Auditory Charles Bonnet syndrome and psychosis: Is there a relation? – A case report

Background

Auditory hallucinations are relatively frequent in schizophrenia. Musical hallucinations are a specific hallucination type often observed in patients with hearing impairment and also known as auditory Charles Bonnet syndrome. Here, we present the case of a patient whose clinical course illustrates the often forgotten and overlooked association between hearing loss and psychotic symptoms.

Case presentation

This case report describes a 37-year-old woman without a previous psychiatric history who presented with delusional beliefs and auditory hallucinations on hospital admission. Despite partial remission of some psychotic symptoms with antipsychotic medication, her auditory hallucinations remained constant and disturbing. Unexpectedly, after several years of treatment, the patient developed musical hallucinations. Further investigations revealed bilateral hearing loss due to otosclerosis, thus suggesting a possible link between her hearing impairment and the hallucinations. Surgical intervention was performed to treat otosclerosis and led to complete remission of hallucinatory phenomena.

Conclusions

The purpose of this case report is to increase awareness of hearing impairment as a potentially reversible contributor to, or comorbidity with, psychosis. Prompt diagnosis and early intervention can have transformative effects on patients' mental health, functioning, and quality of life.