not the frequency component of severity. No significant relationship was found between MMSE and hallucination severity in these analyses. Conclusion: Our findings highlight the importance of hallucination-specific insight, distress and duration across groups. A better understanding of the role these factors play in VH may help with the development of future therapeutic interventions trans-diagnostically.

Publication metadata

Author(s): Montagnese M, Vignando M, Collerton D, ffytche D, Mosimann UP, Taylor J-P, daSilva Morgan K, Urwyler P

Publication type: Article

Publication status: Published

Journal: Cognitive Neuropsychiatry

Year: 2021

Volume: 27

Issue: 2-3

Pages: 105-121

Online publication date: 02/08/2021

Acceptance date: 22/07/2021

Date deposited: 25/08/2023

ISSN (print): 1354-6805

ISSN (electronic): 1464-0619

Publisher: Routledge


DOI: 10.1080/13546805.2021.1960812


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Funder referenceFunder name
NIHR Newcastle Biomedical Research Centre