A patient describes seeing something that isn't there. Before revealing the answer, decide what two questions would tell a pseudohallucination apart from a true hallucination.
Ask where the experience seems to be happening: does it feel like it's out here in the room, or more like it's inside their head? And ask whether they can tell, in the moment, that it isn't real. Location in inner subjective space, combined with retained insight, points to a pseudohallucination. A true hallucination is experienced as being out in the external world with the same perceptual conviction as ordinary perception, and insight into its unreality is not always present at the time.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 3, 'Disorders of Perception'.