The Charles Bonnet syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically normal people. The syndrome occurs predominantly in the visually handicapped elderly. Little is known about its etiology and pathogenesis. The aim of this study was to examine the associations of CBS with psychological and social determinants. All subjects were patients older than 64 years from a low-vision unit. Using a case-control approach, 50 patients with CBS and 80 patients without visual hallucinations were interviewed about their educational level, social circumstances, number of social contacts, and ability to cope with visual handicap. Loneliness was measured with the De Jong-Gierveld-Kamphuis loneliness scale, and personality traits were examined with the Dutch-language short version of the Minnesota Multiphasic Personality Inventory ([MMPI] Nederlandse Verkorte MMPI [NVM]). Compared with the control group, significantly more CBS patients were lonely. Mean scores on the NVM shyness scale and extraversion scale were significantly higher and lower, respectively, in CBS patients. In multiple logistic regression analysis for the three determinants simultaneously, loneliness and low extraversion were significant predictors for CBS, but shyness was not. It is concluded that loneliness, low extraversion, and shyness are risk indicators for CBS in elderly visually handicapped people. The findings suggest that CBS is associated with a low quality of social contacts.