An Episode of “Third Person” Phenomenon Involving Somesthetic and Visual Hallucinations in a World-Class Extreme Altitude Climber
Eduardo Garrido, Katharina Hüfner
Wilderness and Environmental Medicine August 22, 2023 DOI: 10.1016/j.wem.2023.07.004 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A highly experienced male climber during an extreme-altitude expedition on Gasherbrum I |
| Duration | Symptoms lasted approximately 3 hours; resolved on reaching high camp at 7150 m |
| Citations | 3 |
| Key findings | An experienced climber developed an isolated psychotic episode at approximately 7500 m, consisting of a 'third person' phenomenon with a felt presence and visual hallucinations of two flashlight lights, lasting about 3 hours and resolving completely at 7150 m. The authors propose that hypoxia plus factors such as sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, isolation, and perceived danger may have contributed. |
Abstract
Psychotic symptoms can occur at high altitude. However, most reports are in the mountaineering literature and lack a clear medical assessment and interpretation. Here we report an episode of isolated high-altitude psychosis. It consisted of a "third person" phenomenon involving 2 sensory modalities: somesthetic (felt presence) and visual (the light of 2 flashlights) hallucinations. This episode occurred in a highly experienced climber when he was at an altitude of approximately 7500 m while descending at dusk from the summit of Gasherbrum I (8068 m). The symptoms lasted approximately 3 h and had fully resolved on reaching high camp (7150 m). No other physical or mental symptoms were reported. In addition to hypoxia, a number of other risk factors could have contributed to the occurrence of psychosis in this climber. These included sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, feeling of isolation, and perceived danger. The climber has participated in many extreme altitude expeditions, and neither before nor since this episode has the climber experienced psychotic symptoms.