Multimodal Hallucinations in Psychotic Disorders

Multimodal hallucinations—perceptual experiences that occur across two or more sensory channels—are increasingly recognised as a core feature of psychotic disorders. These experiences can arise simultaneously or in sequence, involving combinations such as auditory–visual, tactile–auditory or more complex sensory blends. Their presence is associated with greater illness severity, elevated distress and higher risk of adverse outcomes, including functional impairment and suicidality. Neurobiological research points towards disruptions in multisensory integration networks, altered connectivity in sensory association cortices and dysregulated top-down modulation from regions implicated in self-monitoring. Developmental factors, including early brain-growth anomalies and childhood trauma, appear to shape individual vulnerability to multimodal phenomena. Clinically, accurate identification and assessment of multimodal hallucinations support more tailored interventions, including targeted cognitive-behavioural strategies and neuromodulatory approaches that address the integration of sensory inputs rather than single-modality symptoms alone.

Research from Nature Portfolio

A comparative investigation of hallucinatory profiles across two neurological populations revealed that individuals with schizophrenia display a higher frequency of combined auditory and visual hallucinations than those with Parkinson’s disease. Auditory, olfactory and coenesthetic hallucinations were notably more common in schizophrenia, and the co-occurrence of modalities carried a greater negative impact on conviction and control. This work underscores the importance of broad-spectrum assessment scales and interdisciplinary methods in capturing the complexity of concurrent hallucinations and tailoring clinical responses.

Multimodal Hallucinations in Psychotic Disorders publication trend

The graph below shows the total number of articles in multimodal hallucinations in psychotic disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Hallucination: A perception-like experience that occurs without an external stimulus and is perceived as real.

Multimodal hallucination: A hallucinatory event involving two or more sensory modalities, either concurrently or in close succession.

Unimodal hallucination: A hallucinatory experience confined to a single sensory modality, such as auditory alone.

First-episode psychosis: The initial presentation of psychotic symptoms warranting clinical intervention.

Multisensory integration: The neural and cognitive process by which information from different sensory channels is combined to form a coherent percept.

References

1. Hallucinations in schizophrenia and Parkinson’s disease: an analysis of sensory modalities involved and the repercussion on patients. Scientific Reports (2016).
2. Prevalence of multisensory hallucinations in people at risk of transition to psychosis. Psychiatry Research (2023).
3. Prevalence and nature of multi-sensory and multi-modal hallucinations in people with first episode psychosis. Psychiatry Research (2022).
4. A Review of Multimodal Hallucinations: Categorization, Assessment, Theoretical Perspectives, and Clinical Recommendations. Schizophrenia Bulletin (2020).
5. Association between childhood trauma and multimodal early-onset hallucinations. The British Journal of Psychiatry (2020).