0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter   |    
Musical Obsessions or Hallucinations?
Takeshi Terao, M.D., Ph.D.; Naomi Ikemura, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2000;12:518-519. doi:10.1176/appi.neuropsych.12.4.518
View Author and Article Information

ObsessionsTemporal LobeHallucinations

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.2

Finally, 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.

Zungu-Dirwayi N, Hugo F, van Heerden B, et al: Are musical obsessions a temporal lobe phenomenon? J Neuropsychiatry Clin Neurosci  1999; 11:398—400
 
Hamilton M (ed): Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry. Bristol, UK, John Wright and Sons, 1985
 
Hammeke TA, McQuillen MP, Cohen BA: Musical hallucinations associated with acquired deafness. J Neurol Neurosurg Psychiatry  1983; 46:570—572
[CrossRef] | [PubMed]
 
Miller TC, Crosby TW: Musical hallucinations in deaf elderly patients. Ann Neurol  1979; 5:301—302
[CrossRef] | [PubMed]
 
Terao T, Tani Y: Carbamazepine treatment in a case of musical hallucinations with temporal lobe abnormalities. Aust NZ J Psychiatry  1998; 32:454—456
[CrossRef]
 
+

References

Zungu-Dirwayi N, Hugo F, van Heerden B, et al: Are musical obsessions a temporal lobe phenomenon? J Neuropsychiatry Clin Neurosci  1999; 11:398—400
 
Hamilton M (ed): Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry. Bristol, UK, John Wright and Sons, 1985
 
Hammeke TA, McQuillen MP, Cohen BA: Musical hallucinations associated with acquired deafness. J Neurol Neurosurg Psychiatry  1983; 46:570—572
[CrossRef] | [PubMed]
 
Miller TC, Crosby TW: Musical hallucinations in deaf elderly patients. Ann Neurol  1979; 5:301—302
[CrossRef] | [PubMed]
 
Terao T, Tani Y: Carbamazepine treatment in a case of musical hallucinations with temporal lobe abnormalities. Aust NZ J Psychiatry  1998; 32:454—456
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 4

Related Content
Books
Textbook of Psychotherapeutic Treatments > Chapter 6.  >
DSM-5™ Clinical Cases > Chapter 4.  >
APA Practice Guidelines > Chapter 12.  >
APA Practice Guidelines > Chapter 12.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
PubMed Articles