Delusions and hallucinations are among the psychiatric symptoms of Huntington’s disease, occurring in an estimated 3-11 percent of patients. These symptoms are also collectively referred to as psychosis.

What are delusions and hallucinations?

Delusions

Delusions can be defined as false beliefs. No arguments or evidence can convince patients with delusions to change their minds. For example, affected individuals might believe that someone is living with them when they actually live alone.

Delusional beliefs that involve accusing others of something they haven’t done is known as paranoia. A person with paranoia thinks without good reason that other people are mean, unfair, and lying. For example, an individual might lose something and accuse someone else of stealing it.

According to psychiatrist and philosopher Karl Jaspers, delusions always fulfill three criteria:

  • Certainty: The patient is absolutely certain that the delusion is true.
  • Incorrigibility: The patient’s perception cannot be changed.
  • Impossibility: The perception cannot be true.

Hallucinations

A hallucination is a sensory perception that is not real. All senses can be affected, but seeing and hearing are the most commonly affected. For the person experiencing the hallucination, these things seem real, but they cannot be verified by anyone else. For example, the person might see a spider on the floor that is not really there.

A hallucination should not be confused with mistaking something for something else, for example, confusing a scarecrow for a real person. This occurs when an object is not seen clearly and can happen to anyone.

Delusions and hallucinations are not always frightening and negative. Patients might also sense unreal things that are pleasant.

Management of delusions and hallucinations 

Some environmental and behavioral adaptations can help manage delusions and hallucinations.

The person that tends to have delusions and hallucinations should live in a familiar and comfortable environment, and this should not be changed, for example, by rearranging furniture.

Family members and caregivers should try to keep routines and schedules consistent. Familiar habits such as listening to music, playing board games, and looking at photographs can help relieve distress.

Suspicious stories should not be ignored. If an individual thinks that something has been stolen, family members should help to look for it and investigate, even if this experience is not based on fact. Unusual things can indeed happen in real life. If the person persists in his or her version of the story even though it cannot be true, it can help distract the person. Getting angry and arguing should be avoided.

If adaptions in day-to-day life are not sufficient for the management of delusions and hallucinations, antipsychotic medications might be prescribed. Many Huntington’s disease patients may already receive antipsychotics for the treatment of other symptoms, such as chorea.

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