Musical obsessions or hallucinations?

Abstract

Back to table of contents Previous article Next article LetterFull AccessMusical Obsessions or Hallucinations?Takeshi Terao, M.D., Ph.D., , and Naomi Ikemura, M.D., Takeshi TeraoSearch for more papers by this author, M.D., Ph.D., Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK, and Naomi IkemuraSearch for more papers by this author, M.D., Institute of Psychiatry, University of London, Maudsley Hospital, London, UKPublished Online:1 Nov 2000AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail SIR: We read with interest the article by Zungu-Dirwaryi et al.,1 in which they reported two cases of musical “obsessions,” but we wonder about their diagnoses.First, the essential feature of obsession is that it appears against the patient's will.2 However, their patient of Case 1 was asked to bring her musical tunes to mind, as if to mimic the state in which she usually had these “obsessions,” when the SPECT of the brain was performed. If the patient could hear musical tunes, this is contrary to the feature of obsessions. Conversely, if she could not hear music, the findings revealed by the SPECT study might not have been directly related to her musical tunes. On the other hand, there are some reports3,4 of musical hallucinations where the patients were able consciously to alter the tune or its speed or volume.Second, Zungu-Dirwaryi et al.1 diagnosed their patients' musical tunes as musical “obsessions” because the source of musical hallucinations is presumably often experienced as outside the head, whereas in their patients the music was experienced as an internally generated cognitive product. However, there is an opinion that pseudo-hallucinations are not located in objective space but in subjective space.2Finally, both of their patients did not suffer from any other compulsions or obsessions.Thus, we believe that musical hallucinations (strictly speaking, musical pseudo-hallucinations) rather than musical obsessions seem to be appropriate diagnoses for their patients' musical tunes. Even if their diagnoses are changed from musical obsessions to musical (pseudo-)hallucinations, the SPECT findings are still important because thereby they suggest the functional relationship between musical hallucinations and temporal lobe abnormalities, which we5 have also indicated by using a finding of electroencephalography.References1 Zungu-Dirwayi N, Hugo F, van Heerden B, et al: Are musical obsessions a temporal lobe phenomenon? J Neuropsychiatry Clin Neurosci 1999; 11:398–400Google Scholar2 Hamilton M (ed): Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry. Bristol, UK, John Wright and Sons, 1985Google Scholar3 Hammeke TA, McQuillen MP, Cohen BA: Musical hallucinations associated with acquired deafness. J Neurol Neurosurg Psychiatry 1983; 46:570–572Crossref, Medline, Google Scholar4 Miller TC, Crosby TW: Musical hallucinations in deaf elderly patients. Ann Neurol 1979; 5:301–302Crossref, Medline, Google Scholar5 Terao T, Tani Y: Carbamazepine treatment in a case of musical hallucinations with temporal lobe abnormalities. Aust NZ J Psychiatry 1998; 32:454–456Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByInducing involuntary musical imagery: An experimental study18 May 2012 | Musicae Scientiae, Vol. 16, No. 2Musical activities predispose to involuntary musical imagery27 June 2011 | Psychology of Music, Vol. 40, No. 2CNS Spectrums, Vol. 13, No. 2 Volume 12Issue 4 November 2000Pages 518-519 Metrics History Published online 1 November 2000 Published in print 1 November 2000