Musical Hallucinations, Depression and Old Age

Abstract

The association between musical hallucinations, depression and acquired hearing loss is described in two elderly patients. Following the presentation of this underdiagnosed clinical phenomenon we propose that musical hallucinations should be addressed as a final outcome of several factors including both mental and physical components. This conceptual framework enhances our understanding and treatment of such phenomena.

Musical Hallucinations and Hearing Deficit in a Young Non-Psychotic Female

“…A psychiatric diagnosis should not be considered before hearing de ficits had been ruled out. Indeed, it seems that mental states like depression or anxiety may aggravate the clinical picture [7,8] but as is the case with our patient, anxiety might be secondary to this unusual phenomena.…”

“…The patient was not aware of any hearing problems. Based on our past experience with patients presented with musical hallucinations [7,8], we called for a thorough auditory inquiry. Clinical exami nation revealed an old perforated ear-drum in the right ear, and audiometry and BERA demonstrated hearing damage compatible with phonal trauma.…”

“…These cases are characterized by the absence of prominent psychopathol ogy and by advanced age. Depression had been shown also to be associated with musi cal hallucinations in elderly patients with diminished hearing [7], We describe a young female presented to us with the sole com plaint of auditory perceptual disturbance of 'hearing music'.…”

Musical Hallucinations in Schizophrenia

“…Only a depressed state was relatively common among them, and they ruled out any association with specific mental disorders. In general, investigators have pointed to an association with deafness [5,6,[9][10][11] and similarities to Charles Bonnet syndrome [12][13][14][15], and the principal concepts proposed to explain it appear to have been based on the theory of sensory deprivation [9,11,[14][15][16] and the 'fragility of cerebral function' due to aging [14,15].…”

Musical hallucinations in psychiatric patients

“…In several case studies, musical hallucinations were associated with female gender, old age, progressive deafness, tinnitus, depression (Eizenberg et al, 1987;Wengel et al, 1989;Berrios, 1990Berrios, , 1991Keshavan et al, 1992;Pasquini et al, 1997;Fukunishi et al, 1998;Johns et al, 2002) and psychiatric illness (Eizenberg et al, 1987;Wengel et al, 1989;Keshavan et al, 1992;Pasquini et al, 1997;Saba et al, 1997).…”