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Musical Schizophrenia

Musical Schizophrenia

Interestingly enough, this discussion about the phenomenon of musical schizophrenia starts with obsessive-compulsive disorder and it’s symptoms.  Obsessive-compulsive disorder is often comorbid with a schizophrenia diagnosis and when this occurs the symptoms present tend to modify the experience of the schizophrenic drastically.  The unique mixture of schizophrenia symptoms in the form of acute psychosis combine with the obsessive features of OCD to produce very peculiar effects, and in this case we are most interested in the strangeness of musical auditory hallucinations.

It is not unusual for someone dealing with the effects of schizophrenia to experience auditory hallucinations.  They are rather fragmented and oftentimes nonsensical, or in the case of a person dealing with paranoid schizophrenia they could take the form of a running commentary of the morality of action or can be a constant suggestion towards some negative impulse.  It is the obsession and impulse, however, that can cause the person to focus upon the hallucination and feed it enough energy for it to take form.  In many cases it can take the form of music, melody, harmony, and rhythm.  This is what we are describing as musical schizophrenia.

How Common is Musical Schizophrenia?

In a paper published in the CNS Spectrums Neuroscience Journal, doctors Bleich-Cohen and Hendler probed the relative frequency of musical schizophrenia among those with the double diagnosis of schizophrenia and obsessive-compulsive disorder.  Taking a large sample population of these peoples with the dual diagnosis and applying more filtering parameters, they kept the portion among those who’s positive symptoms of schizophrenia, such as delusions and hallucinations, were significantly impacted by the presence of obsessive symptoms.

They took care to describe this interaction as “psychotic in content and obsessive in form.”  The portion remaining who exhibited this phenomenon was close to ten percent of the patients.

A Description of the Musical Schizophrenia Experience

Among the common auditory hallucinations, there is a subset recognized as musical hallucinations that are as described by the label.  They feature qualities that people would interpret as musical.  While it is not ultimately clear what is causing this specific type of hallucination, there are correlations with the advancement of a person’s age in years, an impairment in hearing such as tinnitus or volume dampening, and certain neurological disorders such as the damage caused by a stroke, seizure, or neoplasm.

It is said that about one-fifth, or 20%, of all patients with schizophrenia or OCD experience musical hallucinations.  This is a very large portion of people that demands and justifies much investigation into this phenomenon.

Musical schizophrenia essentially refers to hallucinations that are heard that are largely comprised of musical content that occur without any external stimuli.  In fact, silence may bring on the symptoms as the brain generates its own stimuli in the absence of any other.

Side Note on Musical Schizophrenia and Obsessive-Compulsive Disorder

The presence of this music could be soothing in nature, but it is the inability to control it that becomes distressing to the experiencer.  OCD symptoms are obsessive, meaning that the person dealing with them tends to focus on them with quite some energy.  This expenditure is usually targeted towards attempting to cease the obsession.  The expenditure of energy is the compulsion, an attempt to force the negative experience away, which is only formed out of the obsessive efforts surrounding the experience.  This is the unfortunate cycle of obsession, compulsion, and the invasive nature of hallucinations.

The Unique Factor of the Musical Hallucinations

Many hallucinations are obviously originating inside the mind of the schizophrenic, but the hallucinations involved with this musical illness take on a very confusing sense of being based in reality somewhere external to the person’s mind.  It is truly as if a sensory input is being interpreted by the person’s ears.  By being this indistinguishable from real music, tones, and patterns emerging from the environment, these hallucinations can greatly impair the experiencer.

The comorbidity of OCD is very important here, as the arising of the music is correlated with the activation of certain brain regions, namely the right orbito-frontal cortex and striatum, that are implicated and associated with the pathology of OCD.


It is simple to summarize.  For those dealing with both schizophrenia and OCD, musical schizophrenia is not remotely a rare experience.  But the information available and the research performed is lacking.  To turn some of our focus towards this troubling constellation of symptoms would prove to be quite auspicious in the reduction of suffering for many people.

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