Charles Bonnet Syndrome with Major Depression in a Chinese Middle-Aged Man

Objective: To describe a middle-aged patient with Charles Bonnet syndrome (CBS) suffering from concurrent major depression. Clinical picture: A 41-year-old Chinese man with retinitis pigmentosa developed complex and vivid visual hallucinations. This was followed by the onset of major depressive illness. His visual hallucinations were greatly influenced by his cultural background and changed during the course of his depression. Treatment: The patient was treated with imipramine. Outcome: The patient had a relapse of depression due to his non-compliance. He recovered after the resumption of imipramine but the visual hallucinations persisted. Conclusions: Patients suffering from CBS can have another concurrent psychiatric illness. The content and form of this patient's visual hallucinations were modified by his cultural background and depressive illness. Sensory deprivation is suggested to be the pathogenic mechanism of his visual hallucination.