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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0801

Non-auditory hallucinatory phenomena in a severe depressive episode: a psychopathological report

NON-AUDITORY HALLUCINATORY PHENOMENA IN SEVERE DEPRESSIVE EPISODE: A PSYCHOPATHOLOGICAL REPORT

Bizarre zoomorphic visual hallucinations occurring in clear consciousness without accompanying systematized delusions may represent an atypical psychopathological expression of severe depressive states.

The aim is to describe atypical hallucinatory phenomena arising during a severe depressive episode, particularly non-auditory perceptual disturbances, from a psychopathological perspective. The report presents the case of a 53-year-old man with recurrent depressive disorder who was hospitalized for a severe episode with suicidal ideation. A longitudinal, phenomenologically oriented assessment was conducted throughout inpatient treatment, focusing on the level of consciousness, the presence of formal thought disorder, the content and modality of hallucinations, and their course in relation to the severity of mood symptoms. During the acute phase (June 2025), bizarre zoomorphic visual hallucinations, such as horned horses and distorted dogs, were identified; consciousness was clear, with no formal thought disorder or persistent delusional systematization. During the same period, severe depression characterized by psychomotor retardation, anhedonia, and hopelessness was reported, along with a recurrent overvalued idea concerning genital inadequacy, a passive wish to die, a risk of self-harm, and severe functional impairment. Treatment consisted of lithium, fluoxetine, quetiapine, and 12 sessions of electroconvulsive therapy (ECT). The October 2025 assessment revealed a progressive reduction in hallucinations, marked improvement in mood and energy, reduced somatic preoccupation, no suicidal ideation at discharge, and recovery of self-care and functioning. The authors suggest that bizarre non-auditory content occurring in clear consciousness without accompanying systematized delusions may represent an atypical psychopathological expression of severe depressive states, and consider the idea of genital shrinkage to be secondary to depression rather than primary Koro. They note that no conclusions regarding prevalence or mechanisms can be drawn from a single case and emphasize the importance of a detailed phenomenological assessment of non-auditory domains of perception.

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