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Prevalence Rate of Musical Hallucinations in a General Hospital Setting

Key Words: Letter • Hallucinations • Auditory Hallucinations • General Hospital • Letter • Music

TO THE EDITOR: Musical hallucinations such as the hearing of melodies only seldom manifest.^1,2 Musical hallucinations stem from various diseases (e.g., psychiatric disorders,^1–3), neurological diseases⁴ such as degenerative brain disease, and side effects of drugs⁵ and have been regarded as lacking disease specificity. Berrios^1,2 reported that musical hallucinations are likely to manifest in persons with deafness, the elderly, and females. However, there has been only a small number of reports on musical hallucinations in the general hospital.^1–5 The total number of reported cases with musical hallucinations has not reached more than 200 or so, and there has been no report on the prevalence rate of musical hallucinations in a large clinical sample.

In this study, the prevalence rate of musical hallucinations was examined in a general hospital setting. The subjects were 3,678 patients who were admitted during 1995 to 1996 at the Department of Psychiatry of 2 general hospitals. They consisted of 1,821 males and 1,857 females with a mean±standard deviation (SD) age of 42.4±16.1 years (range: 9–89). According to DSM-IV,⁶ a psychiatric diagnosis was assessed. The disorders usually first diagnosed in infancy, childhood, or adolescence (n=109) were delirium, dementia, and amnestic and other cognitive disorders (n=613); mental disorders due to a general medical condition (n=146); substance-related disorders (n=166); schizophrenia and other psychotic disorders (n=308); mood disorders (n=757); anxiety disorders (n=898); somatoform disorders (n=187); dissociative disorders (n=41), eating disorders (n=141); sleep disorders (n=172); adjustment disorders (n=66); personality disorders (n=22); and others (n=52).

The prevalence rate of musical hallucinations was 0.16% (6 of 3,678 cases). Five of the six were female, and three of the six were elderly. Three of the six used a hearing aid because of deafness.

Recent reports have indicated that the prevalence rate of musical hallucinations seems to be extremely low.^1,2 As expected, this study found a low prevalence rate of musical hallucinations of 0.16% in a large sample in the general hospital setting. Although the number of patients in this study with musical hallucinations was small, the clinical factors associated with these patients were as follows: elderly (3 cases), female (5 cases), and deafness (3 cases). These factors are consistent with those seen in prior studies.^1,2 All 6 cases had other psychiatric symptoms besides the musical hallucinations. The 6 patients with other psychiatric symptoms could be divided into two types: 1) musical hallucinations appearing alternately as other psychiatric symptoms improved (3 cases), and 2) musical hallucinations appearing together with other psychiatric symptoms (3 cases). Although we are unable to draw a conclusion based on the clinical features seen in patients with musical hallucinations, the findings may be useful as a basis for larger studies on this issue.

REFERENCES

1. Berrios GE: Musical hallucinations: a historical and clinical study. Br J Psychiatry 1990; 156:188–194[Abstract/Free Full Text]
2. Berrios GE: Musical hallucinations: a statistical analysis of 46 cases. Psychopathology 1991; 24:356–360[Medline]
3. Aizenberg D, Schwartz B, Modai I: Musical hallucinations, acquired deafness and depression. J Nerv Ment Dis 1986; 174:309–311[Medline]
4. Penfield W, Perot P: The brain's record of auditory and visual experience—a final summary and discussion. Brain 1986; 86:595–596
5. Terao T: Tricyclic-induced musical hallucinations and states of relative sensory deprivation. Biol Psychiatry 1995; 38:192–193[Medline]
6. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994

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