Altered States on ICU

Chronicling the visual hallucinations described by patients

The pictures displayed were collected during the Cardiff Delirium Study, they give a unique insight into the patients’ subjective experience on the intensive care unit (ICU).

Delirium is a common condition effecting about 20% of all hospital patients. Symptoms fluctuate and include poor attention, disorientation and in severe cases visual hallucinations and paranoia.

These symptoms can be very distressing and the patient cannot go home until they have resolved. The cause of delirium is poorly understood but is more common in the elderly and severely ill. There are no blood-tests or medicines designed for the treatment of delirium and the government (NICE) has identified that research is urgently needed.

The aim of this study was to investigate the relationship between the biological and psychological changes that occur in patients on intensive care after heart surgery.
Patients who agreed to take part in the study described their visual hallucinations to Jan Sharp the Medical Artist. Photo-montage was chosen in an attempt to accurately represent the hallucinations and enable viewers to experience what they saw.

Layers of photographs were distorted, overpainted and combined using Adobe Photoshop and digital airbrushing techniques to create these strange and bizarre, dream-like scenes.

You will notice that many of the hallucinations existed against the background of the ICU but this was not true of all the images collected.

Many were fantastical hallucinations not related to the ICU, others were simple colours and shapes. Out-of-body and a near-death experience were also captured.
We are very grateful to the patients who agreed to help with the study during this very challenging time and for the support of the clinical staff who made the study possible.
Dr Martyn Stones is a Psychiatry trainee and PhD student.
Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University.

StonesML@cardiff.ac.uk
Jan Sharp is the Senior Medical Artist
Department of Medical Illustration, University Hospital of Wales, Cardiff.

Janice.sharp@wales.nhs.uk