Delusions and visual hallucinations in dementia patients: focus on personal history of the patients.

Psychotic features are frequently seen in dementia patients, which indeed cast a huge psychological and physical burden onto their care givers. This is especially true for delusions and hallucinations. If inquired into in greater detail, some of the delusions and even hallucinations can be found to arise from plausible origins. In this article, the author reports two dementia patients, with an attempt to link the unique psychotic features to the personal history of the individual patient. In addition to biological predisposition, the background and the personal history of each patient may play a role in the development of such psychotic features. To emphasize the background of the patients and to treat him or her as a person is also the core spirit of medical humanity, which is an issue important for dementia care. The author also discusses the two topics: visual hallucination in patients with dementia with Lewy bodies and the genetic polymorphism of dopamine D2 receptor gene in dementia patients with delusions. If clinicians spend more time to understanding the history of their patients, at least some of the need to use medical treatment can be reduced.